Southern Ocean County’s First Free Medical Clinic to Open SoonCoastal Volunteers in Medicine Two Years in the Making
The numbers alone are staggering.
According to Coastal VIM (Volunteers in Medicine), a newly-minted private not-for-profit foundation preparing to open the first free medical clinic in Southern Ocean County, there are 48.6 million people in the United States who do not have medical insurance. Coastal VIM estimates about 1,123,000 of those people hail from the Garden State with approximately 51,384 of them calling Ocean County home, including 13,582 in the nine southernmost ZIP codes of Southern Ocean County.
But the numbers, said Sonia Rich-Mazzeo, the chairperson of the new organization’s board of directors, tell just part of the story. They represent real people.
Rich-Mazzeo, an “advanced practice nurse – certified” (New Jersey’s term for a nurse practitioner/clinical nurse specialist), was employed by New Gretna’s Viking Yacht Co. when the “Great Recession” of 2008-2009 hit, causing a large number of layoffs. Viking, she said, was “great,” allowing not only laid-off workers but their families to continue to receive primary and preventative medical care from the company’s in-house medical department. But Rich-Mazzeo started thinking about all of the area’s other workers who were suffering layoffs and realized they would be losing their health care benefits – it they had them in the first place.
People who have no health insurance, said Rich-Mazzeo, usually aren’t very poor people on government assistance. Many of them are eligible for Medicaid. America’s older citizens are covered by Medicare. Most states have programs for uninsured children under the age of 18. So who are the people without medical coverage?
“They’re full-time, Caucasian workers, sometimes working more than 40 hours a week,” said Rich-Mazzeo. “Or they are people who couldn’t get insurance because of pre-existing conditions. There are also those people who made 2 cents over the poverty level and therefore couldn’t qualify for Medicaid.”
In other words, people without medical insurance typically don’t match the lazy and shiftless stereotype at all, but are the “working poor” whose employers don’t offer insurance or who cobble together several part-time jobs to put food on the table and, thus working “part-time,” aren’t eligible for employer-provided policies. At the end of the first decade of the third millennium the ranks of the uninsured were swelled by people who had lost their jobs due to the recession.
Where can uninsured individuals turn when they become sick? Often their only option is hospital emergency rooms, which, in New Jersey, by law, can turn no patients away, insured or not.
There is a price to be paid, however, for ERs substituting for primary physicians’ offices. Patients are often diagnosed when a disease has reached a later stage, thus requiring more expensive treatment. Who picks up the tab for that treatment? Hospitals are supposed to be reimbursed by the state for indigent care, but over the past several years the reimbursement rate has consistently fallen, meaning paying patients have to be charged more for their care to make up the difference. And, even with falling reimbursement rates, taxpayers still end up paying much of the bill.
Of course, the people who suffer the most are the uninsured patients, who have conditions that have become far more serious because they weren’t caught early in an annual physical or an early trip to the doctor when symptoms first became apparent. It is a classic example of a lose-lose situation.
Rich-Mazzeo decided something had to be done about the situation in Southern Ocean County. Perhaps a free medical clinic could be opened. But how?
She went on the Internet to find answers and discovered the website of an organization called Volunteers in Medicine.
Founded in 1994,
93 Clinics Strong
The situation was even worse in Hilton Head, S.C., back in the early 1990s. One in three persons living on Hilton Head Island had no access to health care, a rate twice the national average.
Like Southern Ocean County, Hilton Head had become a retirement Mecca. A number of retired physicians, nurses and dentists, led by Dr. Jack McConnell, decided their skills were going to waste and in 1994 opened a free medical clinic. It was successful, so much so that calls and letters started flooding in from the rest of the nation asking how McConnell and Co. had done it.
McConnell responded by creating a separate not-for-profit to assist other communities in launching their own clinics. Now based in Burlington, Vt., Volunteers in Medicine has helped create 93 clinics across the nation, with three in New Jersey (Cape May Courthouse, Red Bank and Hackensack).
There’s no doubt about it, Volunteers in Medicine, which bills itself as “the only national nonprofit dedicated to building a network of free primary health care clinics for the uninsured in local communities,” has made a splash. In 2011 VIM clinics provided healthcare services to 95,391 patients involving 362,758 visits. One of its backers is the rock band Phish (which is based, like VIM, in Burlington) and the band’s charitable WaterWheel Foundation. Four of its clinics, including the one in Cape May County, received grants from the American Medical Association Foundation in November. That’s four out of 15 such grants awarded nationwide by the AMA Foundation.
The key to VIM’s success has been its hands-on approach to helping create and sustain clinics. The organization assigns a “coach” to each aspiring community group that seriously wants to open and operate a clinic, having learned that “relying solely on a written guide for starting a clinic is insufficient for most communities to build an organization that is sustainable and responsive to need.”
So, Rich-Mazzeo contacted Volunteers in Medicine and, with that organization’s assistance, worked for two years to form a clinic.
