BIDDEFORD — Dr. Frank Kleeman has waited a long time to close the doors of the Biddeford Free Clinic.

When he first opened it 22 years ago, he thought for sure there would only be a need to provide free medical care for uninsured Mainers for a few years. But with no major changes to the health care system until the 2010 Affordable Care Act, the number of patients who couldn’t afford a doctor held steady.

Dr. Frank Kleeman, founder of the Biddeford Free Clinic, goes over paperwork as he prepares for the clinic’s closure in September after 22 years.

For years, the clinic – the first of its kind in Maine – would open three nights a week, staffed by dozens of volunteers who diagnosed and treated acute and chronic illnesses, performed lab tests and filled prescriptions. As many as 700 people showed up each year to see a doctor and pick up medication they otherwise would go without.

In the past year, the clinic has reduced its hours to one night a week and the number of patients has fallen off dramatically as they buy insurance available through the ACA marketplace. The clinic now has fewer than 75 active patients and will close for good on Sept. 23.

Clinic volunteers have helped 100 patients determine if they were eligible for health insurance subsidies and connected them with navigators to help them sign up for insurance. They also are helping the remaining patients apply for free or reduced medical care through Southern Maine Health Care.

“I think it’s great. We’ve done what we set out to do,” Kleeman said of the clinic. “We saw a need, we filled it and now it’s time to go because that need doesn’t exist anymore.”

For clinic director Joan Gordon, the closure is bittersweet.

“I know it’s time to go, but it’s hard to go,” she said.

THE FIVE-YEAR PLAN

The idea for the free clinic came about over Thanksgiving 1992 as Kleeman and his children sat around the dinner table. President Bill Clinton had recently been elected and he had talked a lot about implementing universal health care during his campaign.

“My kids said to me, ‘All you doctors are lazy because you don’t provide care to people without insurance,'” said Kleeman, who was a practicing urologist when the clinic opened but is retired now . “I told them if you really think there are so many people without insurance, find out if that’s true. We found out there really was a need.”

After learning that 92,000 Maine residents – out of a population of 1.1 million – didn’t have insurance in 1987, Kleeman asked local health officials if a free clinic would ease the burden in Biddeford.

They told him it would, but it wouldn’t be easy to make it work.

Kleeman’s children, Mike, Chris and Julie, helped their father secure rent-free space in a community center in Biddeford, raise money and gather donated medication. Dozens of doctors, nurses, pharmacists, medical technicians, medical students and administrative personnel signed up to volunteer.

“My expectation was we’d be open five years,” he said. “I had no idea how long it would be.”

FILLING A NEED

When the clinic first opened, about 700 patients came through its doors each year. It wasn’t uncommon for doctors to see a dozen patients and for pharmacists to fill as many as 70 prescriptions each night.

Now, the pharmacy fills about 25 prescriptions each week and there are weeks when only four or five patients need to see a doctor.

In 2013, the clinic treated 392 patients, mostly from Biddeford, Saco and other York County towns. The Dental Wellness Center saw 95 patients, according to the clinic’s most recent annual report.

“At this point, people have other avenues to get their health care,” said Denise Doyon, a clinic board member and volunteer pharmacist. “I think it’s been very helpful for those people in the middle who weren’t poor enough to qualify for assistance but didn’t have a good enough job to have benefits.”

Since 1993, the clinic has provided $6.5 million worth of medical and dental services.

From the beginning, it has relied on grants and donations from organizations like the United Way, local businesses and private residents. Local communities provided additional funding.

In 2013, the clinic spent about $192,000 of its $194,000 income, mostly on operating costs and medication. The clinic has two part-time employees.

“It has been a wonderful resource for people,” said Eric Allen, a volunteer nurse from Kennebunk. “It gives people a direction to seek health care and has opened a door that was otherwise shut.”

WINDING DOWN

Kleeman arrived early at the clinic last Wednesday, a couple of hours before the other volunteers would show up and he would begin seeing patients.

Now 81, Kleeman moves swiftly through the clinic with the energy of a much younger man. He’s there almost whenever the clinic is open, greeting patients, filling in when there is no volunteer doctor or doing whatever else needs to get done.

“He is the heart and soul of this organization,” said Gordon, who has worked there since the beginning. “There isn’t anyone like him in the world. This wouldn’t have happened without him.”

Terry Lebrun sat on a couch in the hallway as she waited to see Kleeman and a nurse last week. She started coming to the clinic in 2011 because she was having trouble with her hands. She has since been diagnosed with rheumatoid arthritis.

“They’re excellent here. They get me all of my medications,” she said. “I don’t know what I’m going to do when they’re gone.”

Lebrun is hoping to get insurance through the ACA in November. In the meantime, she has applied for reduced care through the hospital.

Nearby, Daniel Michaud and his wife filled out forms to apply for assistance at the hospital. Michaud, 54, of Biddeford has been coming to the clinic off and on for eight years to help handle his diabetes, high blood pressure and the lingering effects of an accident. He is applying for disability, but has no insurance and can’t afford to pay for his medication.

Michaud said the clinic volunteers have helped him learn to care for himself and manage his illnesses better.

“Every time I needed medication, I’d come here and get it,” he said. “I hate to see this place go. If it wasn’t for this place, I can only imagine where I’d be today.”

When Michaud was done filling out his forms, he gave them to a group of volunteers to review. The goal, Gordon said, is to make sure no patients go without medical care after the clinic closes because they didn’t properly apply for assistance.

Kleeman said the decision to close was a gradual one, but he’s more focused on the next few months, rather than the actual end. The clinic is working to set up a program through the hospital that will provide free medication to people in the community who can’t afford it. That program will be funded with the clinic’s remaining money.

The clinic’s equipment will be donated to Partners for World Health in South Portland.

Kleeman said there also are plans underway for an open house to thank everyone who helped the clinic help so many people.

“I think people have gotten better health care because we’ve been here,” he said. “I’m sure we’ve saved some lives and saved people from discomfort.”

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