As a physician volunteering in Athens County, John Brose said he often gave first checkups to patients who were at least 50 years old.
With 16.1 percent of the adult population uninsured in Athens County, Brose, Ohio University’s vice provost for health services, was inspired to help create the Heritage College of Osteopathic Medicine’s Community Health Program, which has offered free and reduced fee clinics since 2005.
The free clinic, also known the Heritage Community Clinic within the Community Health Program, is offered at OU-HCOM’s Athens campus but travels to many surrounding counties to provide free care elsewhere.
Brose said that through his work as a family practitioner it became evident that a free OU clinic was an Athens County necessity.
“I frequently ran into a lot of patients who didn’t qualify for Medicaid but also didn’t have any insurance, and it was very sad to see those folks,” Brose said.
The free clinics are currently supported by private donations and a sponsorship from O’Bleness Memorial Hospital, so Brose said he isn’t worried that the Affordable Care Act will affect the free clinic’s functioning.
OU-HCOM failed to provide how much it receives to fund its free clinics by press time.
Once the Affordable Care Act is implemented, healthcare programs for the underinsured, like the Heritage Community Clinic, will have to target those who fall into the gaps of company insurance, or their existence may be threatened.
The State of Ohio has not decided how free clinics will be impacted under the Affordable Care Act, but Kathy Trace, director of the Community Health Program, said the need for free clinics will not disappear with increased health insurance and expansion of Medicaid coverage.
“This may be a year of transition for our Heritage Community Clinic and our free clinic programs if Medicaid expansion and/or reform passes in Ohio,” Trace said, in an email. “Even if the Medicaid expansion passes in the state legislature, there will still be many people in Southeast Ohio with unmet healthcare needs and without adequate coverage.”
Although it’s unclear how the state and private companies will continue to support free clinic services, the staff of the free clinic will provide information on the Affordable Care Act and Medicaid insurance to all of their patients and help those who are eligible enroll for the program, said Wayne Carlsen, senior associate dean for OU-HCOM and director of the Community Health Program.
“There are a lot of expenses, of course, to providing free care, so if the care is available under a covered entity, then that (patient) can be covered using that source, and we can provide care for other patients,” Carlsen said.
Nancy Cooper, coordinator for the Health Policy Fellowship, which provides legislators with medical insight to inform their policymaking, said use of free clinics is not likely to decrease under the Affordable Care Act because there are different sections of the population that will still not qualify for health insurance.
Some of the people who will not qualify for health insurance are those who fall below the poverty line, undocumented immigrants and immigrants who have been in the U.S. for fewer than five years.
“The very poor patients are not eligible for subsidies on these (insurance) exchanges,” Cooper said. “It’s kind of a glitch in the law.”
If a patient who is uninsured and unable to pay comes into an emergency room with a life-threatening condition, a hospital will end up having to front the bill, so Community Health Programs tries to prevent those kinds of situations, Brose said.
“Our hope has always been in the free clinic that we could address those illnesses before they become extensively expensive for society,” Brose said.
The amount of patients needing free clinics will also be dependent upon whether Ohio chooses to pass an expansion on the Medicaid program, which provides health insurance for certain categories of low-income individuals, such as children of poor parents, seniors and pregnant women.
If Ohio’s healthcare climate necessitates additional free clinics, William Burke, dean of OU-HCOM’s Dublin campus, said he would like to create partnerships in order to start a free clinic in central Ohio.
“We fully expect that if a decision is made to go forward with that, we will work with our partners to make opportunities available for resident (physicians) to help with this,” Burke said.
Community Health Programs offer a general free clinic, Heritage Community Clinic, and it hosts specialized mobile clinics out of two vans for dermatology, diabetes, immunizations and breast and cervical cancer.
“I think as long as the need is there, the medical school and the university will respond to that need,” Brose said.
dk123111@ohiou.edu
@DanielleRose84
