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Clinic crucial to health of working poor

June 10, 1999

Lorri Rice sits in her little cubbyhole of an office at Hagerstown's Community Free Clinic and says she's not sure what to do. Once the Free Clinic's clinical director, she became its executive director last winter and from then until now, things have gone well. That is, until very recently when, as she put it, she "tramped in a mud puddle."

One of her volunteers, concerned about the clinic's ongoing financial problems, and the fact that this year's funding will run out in July, wrote a two-page appeal to the public which noted that the Potomac Street Community Health Center had received a $300,000 loan to help renovate a building on Prospect Street.

"Once again," said the sheet, " the Community Free Clinic - your medical providers - were left out." A second page of the handout notes that the Potomac Street Center is operated and funded by the hospital, and that while "we are happy for their growing success...the financial needs of the Community Free Clinic are equally important."

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Rice looked at the handout, and "against my better judgment" she allowed the volunteer to make copies and put them on a table in the clinic's waiting room for distribution. A copy made its way to hospital officials, who have told some of her board members that they're not pleased. She's sorry and would like to make amends, but said "the intent was not to cast aspersions. The intent was to educate people that we are not the same."

The Free Clinic was founded in 1990 by Dr. Martin Gallagher, who operated out of donated space at the Union Rescue Mission. That first year Gallagher, and other physicians who volunteered their time, treated 500 patients. The next year the patient load had grown to 2,000. By last year, after a move to 18 W. Franklin St. downtown, the tally was up to more than 8,000.

For the most part, "the clients we serve are the working poor, who are making too much to qualify for Medicaid cards," Rice said.

"We take care of a lot of single mothers and we also have a huge chronic caseload. We've got 150 diabetics, a lot of people with asthma and we get a lot of referrals from the Washington County Hospital emergency room," she said.

That's one reason Rice regrets the controversy that's arisen over this handout. In her view, all local health-care providers need to cooperate.

Potomac Street, which charges those treated there on a sliding scale, may be a separate entity, Rice says, "but that doesn't mean we can't work together."

The main difference is that the Free Clinic is in a much more precarious position in terms of funding, Rice said. Its annual budget is $240,000, funded in part by grants from the Washington County Gaming Commision, the United Way and Washington County Health Care Systems, which gave $50,000 this year.

Despite that, Rice said, the Free Clinic only has operating funds to carry it through the end of July. The clinic is applying for grants, but Rice said that in many cases, grants are set up to provide "bricks and mortar" and not operating expenses.

The caseload at the free clinic is growing, Rice said, but not because of any attempt by people to get something for nothing. Patients must provide their Social Security numbers so clinic officials can verify that they don't have insurance.

Rice said that for smaller companies, it's becoming more cost-prohibitive to offer workers health insurance. Others are utilizing temporary agencies to provide more of their staffing needs. And she said, under state guidelines, a family of four with an income over $17,500 is ineligible for any state-funded medical benefits.

So what does a family do when it becomes ineligible for state benefits? In Washington County, 46 percent of those without health insurance were treated at the Free Clinic, by physicians volunteering their time, according to the "Healthy Communities 2000" health needs survey.

If you visit the clinic, you'd find a lot of facilities of a regular doctor's office, though most of them, like the exam rooms, are smaller. And you'd begin to understand, with all the activity going on, how Rice made a snap judgment she now regrets.

Hospital officials should accept her apology for one very important reason; the clinic kept 8,000 people with no means of paying their bills out of the emergency room last year. Just thinking about the paperwork they didn't have to do should give hospital folks a warm fuzzy feeling about the Free Clinic.

As for the rest of the citizens, there are several reasons to contribute to the Free Clinic. If you don't do it out of an obligation to your fellow man, consider the possibility that someday you may find yourself out of work and in need of help.

And if you're one of those people who wanted the welfare rolls trimmed, it's been done, but a lot of folks who got a ticket to the working world found it didn't include health insurance. If we don't help out, there may be a new call for government to do so. Donations can be sent to the Community Free Clinic, 18 W. Franklin St., Hagerstown, Md., 21740.




Bob Maginnis is editor of The Herald-Mail's Opinion page.

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