Free Clinic

Het hele weekend heb ik gewerkt en het was best rustig. Dat is eens een verademing. Het kan zo verschillend zijn.

Deze week gaat in Ithaca een gratis kliniek open voor mensen die geen gezondheidszorg verzekering hebben. Een paar van mijn collega's hebben meegewerkt aan de opzet van dit project, iets waar ik pas kort van hoorde. Hier is het hele artikel in de krant van gisteren; http://www.theithacajournal.com/apps/pbcs.dll/article?AID=/20060121/NEWS01/601210323/1002


ITHACA — The 10,000-plus people living in Tompkins County with no access to health insurance will soon have an outlet to connect them with doctors, nurses and medicines — all free of charge.
Opening on Monday, the Ithaca Free Clinic will offer health care screenings and referrals to any uninsured person who walks through the doors.

“There are a lot of smart people in Ithaca who have known for years that we've needed a free clinic,” said Scott Marsland, co-chairman of the Ithaca Free Clinic steering committee. “This is really a watershed moment.” The free clinic is a program of the Ithaca Health Alliance, a grassroots, cooperative health care plan started in 1997. The alliance fronted $45,000 of its own equity for startup costs, according to Marsland.
Following the model of similar initiatives in other municipalities, including Watkins Glen and Schenectady, Ithaca's clinic will be open two days a week to anyone without health insurance. Medicaid patients will not be eligible for services at the clinic.
Supported by volunteersWith a total annual projected budget of about $31,700, the Ithaca Free Clinic's backbone is its long list of local volunteers, including 30 doctors, 25 nurses, five nurse practitioners and two physician's assistants. About 30 clerical volunteers also have signed on, as well as nearly 20 complementary alternative medicine providers: Four chiropractors, two acupuncturists, 10 licensed massage therapists and three herbalists.
“Everyone is so passionate about the clinic,” said Clinical Coordinator Marie Constant. “I find it unique to Ithaca.”
On a voluntary basis, doctors will offer screenings and other services, including free referrals for clinic patients, Constant and Marsland explained.
In some cases, doctors can extend the benefits of their individual medical malpractice insurance to help defray those substantial costs to the clinic, Marsland said.
The volunteer services of CAM providers — herbalists, acupuncturists and massage therapists among them — will be free and open to anyone, not just those who are uninsured.
“Most insurance doesn't cover that stuff,” Marsland said.
Keeping in mind that the uninsured often have multiple financial problems, Constant also said clinic staff will be trained to connect patients with other services around the county, such as housing or mental health services.
Data shows needBeyond what observers see as overwhelming anecdotal evidence, the need in the community for a free health care clinic is evidenced by the 2003 Compass II study conducted jointly by the United Way and the Tompkins County Human Services Coalition.
Access to affordable health care was among the many collective needs identified through Compass II. In that survey, 67 percent of respondents rated a lack of affordable specialty care as a critical problem, and 65 percent cited a lack of affordable primary care as a critical problem.
Of those households surveyed in the lowest income brackets, the need was especially stark. Forty-five percent of respondents with household incomes of less than $15,000 reported problems paying doctor or prescription bills. Twenty-seven percent with household incomes of between $15,000 and $24,999 cited similar problems affording health care, the Compass II study revealed.
Overall, 10.69 percent of Tompkins County's 100,000 residents have no health insurance at all, according to Health Planning Council of Tompkins County Director Betty Falcao. That compares with the state average of 15.5 percent, she said.
Daunting challengesDespite the need for a free health clinic in Tompkins County, the task of creating one is daunting, for financial and legal reasons, officials said.
To claim stake on any kind of long-term future for the clinic, the group has set a fundraising goal of $30,000 through the end of 2007, according to a clinic budget prepared in September 2005.
Marsland likened the effort to a small group of people moving “a really big boulder.”
Despite the financial obstacles, many in the community have stepped forward as key partners, in addition to the doctors and nurses volunteering their services. Bangs Ambulance donated a defibrillator — a $2,000 piece of equipment. Northeast Pediatrics has supplied about $6,000 worth of office equipment, Marsland said. Countless others have stepped in with supplies or financial donations.
Seeking Article 28 statusOn the legislative side, the free clinic is hoping for some good news early this year, too. The group is in the process of applying for what's called Article 28 status, granted under New York State Public Health Law regulations for the operation of free-standing clinics.
But instead of going about getting Article 28 status the traditional way, the Ithaca clinic is applying for special exemptions through Public Health Law 260, a piece of legislation from 2003 set up originally through the efforts of the Schenectady Free Health Clinic, which was a pioneer in volunteer health clinics in New York state.
The Schenectady clinic's executive director, Bill Spolyar, explained that Public Health Law 260 set up a category of volunteer clinics that would free them up from some of the heavy regulations placed on free-standing clinics and hospitals, from levels of air quality to restrictions on writing prescriptions from the clinic.
Sen. George Winner, R-53rd Dist., said he was interested in either helping the Ithaca Free Clinic obtain those exemptions or drafting separate legislation to help the group.
“If this is a need identified by folks in Tompkins County and it can be accomplished without major disruption to the health care community, then it certainly sounds like something we ought to actively be looking at,” Winner said.
Spolyar said Public Health Law 260 is scheduled to sunset — or expire — in December 2006, and he and others are working to get a follow-up bill passed to make the category for such clinics permanent.
“It's important that we get the legislation passed before it sunsets,” Spolyar said. “It won't affect us because it won't affect existing entities. If Ithaca were to get approval before Dec. 31 it wouldn't affect them either.”
Funding possibilityIn a separate effort, the Schenectady clinic is hoping to get a bill passed to allow funding from the state Health Department for 10 more volunteer clinics around the state, with Ithaca's included as a possible site, Spolyar said. For those clinics, they're asking for funding of $100,000 over three years, the level of funding the Schenectady site currently receives.
Ithaca, Oneonta and five or more other sites have been identified as eligible for this funding, Spolyar said.
In the meantime, the Ithaca Free Clinic will be concentrating on its mission of providing direct service care to the neediest in Tompkins County, with or without the health law exemptions. The clinic will be open from 2-6 p.m. Mondays and 4-8 p.m. Thursdays starting this Monday. The office is located at 225 S. Fulton St., above and behind Radio Shack.
Workshop series plannedOn Jan. 31, the clinic will host its first of many wellness workshops. The 7 p.m. event is entitled “Naturopathic Medicine: A Whole Body Approach to Health.” Deanna Hope Berman, a state-certified midwife and Washington state licensed naturopathic medicine doctor, will give the presentation.
Finally, the clinic is kicking off the year with aggressive fundraising efforts. Its first large-scale event will take place on March 25 at Olivia, in the form of a $100-per-head dinner.


In deze county zijn er ongeveer 10% van de mensen onverzekerd, het landelijke gemiddelde ligt op 15%. Het is wel een goed initiatief om zo'n kliniek te starten, en ik ben benieuwd hoe het zal gaan. Ze werken helemaal met vrijwilligers, maar eer ik daarvoor teken kijk ik eerst eens de kat uit de boom.
Voor de mensen die geen verzekering hebben zal die kliniek zeker een uitkomst zijn, maar het is een pleister op een hevig bloedende wond. Het hele systeem van zorgverzekeringen is scheef en moet veranderd worden. Om iets te noemen; een verzekeringsmaatschappij onderhandeld met een ziekenhuis over de prijzen en ze krijgen goedkopere service dan iemand die niet verzekerd is en de volle prijs moet betalen...