Free Clinic Story Archives - West Virginia Public Broadcasting

Free Two-Day Clinic Coming To Charleston

A non-profit provider of pop-up clinics will deliver free dental, vision and medical care to those in need in Charleston.

Remote Area Medical (RAM) collaborated with West Virginia Health Right to set up a free, two-day clinic Oct. 21 and 22.

RAM works on a Community Host Group model, meaning, a local group reaches out to their organization for a visit, but must provide support to the non-profit during the duration of their stay.

Angela Settle is the CEO of West Virginia Health Right, based in Charleston, West Virginia.

“West Virginia Health Right serves the underserved, and it is a free and charitable clinic every day, 365 days a year,” Settle said. “But this is basically doing that on steroids over two days. And we have to get all the volunteers, raise all the money to support it, you know, to pay for the rooms for their staff to feed all the volunteers, you know, things like security and porta potties and all that kind of stuff we are responsible for doing as a community host partner.”

This is not the first time West Virginia Health Right has teamed up with RAM to provide health care to those in need. The first clinic was set up in Elkins after the 2016 flood.

“The next year, it moved to the Bible Center School, just because it’s a nice, you know, bigger location and kind of more central to southern West Virginia. And we stayed there and had one every year, I can’t tell you how many we had,” Settle said. “I’d say probably seven or eight.”

According to RAM clinic coordinator Brad Hutchins, their model works well in West Virginia because it meets patients where they are, literally and figuratively. All services are free and no ID is required.

“Because honestly, it doesn’t matter, at least not to, not to us,” Hutchins said. “If a patient comes in and they have a need, if we have the capacity to serve them, that’s what we’re there to do. That’s what the volunteers sign up for. So ultimately we just come and dedicate that amount of time to see as many patients as that time allows.”

Due to time constraints, patients of the RAM clinic should be prepared to choose between dental and vision services.

“You know, so, RAM we see that, you know, we’re not the solution, of course, but we are a resource that’s able to bridge the gaps and bring needed vision, medical or dental services, to these, to these areas that are underserved,” Hutchins said.

Services available at the free RAM clinic include dental cleanings, fillings, extractions and X-rays. Services also include eye exams, eyeglass prescriptions, eyeglasses made on-site, women’s health exams and general medical exams.

Starting January 1, 2014, West Virginia expanded Medicaid under the Affordable Care Act. Under the expanded eligibility guidelines, adults aged 19 to 64 are eligible for Medicaid with a household income up to 138 percent of the poverty level.

For a single adult in 2023, that amounts to $20,120 in total annual income.

Settle praised West Virginia’s expansion of Medicaid but said there are still a lot of people out there in need who cannot qualify.

“We know that expanding Medicaid was wonderful, that helped, but there’s still a lot of people out there in need,” Settle said. “Because, you know, there’s a lot of working poor, and I mean that lovingly – people that work every day, but maybe make too much for Medicaid, but they don’t qualify, or the benefits that they qualify for are too pricey.”

Medicaid enrollment in West Virginia is up 80 percent since 2013 but is expected to continue to decline as disenrollments continue after a three-year pause for the COVID-19 pandemic.

During the COVID-19 pandemic, benefits were expanded, and restrictions loosened to help immediate needs across the country. Now, those benefits have run out.

“People are deciding between health care, and the basic necessities like food, utilities, et cetera,” Settle said. “So we want to be instrumental in removing that. We want to make sure that people have access to health care.”

An integral part of continuing health care is follow-up appointments. Hutchins says West Virginia Health Right will help with care plans.

“And she provides her organization a lot of support, not only throughout the planning, and execution, but also they have a big hand in the follow up care process as well,” Hutchins said. “So we don’t actually provide any services that we can’t first align the follow-up care plan for because it benefits no one for us to come in and identify an issue with the patient without offering some type of solution.”

Settle said Health Right aims to be a source of resources and information to the public it serves.

“Well, we don’t want to be a dead end, you know, if somebody found out that they have an issue that day, we want to certainly, you know, be a follow-up source for them, where they can come to and get that rectified,” Settle said. “It’s not enough to just see them that one day, we want to make sure people have follow-up care.”

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.

Free Clinic Provides Care for Communities Impacted by Floods

The first free health clinic offering comprehensive services ran this past weekend, with more than 600 people receiving care from about 350 volunteer healthcare providers. Motivated to help folks in communities hit by record-breaking flooding last summer, West Virginia Health Right partnered with the nonprofit Remote Area Medical to offer the free health clinic over two days.

The event was based at Elkview Middle School in Kanawha County – the heart of the flood zone. Volunteers in bright green shirts sat in rows at lunch tables checking patients in. They asked for a name and the service desired, but little else. Unlike many free clinics, everyone was welcome, regardless of medical insurance status.

“This is an event that we’re saying right up front – you know no judgement zone – we know there are challenges out there,” said Angie Settle, CEO of West Virginia Health Right.

“We know you might have insurance, but we also know there’s a $5,000, $10,000 deductible, and rather than take that and go buy yourself a pair of glasses or do something for yourself, you may take your child to the doctor, or you’re going without,” she said.

