Reprinted with permission of The Pilot, 2007.
Moore Free Care Clinic Helps Fill Increasing Need
BY CLAUDIA WATSON: SPECIAL TO THE PILOT
Until December of last year, Yvonne Covington, 52, worked two part-time jobs -- as a custodian at a local elementary school and as a home care aide.
Then things fell apart. As she was dressing for work, she felt it – a lump in her breast.
"I was frightened about the lump, but I was also frightened of the cost of finding it," she says.
Covington does not have health-care insurance because her employers do not offer it to part-time employees, and she can not afford health insurance in the private market with her income. She lives in Carthage with her husband who is 70 and unable to work due to his disability.
Covington, who suffers with asthma and has blood pressure problems, was already a patient at Moore Free Care Clinic, so she called them and was seen by clinic director, Susan Craven, a nurse practitioner.
Craven confirmed the presence of the lump and referred Covington to FirstHealth for follow-up. Then she was sent to Pinehurst Radiology for a mammogram -- the first she'd ever received.
"I just could not afford to have one before," she says.
The result of the mammogram indicated the need for a biopsy, which showed she had malignancy. She had a lumpectomy and several lymph nodes were also removed.
"I can't believe that at 52 they found cancer," she says. "It is the most frightening thing anyone ever said to me."
She has undergone six rounds of chemotherapy and has two more to go, and then she'll get six weeks of radiation. She lost her hair after the first chemotherapy session.
"It just came out in tufts," she says.
But the worst is how she's feels, just very tired all the time. The doctor has ordered her not to work while she undergoes all of her treatments, but she says she plans to get back to work, if she "can get right." She's now covered by Medicaid.
"This really messes you up," she says, "but being out of work is the worst part of it. I don't like sitting at home. I've worked all of my life. I really need to be working, we need the income. But you just try to make it and do the best you can."
Moore Free Care Clinic will begin its fourth year of operations at the end of this month. Covington's story is one of many examples of how the clinic has helped Moore County residents who lack health insurance. Nearly 45 million Americans live without health insurance, according to the clinic.
April 23-27 is national Cover the Uninsured Week.
Desperate to Stay Alive
"I used to drive a lady to her free clinic appointments when I lived in Indiana," says Mary Underwood, 59, of Vass. "I didn't ever think I'd be in the position of needing the services of a free clinic. When I was waiting for her in the car, I'd think, 'I am blessed to have health care insurance and not have to go in there.'"
Then things came apart. In a matter of months her situation changed. Her husband, who was employed as an engineer for over 30 years and just accepted an early retirement, found out that his life's savings were lost due to poor investment advice he'd received from his long-time tax adviser. She was having health problems and struggled to stay on the job and finally quit, losing health insurance, too.
"I had very low self-esteem," says Underwood, who suffers from diabetes and hypertension. "But I needed medical treatment and I needed my mediations. . "I never thought I'd be one of them -- you know -- people in need of a free clinic. I was hurting to even call the clinic.
"When I got to the clinic they treated me with so much respect and kindness. It was apparent they wanted what was best for me – and their care erased all those feelings I had before."
When she moved to Vass last summer, she was confronted with not knowing how to get care or where to get her medications.
Too young for Medicare and not qualified for Medicaid, she did not know how to get the help she needed in North Carolina.
"I didn't know where to start," she says. "I thought I'd try calling the drug companies to see if they would help me, but I knew that wouldn't work."
The medications she takes are among the most expensive for the treatment of diabetes, neuropathy and high blood pressure – and her supply was running critically low.
She found out about Moore Free Care Clinic and called for an appointment.
After her medical exam she was referred to Millie Lopez, the clinic's full-time patient assistance program coordinator.
When Lopez was enrolling Underwood in the patient assistance program, a program offered by the pharmaceutical companies that provides medications at no cost to the patient, she found that Underwood was missing a crucial tax document.
"I'd unknowingly given my original Form 1040 to someone along the way, and I needed it to prove my eligibility," she says. "Millie was determined to get me cleared. She worked on the problem and found a way to get the approvals so I could receive the medicine."
Underwood goes to the clinic for her follow-up exams every six weeks, and she attends a diabetes education program offered by the military.
"My sister has military insurance -- that's gold," she says. "So I go with her to the program – it's a buddy system."
But she gives credit to Moore Free Care Clinic for saving her life.
"They keep me alive. I often think back to last summer when I was so desperate. I think I would have been very sick -- most likely, I would have expired."
Good Care Is a Relief
Brenda Douglas, 62, has diabetic neuropathy – a painful nerve condition that affects the arms, legs, hands, and feet that means she has difficulty sleeping. She also suffers from blood pressure problems and says her hands need surgery, too.
Douglas, who is divorced, lives alone in a trailer on her son's lot in Carthage. She is unemployed and uninsured. "Lord knows when I had health insurance," she says. "It was at least 15 years ago."
Living on $366 a month from her ex-husband's social security, and with help from her son and daughter-in-law, she says that getting preventive exams was not feasible due to the cost.
"I was going to a doctor here and I ran up a big bill. I could hardly pay him, let alone get any special exams done. That's when he referred me to the free clinic."
Registered as a patient at the free clinic two years ago, Douglas received an examination and was enrolled in the patient assistance program so she could receive her insulin as well as several medications from the pharmaceutical companies to keep her diabetes and blood pressure under control.
"I was trying to get my medications, to buy them, but I just could not afford them any longer," she says. Without insurance, or the prescription assistance provided through the clinic, the medicine Brenda has to take every day would cost her $1,419 every 90 days.
"Now I need other treatments and maybe surgery on my hands," she says. "I go in for my follow-up appointments every few weeks. They [the clinic] are trying to get me enrolled into Medicaid so I'll be covered through that program. If it's not successful then I will stay a patient at the clinic until I am ready for Medicare.
"The clinic's been very good to me -- it's a relief to know they are there to help me when I'm not feeling good," she says.
Didn't Know Where to Turn
"I ran out of my blood pressure medicine, and when I called to get it refilled, I found out that my doctor was no longer in practice," says Marie Hill, 54, of Southern Pines.
On top of that, she was also unemployed, and had lost her Medicaid coverage when her daughter turned 18.
"I really had nowhere to turn."
Hill says she found out about Moore Free Care Clinic when it opened nearly four years ago.
"It was an answer for us," she says. "We really did not have anywhere else to go. I registered, was qualified for care and saw a doctor that night. The next day I went back and they gave me some medicine samples and enrolled me so I would get my blood pressure medicine on a regular basis."
Now Hill comes to the clinic once every three months so they can monitor her blood pressure, overall health and refill her medicine.
Her husband of five years, Ronnie, 52, is a self-employed landscaper and is not able to afford health insurance coverage. He developed serious knee problems that require rehabilitation and surgery.
Recently, his knee problem has worsened and he was referred to an orthopaedic specialist who has recommended surgery. He is in rehabilitation now, and they are waiting to see if he will be approved for the surgery that will make him pain-free.
"We are very thankful this clinic is available for us when we've needed the care," she says.
Claudia Watson can be reached firstname.lastname@example.org.