Reprinted with permission of The Pilot

Free Clinic Provided $1.9 Million in Care in 2007

BY CLAUDIA WATSON: SPECIAL TO THE PILOT

Moore Free Care Clinic (MFCC) provided $1.9 million in service value to the limited-income and uninsured of Moore County in 2007.

This figure represents a 97 percent increase in the value of services since last year, the clinic recently reported.

The free clinic's executive director, Laura Tremper-Jones, says the growth in service value is directly related to the clinic's ability to acquire medications free of cost from the pharmaceutical companies. The clinic received $706,606 in medication assistance from the patient assistance programs offered by pharmaceutical companies, a 221 percent increase since 2006.

In addition to providing care and monitoring patients' health, the clinic enrolls patients in these medication assistance programs. Once enrolled, they are eligible to receive their medications at no cost.

"We have one person who is dedicated to the time-consuming process of getting the medications from the pharmaceutical companies, so we've become more efficient in getting these medications in a timely manner," Tremper-Jones says.

Sometimes patients are unsure as to why they are asked for so many types of financial documents, but she explains that it is directly related to the requirements of the various drug companies.

"If they can't provide the documentation the pharmaceutical company needs to get enrolled, then we'll try to find a generic equivalent that we can purchase at low-cost," she says.

The amount the clinic spent on these types of medications dropped by 40 percent -- to $47,719, in 2007. In addition, physicians' offices provided medication samples, and often patients will purchase their own low-cost medications. Cooper's Pharmacy has been particularly generous with donations of medicine to the clinic's patients.

"The patient assistance programs are the only way these folks can make it," says Tremper-Jones.

On average, the clinic's patients receive $132 a month in medications. Some patients have much more expensive medications and some have very inexpensive generic medications.

"You just can't pay for the medications when you make $1,276 a month and have the rent, gasoline and food to pay for," Tremper-Jones says. "Things slip and it's usually the medications."

She says that most of the clinic's patients have health issues related to being noncompliant with their medications.

"The uninsured are at more risk for developing debilitating illnesses, an increased number of hospital stays, and reduced productivity at their jobs because they can't afford their medications and they don't have access to health care," she says. "They often end up in the ER or worse, admitted to the hospital for a lengthy stay, and they don't have the ability to pay those bills."

Chronic Disease Management
According to the Institute of Medicine and the National Academy of Sciences, the low-income uninsured are 4.5 times more likely to have diabetes. They are 30 percent more likely to have high blood pressure, and 50 percent more likely to have high cholesterol. Being uninsured also means they have a 25 percent greater chance of premature death.

Tremper-Jones estimates that 60 percent of her patients are in the clinic's chronic disease management program. That program was established to care for patients with diabetes, high blood pressure, heart disease and other chronic illnesses, and it monitors patients for long-term progress. "Currently, 23 percent of our patients have diabetes, 43 percent suffer from high blood pressure, 18 percent have high cholesterol, and 28 percent suffer from depression or anxiety," Tremper-Jones says.

Many of these patients are on multiple medications and need to have frequent lab tests. The clinic also helps patients with their diabetes testing supplies. "Chronic disease is difficult enough for those of us that are lucky to have medical insurance, so imagine how difficult it is if you can't afford the necessary medications or lab tests to continue your care," Tremper-Jones says.

The free clinic's program also establishes a monitoring program for patients, and they return to the clinic for a follow-up appointment and lab test every 12 weeks, or as needed.

"We provide not only the care and medications, but also the education and support our patients need to care for their chronic illnesses," she says. "This helps them make healthy choices and decreases the chance of serious complications and visits to the ER. They're just on a better road to health."

Uninsured Growing
MFCC, which opened in April 2004, has registered more than 1,500 of Moore County's neediest residents for care. They do not have access to health-care insurance or aren't able to afford it. If patients become eligible for Medicaid, Medicare or commercial insurance, they are no longer eligible for care at the clinic.

The free clinic, which has 650 active patients, operates five days a week and two nights and sees registered patients every day by appointment only.

"Currently, because of our space constraints, we do not offer a walk-in clinic for people suffering from acute illnesses," Tremper-Jones says. "We hope that in the future we might be able to expand our services to care for walk-in patients."

According to Tremper-Jones, the patients come from all walks of life -- every level of education, gender, age group and ethnicity. Most hold full-time jobs, or work two jobs, and some are self-employed.

The Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill estimates that 17.2 percent of the state's population -- about 1.3 million North Carolinians -- are uninsured.

Moore County, which ranks 28th among the state's 100 counties, has 8,948 people ages 18 to 64 who are uninsured. These figures represent all uninsured, not just the low-income uninsured population, and are based upon the most recent data available to the center.

"The number of medically uninsured is growing, and we are committed to helping them in their time of a health care crisis," Tremper-Jones says.

Anyone needing more information on Moore Free Care Clinic can visit www.moorefree-care.org or call 947-6500. Moore Free Care Clinic is a registered tax-exempt, not-for-profit organization and does not receive any federal or state funding.

The clinic derives its revenue primarily from the generosity of public donations and grants. Donations can be mailed to: Moore Free Care Clinic, P.O. 161, Pinehurst, NC 28370.