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December 5, 2012

Gabe Souza / Staff Photographer

The free clinic at the India Street Public Health Center, photographed on Wednesday, Dec. 5, 2012. The clinic that provides free medical care to low-income people who lack insurance will run out of money in February if it can't find a partner to help pay its bills.

Portland's free clinic in critical condition

By Tom Bell
tbell@pressherald.com
Staff Writer

PORTLAND – A clinic that provides free medical care to low-income people who lack health insurance will run out of money at the end of February if it can't find a partner to help pay its bills.

For two decades, the Portland Community Free Clinic at 103 India St. was funded by Mercy Hospital and received in-kind support from the city.

A year and a half ago, Mercy stopped its annual contribution of $210,000, citing shifting priorities and its belief that Portland had other resources to serve the same kind of patients.

The clinic is now operating on an annual budget of just $100,000 -- the approximate cost of two heart bypass surgeries at a hospital -- to pay its expenses, primarily wages for three part-time employees.

The city provided $9,000 a month for July, August and September to give the clinic time to find other partners. Now, the clinic is using reserve funds, which will run out by the end of February.

The Portland Community Free Clinic serves 500 to 600 patients in Cumberland County. While poor people can get health care elsewhere in Portland, including the city's Health Care for the Homeless clinic on Portland Street, the Free Clinic targets people who earn too much to qualify for MaineCare but can't afford health insurance or visits to the doctor, said Caroline Teschke, program manager of the city's Public Health Department and administrator of the clinic.

The clinic, which operates in space leased by the city, is open from 6 to 9 p.m. Monday through Thursday, to accommodate people's working hours.

The care is provided by doctors and nurses who volunteer their time after they get off from work. Patients can see both primary care doctors and specialists.

Teschke said, "If Barack Obama knew we could care for 600 patients on $100,000, he would make us the gurus of health care, because it's the best deal going."

Mercy Hospital ended its partnership with the Free Clinic primarily because the Portland Community Health Center on Park Avenue, which opened in 2010, provided additional capacity to serve the same population, said Melissa Skahan, Mercy's vice president of mission effectiveness.

She said the hospital is now working closely with the new health center, although it doesn't provide money.

The health center on Park Avenue is a newer model for providing health care to poor people.

While the Free Clinic on India Street depends on volunteers, the health center has a paid staff and serves people of all incomes, including patients enrolled in MaineCare, the state's version of Medicaid. Patients pay according to their ability to pay, and the federal government provides grant support.

The clinic on India Street, by contrast, doesn't bill anyone.

In other cities around the country, volunteer-based free clinics have closed after federally qualified health centers have opened.

Teschke said that while the health center on Park Avenue is doing great work, some of the patients who use the Free Clinic would balk at the billing procedures and required co-payments. Some would likely end up seeking care in hospital emergency rooms, she said.

"Our patients like our model of care," she said. "They are responding to the support we give them."

Patients of the Portland Community Free Clinic say they are apprehensive about losing the relationships they have established with its doctors.

Leslie Riversmith, 48, a self-employed dog trainer and dog sitter, said she can't afford health insurance. Her husband, who was laid off when his factory shut down during the recession, is now a full-time student at Southern Maine Community College in South Portland. He is diabetic and she suffers from Crohn's disease.

"I am terrified," she said. "I have another year with my husband in school."

Deborah Lovely, 52, of Gorham, who is self-employed repairing rugs and taking care of elderly people in her neighborhood, said she was "freaking out" two years ago, when she was diagnosed with diabetes. She couldn't afford the visits to the doctor.

"When I went to the Free Clinic, I was so happy to find the people who work there are all volunteers," she said. "I was blown away by the great service. To think it is closing is so wrong."

A new ad hoc group called Friends of the Free Clinic has started raising money to begin the process of forming a nonprofit group to keep the clinic open.

Joan Leitzer, a psychiatrist who volunteers at the clinic, joined the effort to save it, saying it fills a gap in the health care system.

"There are people all over town who work long hours and don't have insurance," she said.

 

Staff Writer Tom Bell can be contacted at 791-6369 or at:

tbell@pressherald.com



Gregory Rec / Staff Photographer

Peggy Akers, a nurse practicioner who volunteers at the India Street Public Health Clinic, asks Charles Lafland questions during a physical at the clinic Wednesday, Dec. 5, 2012. The clinic is facing an uncertain future after losing a portion of its funding from Mercy Hospital.

Gabe Souza / Staff Photographer

Caroline Teschke stands outside the India Street Public Health clinic Wednesday, Dec. 5, 2012. Teschke is the clinic's administrator.



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