She formed a 12-person board of directors, made up of healthcare professionals, members of the clergy and members of the public at large. A $55,000 start-up grant was engineered from the Horizon Foundation for New Jersey. Negotiations were conducted with the Southern Ocean Medical Center so that the clinic could use the hospital laboratory and imaging facilities. The actual space for the clinic was provided by the King of Kings Community Church in Manahawkin. A part-time operations coordinator, Maria Hennessy, was hired. The first meeting of volunteers was held on Thursday, with more than a dozen people coming out. Medical supplies were stockpiled, with donations from the response to Superstorm Sandy playing a key role.
Just a few I’s have to be dotted and a few T’s crossed and, hopefully within a matter of a couple of months, “the first free clinic for those medically uninsured in Southern Ocean County, N.J.” the “Coastal VIM Clinic,” will open its doors.
“We’ll be open from 4 to 8 p.m. two times a week, Tuesdays and Thursdays, to begin,” said Rich-Mazzeo. “That’s just because Mondays and Fridays tend to be the busiest days of the week for just about everyone.”
Hopefully, she said, enough volunteers will come onboard to enable the clinic to extend its hours and days of operation. After all, the VIM template is to “employ” retired healthcare professionals and other volunteers, a model that worked so well in Hilton Head. One thing Southern Ocean County has an abundance of is retired people and volunteers.
So, most of the groundwork for the Coastal VIM Clinic has been completed. But what, exactly, will the clinic be doing?
In short, providing free medical services for the area’s uninsured.
Coastal VIM plans on providing free primary medical care and the diagnosis and management of long-term medical conditions such as diabetes, hypertension, arthritis, obesity and allergies. It will also provide free dental care and prescription assistance – a pharmacist in Barnegat has offered to provide prescriptions at cost and, as Dr. Edward Niewiadomski, the Coastal VIM vice chairperson, said, “hopefully we’ll be able to endear ourselves with the drug company reps in the area.” The clinic will offer referrals to participating medical facilities for diagnostic testing.
It will be big on preventative services such as physician and medical professional counseling and health education. Coastal VIM will provide information regarding smoking cessation and will offer drug and alcohol addiction treatment referrals.
Knowing that the Southern Ocean County area has experienced a large influx of Latinos, the clinic will provide translation and interpretation services for Spanish-speaking patients and their families.
Patients will be seen by appointment only and the clinic will not take walk-ins. Its address at King of Kings Community Church is 1000 N. Main St. (Route 9) in Manahawkin. The clinic’s phone number is 609-384-0102.
Who can receive services at the Coastal VIM Clinic?
First of all, services will be provided for people between the ages of 12 and 64. They must live in Southern Ocean County and immediate surrounding areas.
Importantly, patients must not have any sort of medical insurance, nor can they be eligible for Medicare, Medicaid, VA benefits or any other type of government-sponsored health insurance.
Finally, their total income cannot exceed 250 percent of the federal poverty level based on the size of their immediate family. The limit on a single person’s income would be $27,925. A family of four could make up to $57,625; a family of eight would have a combined income limit of $97,225.
Coastal VIM promises one other thing, and a very important thing at that – a “culture of caring.”
“It is based,” reads the group’s volunteer handbook, “on one ethical standard: How people are treated during a visit to the clinic no matter who they are is as important as the medical care they receive. Traditional medical clinics typically provide efficient medical treatments and procedures, but often at the expense of caring.
“Those who come to our clinic are community friends and neighbors in need of our medically specialized help. They survive on limited resources and often exhibit great courage simply trying to get through each day. The clinic environment should enhance the feeling and the actions of caring for one another. Feelings and actions are not reflected by the building or the equipment but by the people. Our challenge is to transform what is ordinary and common into an uncommon and extraordinary clinic of positive change.”
Although the groundwork of the Coastal VIM Clinic has been laid, plenty of volunteers are still needed to make Rich-Mazzeo’s dream a success.
Medical professionals, or course, are needed, such as physicians, nurse practitioners, physician assistants, nurses, medical assistants and EMTs, practicing or retired. Social workers are also a plus, as are dieticians and nutritionists. And, because Coastal VIM is a private, non-profit corporation funded only by individual and corporate donations, grant writers and fundraising and developmental staff will be highly prized.
There will be positions for just about anybody. A medical and clerical office staff will have to be developed. And one position, perhaps, in a way, the most lowly, but, in another, the most important, that of “patient navigators,” will be critical to the clinic’s success.
For more information about volunteering, call Maria Hennessy at 732-687-7685.
Yes, the numbers of the uninsured are staggering. On the other hand, the free clinic movement, of which VIM is a major component, is racking up some pretty impressive numbers itself. According to a study commissioned by the American Medical Association, there were 1,007 free clinics operating in 49 states and the District of Columbia in 2010. They served 1.8 million patients and accounted for 3.5 million medical and dental visits. Some 58.7 percent, like the fledgling Coastal VIM, received no government revenue.
Free clinics aren’t the solution to the woes of the uninsured, but they have certainly put a dent in the situation. Now Coastal VIM is just about ready to add its own fender-bender to the total.