A Closeup of Coastal Volunteers in Medicine’s ‘Culture of Caring’

Serving the Medical Needs of the ‘Underserved’
By MARIA SCANDALE | Mar 15, 2017
Photo by: Jack Reynolds

One measure of Coastal Volunteers in Medicine’s impact is in the numbers – 714 people helped who were otherwise having trouble obtaining medical care. But one is the real number, one at a time in a “culture of caring.”

Patients like 57-year-old Marie of Barnegat are the “underserved” who may fall through the cracks of the healthcare system at no fault of their own, then find a diagnosis and care through the volunteer team of Coastal VIM.

Marie calls the organization “a blessing.” Before, the uninsured woman said, “I was giving up hope.”

Volunteered time of area doctors, nurses and others has staffed the nonprofit organization in Barnegat for 3½ years.

Yet, with 100 percent of operations supported by donations and grants, the public is vital to the organization’s continued success. As more and more people in need become aware of Coastal VIM, that has opened up the need for more volunteer clinicians and for donations to support the program.

“It has been growing and it seems to continue to grow, because the numbers are startling of how many people really don’t have health insurance,” said Larry Picarello, chairman of the board.

“Since June we saw 367 patients,” he said. “We are only open three days a week, and a lot of what we can do is contingent upon the clinicians who come in and help us to do it.

“So, one of the main focuses of our administrative work is to match the clinician to the person, based on what needs they have. We have 70 total volunteers, and I would say approximately 30 of them are clinicians.” Some doctors are specialists, some general practitioners, quite a few are nurse practitioners, among others. Medical director is Kimberly A. Hogan, M.D., a family practitioner.

“The other 40 volunteers do a variety of different things, from the reception desk to coordinating volunteer time,” Picarello said

Coastal VIM is a free, non-urgent family health center treating patients without medical insurance who live in Southern Ocean County and who have a family income below 250 percent of the federal poverty level. In 2016, $29,700 was the maximum gross income for someone older than 18 to quality for CVIM services. Offered is primary care for all ages and psychiatry for adults.

Services include primary and ongoing care; physicals and health screenings; women’s and family care; diabetes and other chronic disease management; diagnostic testing; hypertension clinic; prescription assistance; social service referrals; and health education.

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So, who are the people calling upon Coastal VIM for help? Many are seasonal workers, some are self-employed, some are shift workers. Some recently lost a job.Some have employers who keep hours below the full-time threshold.

“Many people work, but they’re seasonal," added Picarello. "They don’t have enough income. They have too much to be Medicaid-eligible, but they don’t have enough to fall into the category of being able to afford it, or they have a job today, they lose it tomorrow.”

Marie, who would rather not give her full name for privacy reasons, has a story that is typical of many clients who call. Her story ends with her being very thankful for the care she found at Coastal VIM. She was a caregiver of elderly Alzheimer’s patients, working privately, but could not continue when she was ill. Her husband is a construction worker on disability after a work injury in which he lost his leg.

“I have no health insurance. I couldn’t afford Obamacare, and I was very sick for a whole year,” she began. She said she could not afford the $500 monthly premium or the $5,000 deductible that she was quoted for the lowest plan under the Affordable Healthcare Act.

“I was paying to go see doctors to find out what was wrong with me, and they all kept saying, there’s nothing wrong. Yet I went from a weight of 145 down to 109 pounds, I had bathroom issues, and I couldn’t breathe. I was getting very depressed because everybody was telling me there was nothing wrong with me.

“After like a year of seeing doctors, getting colonoscopies done, different things, they all kind of blew me off. Someone told me about this place and, I’m not kidding, in a matter of two weeks, they knew what was wrong.”

An autoimmune disease was the culprit. Now that she is on medications, Marie’s condition is much improved. A connection with pharmacies allows for a discount on prescriptions.

“I think this place is amazing. It is a blessing, you have no idea,” Marie praised. “The volunteers who work here, they’re all amazing. I was giving up hope. I didn’t want to go to another doctor; I didn’t want to be disappointed. But here I wasn’t disappointed.”

Clients say they are happy that the clinicians took time with them.

That is consistent with the Coastal VIM philosophy, the “Culture of Caring.” Says Coastal VIM literature, “It is based on an ethical standard in medicine. We believe that how people are treated during a visit to the clinic is as important as the medical care they receive.”

Described Marie, “They sit and talk; they explain what’s going on; they don’t rush me out the door.”