Health Right began planning the clinic just three or four days after the June 2016 floods that devastated much of the central and southeastern parts of the state. It’s the first clinic of its kind in West Virginia, although Remote Area Medical – the partnering non-profit group – has been holding these types of clinics around the world since 1985.

Settle said even without the flood many of these families were struggling.

“So you think… ‘Do I want to have groceries this week, or can I take $125 and go to the eye doctor?’” said Settle. “A lot of times they are just going to skip it.”

We’re in a classroom where 20 dental chairs are set up. Volunteer providers clean teeth, fill cavities, and extract rotten or broken teeth.

“It’s obvious the need’s there, just from the severity of the mouths we’re seeing,” she said. “Somebody had seven teeth extracted at one time. So think about that…. Somebody’s teeth are so diseased that they had to have seven teeth extracted at once.”

Because a lot of insurance plans, including Medicaid, do not cover preventive dental care or eye exams, the vast majority of the patients came for those two services, Settle said.

Two were Patricia Taylor and her adult daughter Amanda.

“We had our teeth pulled, we had our eyes examined, and it was wonderful,” said Patricia. She held a napkin over the front of her mouth where four teeth had been pulled. Neither Taylor had insurance.

Patricia said her retirement plus Social Security is $100 a month too high to qualify for Medicaid and private insurance is too expensive. Her daughter Amanda was struggling with health issues and recently stopped working – she said she does qualify for Medicaid, but had yet to enroll.

When I met them they had already been at the clinic almost 12 hours, having begun waiting at 1 that morning.

“This gave us an opportunity to get some services done that we couldn’t afford, or we’d have to put some type of bill on hold to try and get that done,” said Amanda.

Patricia gave the example of getting poison ivy several weeks earlier. It cost her $107 to go to her primary care provider – money she took from her utility bill.

The clinic had providers had in almost every discipline – chiropractic, physical therapy, orthopedics. All were volunteers.

“Everybody here is putting in their own time, time they could be working and making money to give us an opportunity to get some kind of preventative or maintenance care,” said Amanda.

By far the most popular were dentists and eye doctors. Patients were able to come in, get a full eye exam, and receive a pair of glasses made the same day.

As the day wore on, though, the volunteer providers had to turn away patients seeking dental and vision care. Settle hopes to recruit more of these providers next year, especially since the event will likely grow as word gets out.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation.

Elkview Free Clinic Treats Hundreds of Patients

Hundreds of people were treated over the weekend at a free health clinic in Elkview.

The Charleston Gazette-Mail reports that organizers of the clinic, which was held Saturday and Sunday at Elkview Middle School, say around 600 patients, some as far away as Virginia and Tennessee, were served.

West Virginia Health Right, a Charleston-based free and charitable clinic, and Remove Area Medical, a nonprofit group based in Rockford, Tennessee, partnered to provide free dental, vision and medical care to anyone who needed it, including flood victims.

Health Right CEO Angie Settle says overall there were about 300 volunteers during the clinic, including dentists, eye doctors and physicians. She says they could have used more volunteer dentists and eye doctors.

She’s planning for the clinic to be an annual event.

Mobile Health Provides Medical Care for Underserved Populations in Southwestern Virginia

In Appalachia, barriers to healthcare include distance from a provider, lack of transportation, lack of health insurance, and the inability to take the time off of work to drive, wait and be seen. So throughout the region, mobile health units are attempting to bridge that gap and bring services to some of the populations that need them the most.

Outside of an old train station in southwestern Virginia, Teresa Gardner and Paula Hill-Meade are seeing patients.

“What we’re doing now is kind of reviewing a couple patients that came in this morning,” says Gardner, executive director of The Health Wagon, a mobile health unit that provides primary care to underserved Appalachian populations. “This gentleman, he has been in the recent coal mining layoffs.

“We are down to less than 100 coal mining jobs in Wise County,” she says. “The coal mining industry has just been devastated. There used to be thousands of jobs in the area and now it’s reduced to less than 100.”

Gardner says the miner’s family had been able to get insurance through the Affordable Care Act, but that it was costing them more than $1,000 a month.

“They were wanting to get established with us because they knew they wouldn’t be able to continue affording that,” she says.

Paula Hill-Meade is the clinical director of the Health Wagon. She says when they first started, they almost exclusively saw people without insurance.

“But now we’re seeing a lot of people with high co-deductibles of some $3,000-$4,000. So it’s really catastrophic insurance because how do you pay out $3,000-$4,000?” says Hill-Meade.

In 2013, the latest year for which data are available, the Health Wagon assisted more than 11,000 patients at 11 southwest Virginia sites. These are often really sick people who either don’t have insurance at all or can’t afford the insurance they have.

“Not a day goes by that patients’ lives are not saved here,” says Gardner. “They come in with various co-morbid conditions, like diabetes, obesity, heart disease or lung disease.”

