Do you know someone who has no healthcare coverage? In a nation where more than 45 million don’t have coverage, I bet you do.
Here in Rhode Island, with more than 62,000 of our fellow citizens lacking employment, there’s a good chance that many of those folks don’t have health insurance; others who work but part-time for lack of full-time employment probably don’t have coverage either. In fact, Rhode Island has the highest percentage of uninsured adults of any New England state – more than 14 percent. We know what the results of lack of access to coordinated coverage mean: people don’t see doctors regularly (or ever) and they go to the emergency room when they get so sick they must seek care. While they do get treated in the hospital ER, lacking insurance coverage they can’t afford to get the follow-up care that’s often necessary to treat their conditions, which often leads to another emergency room visit under a worsened health situation.
Getting a majority of Americans covered is the intent of the controversial HealthCare Affordability Act legislation passed by Congress last year. While aspects of that plan are being rolled out over the next few years and beyond, the situation for most people lacking coverage remains perilous. In Rhode Island there are a number of community based clinic offices that provide healthcare services to those without insurance, but often at a sliding scale based on ability to pay. Again, coordination of care across various medical disciplines can be spotty in the clinic model.
There is one local organization that I know of that provides coordinated care to Rhode Islanders at no cost: that’s the RI Free Clinic. The word “Free” in the organization’s name means exactly that: no one under its care pays anything for the coverage they receive, not even for a prescription. Started in 1999 by Stephanie Chafee, the Governor’s wife and a registered nurse, the RI Free Clinic serves the uninsured working poor and provides medical care and preventive health services like cancer screening and nutrition education, and even yoga to its clients, who are selected by a lottery process after they qualify for eligibility.
The Free Clinic, which has offices on Broad Street in Providence, has a small paid staff but the heart of the organization is its volunteers. These range from lay people who help out at the Clinic to a variety of healthcare professionals in fields ranging from primary care to cardiology, currently numbering almost 700 volunteer doctors, nurses, pharmacists and others. Some of these professionals see patients at the clinic during their off hours and others take appointments in their offices across the state. The Broad Street headquarters has dedicated space for two of the Clinic’s services tied to the chronic condition diabetes that it sees in a number of its patients: ophthalmology and podiatry.
The lottery, which the Clinic has deemed to be fairest method of selecting its patients, is held on the first Thursday of each month. The process selects approximately 75 new patients a month who undergo a health evaluation as the first order of care. From there they are referred to the volunteer health specialists who make up the Clinic’s extended physicians network. The Clinic works with a number of healthcare and social services organizations in the Ocean State, and is affiliated with the Brown Medical School and health field degree programs in nursing at RI College and URI, among others, Lifespan and social service organizations like Crossroads, Dorcas Place and Amos House.
Two of the amazing things about the RI Free Clinic are its high degree of care and professionalism – this is no barebones clinic in the basement of a church but rather an emerging national model for community care – and the fact that it functions almost entirely on donations and support from corporations and philanthropic organizations (disclosure note: The Taco/White Family Foundation is one of its benefactors). The Clinic’s major objective is to expand its volunteer network and the services it can directly provide, and to increase the number of people it can take in for care. It has a goal of achieving 10,000 visits a year.
The RI Free Clinic is an organization of note that, unfortunately, can presently serve only a small portion of the many folks out there in our state who have no healthcare and have pressing healthcare needs. The Clinic is one of those most worthy organizations that are an essential part of the social safety net that’s vital to our society, especially in times like these. As a state and community we are much healthier in body and spirit because of the work of the RI Free Clinic and its partners.
For more information on the RI Free Clinic visit www.rifreeclinic.org.