She found that as a patient with no insurance, she wasn’t given the time or attention at other doctors’ offices to get her illnesses diagnosed, including a MRSA bacterial infection that was found in her nose after her previous requests for a doctor to examine her nose were ignored. “They had told me, just put Neosporin on it.

“I used to come home in tears from the doctor’s office, saying, ‘Why are they saying there’s nothing wrong with me, can’t they see?’ And I come here; I cried the first time because I was amazed at how they treated me, which is wonderful – they spend time with me, they explained everything. And they actually looked up my nose to see what was there, and knew right away.”

Speaking of the general situation, Picarello said, “Her story is extremely reflective of the other patients we have had, just that there are a lot of disenfranchised people like Marie who are out on the sidelines someplace and all of a sudden they come here and they get a caring person who works with them, who is not worried about rushing them through the door, and they sincerely want to help do the best they can for that person.”

Conversely, one of the listed ways that Coastal VIM states that it helps the community is by “relieving hardworking healthcare providers of their nonpaying patients.” Another is “addressing primary healthcare needs where they belong, in a family care setting, instead of in an emergency room.” Also, “preventing development of full-blown emergent health conditions by addressing health problems at their onset.”

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The Affordable Care Act, known as Obamacare, has insured more than before, but as program workers hear from patients like Marie, it is not a cure, when they can’t afford the cost.

“Even with Obamacare, there remains a lot of confusion. There are several levels of confusion, we think. First of all, some people just don’t know how to use it, in which case, when we interview somebody to bring them on board, one of the things we give them is the resource to speak to somebody who can help them negotiate the system,” Picarello said.

He added, that in the meantime, Coastal VIM doesn’t necessarily turn those patients away initially. “We will service them if we can. We are the primary care; we are not specialty care or surgery care.

“If they’re really in dire straits, they should be on Medicaid, but if they’re in that in-between group, the patients we work with, we need to verify that they are in our criteria, which is equal to or below 250 percent of the federal poverty level.”

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Support for this work is an ongoing need. “We can always use help because we’re a nonprofit organization,” said Picarello.

A GoFUNDMe page has recently been set up as a new fundraising effort. The link is https://www.gofundme.com/coastalVIM

An annual dinner dance in the fall has attracted support. “We started a dinner dance in 2015, which was very successful for an initial dance. Last year we raised almost 60 percent more, and had 100 more people than we had the year before.

“So, little by little, Coastal Volunteers is becoming more public and more out there in the community in trying to make people aware that we’re here and that the services are here to use. But obviously, as you go out and recruit patients so they know we’re here, the flip side of that coin comes into play: getting the proper clinicians, the proper volunteers, raising enough funds so that you can provide larger services.”

Coastal VIM gets some small grants, and is thankful for a few generous donors, some of whose donations are matched by their employer. A startup grant of $50,000 from The Horizon Foundation served for the first two years. The budget is under $100,000 per year. Other major partners and supporters are Seaview Orthopaedic, BioRefernce Laboratories and OceanFirst Bank.

A donation envelope states that “Coastal VIM can only continue to serve as a community resource with your help.”

“It’s been a bit of a struggle – 2015 was a struggle, 2016 was less of a struggle, but it’s still a struggle,” Picarello said. Except for a paid nurse manager, currently everyone else is a volunteer.

VIM is a national organization, but the individual VIMs are independent of each other. Among others in New Jersey are one in Bergen County and one in Cape May.

“We meet and share ideas, and we’re working on now sharing resources, hopefully, as well, so we can bolster each other and support each other’s effort,” said Picarello. “But for now, it’s still up to us as Coastal Volunteers of Southern Ocean County to make it work.”

Coastal VIM is appreciative of volunteer clinicians, and could always use more. The number of volunteer hours that are donated to Coastal VIM is what makes the organization work.

In 2016, an estimate that is probably extremely conservative counted 2,078 volunteer hours, Picarello said.

Applying the current rate of pay for nonprofit workers, $23.07 per hour, that would equate to almost $48,000 in donated services last year. However, that estimate is also low because a higher hourly rate could apply to volunteer clinicians in medical nonprofits.

The website quotes Leo Buscaglia, “Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, or the smallest act of caring, all of which have the potential to turn a life around.”

That is echoed by another unnamed patient who wrote, “You will never understand the impact you make on your patients. Thank you for saving one more life.”

To make a tax-deductible donation, call the office at 609-384-0102 or go online to the website coastalvim.org, where more information about the organization is also available. And now GoFUNDMe is a new option.

The office is located at 249 South Main St., Suite 8, Barnegat. Appointments are required by calling the office number above.

mariascandale@thesandpaper.net

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