One of those people is a young woman named Mary. We withheld her last name to protect her privacy. Like almost a million other Virginia residents, she doesn’t have insurance, although she says she should get it in the next couple of months. She started using the Health Wagon about six months ago.

“They’ve really helped me get my diabetes under control, which I wasn’t aware that I had it, so I really don’t know where I would be in the last six months as far as health-wise,” says Mary. “I probably would be in a lot worse shape than I am now.”

The Health Wagon asks for a $10 donation from patients if they have it. But if not, services are free. They are able to provide these services at a free or reduced cost to clients like Mary because the Wagon closely collaborates with universities and organizations around the country, such as The University of Virginia Health System and The Virginia Healthcare Foundation.

Hill-Meade says The Health Wagon takes a holistic, multidisciplinary approach to healthcare. Partnerships with labs, pharmacy schools and universities allow them to provide specialty consults through telemedicine services and tests at free or reduced cost. The vast majority of the population that uses their services are working poor adults. Most of the children in the area qualify for Medicaid.

“We’re trying to address these healthcare disparities because we have higher rates of just about every disease process,” says Gardner. “I mean, we have higher rates of diabetes, have higher rates of mental illness, suicide…”

According to the Health Wagon website, compared with the rest Virginia: Health Wagon clients are 21 percent more likely to die from diseases of the heart, 14 percent more likely to die from diabetes, 40 percent more likely to die from unintentional injuries and 50 percent more likely to die from suicide.

“You know the economy is just kind of devastated here – I’ve been here in this clinic for 23 years and I’ve never seen it this dire for patients,” says Gardner. “They have to make daily choices between eating and paying electricity bill or medications and so on and so forth. We see that on a daily basis. And, unfortunately, people die without a health care access because of the economic factors that play into that.”

This year, in part due to the coal mining layoffs, they’ve had a waitlist for services. The Health Wagon just added a new nurse practitioner to try and meet the demand.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation.

W.Va. Free Health Clinics Asked to Do More with Less

West Virginia has been plagued for the past few years with budget deficits. To deal with the shortfalls, the governor has cut state agency budgets across the board, implemented hiring freezes and dipped into the state’s Rainy Day Fund.

This year, Gov. Earl Ray Tomblin cut the House and Senate approved budget by an additional $11 million, leaving some service programs to wonder how they’ll keep their doors open. The Charleston Health Right is just one of those service programs.

The West Virginia Health Right clinic located in Charleston’s East End is a free and charitable clinic that provides medical, dental and vision services to more than 15,000 uninsured and underinsured West Virginians each year.

Beginning July 1, 2015, though, the Charleston clinic, along with nine other clinics across the state, will see a significant reduction in their budget. Executive Director Angie Settle said the cut for her location will be nearly 33 percent.

After two years of 7.5 percent across the board cuts from Tomblin, Settle’s location will have 48 percent less funding than three years ago. Settle said they’ve looked to cut waste wherever possible, but there is little left to find.

Because of the clinics’ ability to bill Medicaid, something the Charleston clinic began doing in January 2014,Tomblin said in his veto message those clinics should be able to recover part of the money cut.

But Settle said that statement just isn’t true for her clinic. In 2014, her clinic brought in $188,000 from Medicaid billing, but spent nearly $100,000 on a person to do the billing and the software and IT upgrades to make it possible.

Settle said even though the start up costs are complete, Medicaid billing won’t make up for her 2016 33 percent budget cut for two reasons. First, because of notoriously low Medicaid reimbursement rates, and second because of the population she serves.

Executive Director of West Virginia Health Right Angie Settle.

“More than half of the patients we see are the working poor,” she said. “West Virginians with two and three jobs.”

Medicaid allows clinics to bill for some services, but Settle said they often won’t reimburse multiple services that occur on the same day. Because she serves a population who may be prohibited from going to multiple appointments because of their work schedule, child care, or ability to pay for transportation, Settle said her patients just won’t return for multiple appointments.

“It reminds me of almost like a NASCAR pit stop when people come here. We [do] everything we can do for them that day. Talk to them about smoking cessation, dental health, get their blood pressure checked, get their blood work done, get their pap smear if its due, give them a slip to go get a mammogram. Everything we can pack into that visit, as much bang for the buck in that day,” she said of their philosophy of care.

Sometimes Medicaid will cover one or all of those services, and sometimes they won’t, Settle said, but she doesn’t see that as incentive to change the way they serve their population, 50 percent of which have Medicaid coverage and 50 percent of which have no insurance at all.

“By squashing funding to free clinics and saying we don’t want to fund free clinics, it basically tells the people of West Virginia, the working poor, we want you to quit your job so you can get on Medicaid,” she said. “It says we don’t want you to work. We want you to quit your job and get on Medicaid or go without.”

Senate Finance Vice Chair Chris Walters said he and his fellow lawmakers tried to work with the clinics to get their line item appropriations in a workable range, knowing the governor intended to make cuts. He said he understands the importance of the clinics to their communities, but lawmakers had to make tough choices to balance the overall budget.

Walters said the state is expecting another budget deficit in 2016, but said lawmakers are working to come up with ways to increase revenues.