Sharing the season: Community Care Clinic among places where people can get help when needed

Sunday, December 07, 2008 3:00 AM  |  Printer friendly version | E-mail to a friend | By Elizabeth Cook

ecook@salisburypost.com

Franklin Downs of China Grove saw a dentist Wednesday for the first time in 30 years, thanks to the Community Care Clinic of Rowan County.

A friend told him about the Salisbury clinic, where people who qualify can get free medical and dental care.

What would Downs be doing with his toothache if the Community Care Clinic and Dr. Jim Mitchell were not there to help him?

"Probably pulling my teeth myself, like I used to," Downs says.

Downs, 57, is part of a growing stream of people flowing into free clinics like the Community Care Clinic on Mocksville Avenue and the Good Shepherd Clinic on South Fulton Street. Both are nonprofit organizations that rely on donations, grants and volunteers to keep the doors open.

High blood pressure, diabetes and heart disease are among the patients' most common problems, made worse because they have put off getting care. Some have jobs, some do not, but all lack health insurance and cannot afford to pay their own way in the maze of U.S. health care.

As business and industry lay off workers, more people are finding their way to the free clinics.

And not just the recently unemployed.

"A lot of people don't realize," says Connie Antosek at the Community Care Clinic, "we still see some people from Pillowtex."

The textile company put thousands out of work when it closed — five years ago.

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In the past year, the Community Care Clinic has doubled the number of people it can see at its medical and dental clinics, thanks to grants from the Kate B. Reynolds Foundation, the Rowan County United Way and others.

"But the need is still there," says Antosek, who fills the dual role of nurse and executive director.

Between Jan. 1 and Oct. 31 of this year, the Community Care Clinic saw 643 people in its medical clinic and 864 in its dental clinic. Its pharmacy has filled almost 6,000 prescriptions.

And still, the clinic has a waiting list.

"We see the uninsured, low-income adult population of Rowan County," Antosek says. "That number is constantly increasing."

Indeed it is. Rowan County's poverty rate rose from 10.7 percent in 2000 to 15.1 percent in 2005, according to the U.S. Census, and it has continued to rise. With an estimated population of about 136,000, that means some 20,000 people in Rowan are living in poverty.

The Community Care Clinic, with both paid and volunteer staff, is open Monday-Friday, though patients are not seen every day. Residents may call for screening at 704-636-4523.

The clinic's criteria are Rowan County residency, income below 180 percent of the federal poverty level, and a valid Social Security card and drivers license.

The clinic does not treat children — there are other programs for them — or adults on Medicaid or Medicare. It does take clients who are on disability.

Antosek says the clinic asked patients in one survey where they would go for care if the Community Care Clinic closed. Sixty percent said "nowhere."

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Debra Sifford, 55, waiting for her appointment on Wednesday, said she didn't know what she would do without the clinic.

She has diabetes and asthma, she says, and is "about to fall apart."

She worked at Harmony Labs for five years through a temp agency, she says, and is out of work. She has never had health insurance or a family physician.

Her diabetes was diagnosed about three years ago, she says. She got help at the Good Shepherd Clinic and was managing the condition without insulin.

But after moving away briefly, she returned to find her blood sugar had shot up to 575, she says. A normal blood glucose range is in the low to mid 100s.

Now she's on insulin and getting treatment at the Community Care Clinic. Had her diabetes gone untreated, she would have been a prime candidate for heart attack, stroke and a host of other serious problems — problems that might have put her in the hospital.

"It's very important," she says of the clinic. "You have a lot of people out there that needs help and cannot get it."

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The Good Shepherd Clinic, located in the First Ministry Center across from First Baptist Church, has fewer criteria than the Community Care Clinic and will take undocumented immigrants. It sees patients only on Thursday evenings. But in the most important aspects — service to people in need — the two clinics are the same.

Good Shepherd is overwhelmed, "just like any other place that offers indigent care," says Kathy Eagle, who co-directs the clinic with Delores Boone.

Eagle has found people waiting in the parking lot at 12:30 p.m.to go to the clinic, even though the doors open at 4 p.m., and doctors start seeing patients at 6 p.m.

"They just know that they want to be in that line," Eagle says.

The need goes across the board, when it comes to the kind of care people seek, but there's a desperate need for adult dental care for the indigent, she says.

Like the Community Care Clinic, the Good Shepherd offers medical and dental care and has a pharmacy. Services are free.

Arriving at the clinic to find 30 messages on the answering machine is not unusual, she says.

"Health care in this day and time is such a problem," she says. "You can't expect people to go to the doctor and pay $80."

She hopes President-elect Barack Obama will find a solution. "I don't know what the answer is. ... I do know that we definitely need something."

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Dr. Ron Smith, a volunteer physician at the Community Care Clinic, says the patients he sees have the same diseases as people who have insurance and go to the doctor regularly — hypertension, vascular disease, kidney disease and diabetes.

But their symptoms, he says, are "significantly exaggerated." And the patients have limited options.

Without care, he says, the progression of their disease is on a fast track to more dangerous conditions — heart attack, stroke, loss of vision, loss of a limb, dialysis.

The risks are markedly increased, he says. "So's the cost of dealing with them."

Retired recently from Wake Forest University School of Medicine, where he was running clinical research and headed up a review board, Smith has worked in several other states in similar capacities.

"Our support system here in the South is so meager," Smith says. "We have many, many more people falling through the cracks than I've seen in other parts of the country."

While he finds the Community Care Clinic among the best he's worked with, he says its services need to be expanded and coordinated with the other clinic.

People need treatment and education, he says.

One solution to the country's health-care problems is to help people realize they're eating too much and not taking care of themselves, he says.

"The enemy is us."

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Nine out of 10 people who seek care at the Community Care Clinic are eligible, Antosek and assistant director Tisa Thompson say.

The clinic treats their diseases and in the process prevents the need for uncompensated care at Rowan Regional Medical Center.

And the patients are grateful.

The clinic doesn't charge, but a sign in the reception area asks people to make a donation if they can.

"Sometimes they just leave change," Antosek says. Sometimes they'll leave $10. One man shocked everyone by leaving a $100 bill and a note — "Thank you so much."

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The Good Shepherd Clinic also provides services free and occasionally receives a donation in thanks.

Eagle says one woman sent a check for $37.50 — an odd figure, maybe that's what she had to spare. She included a note saying she'd never been able to give before, while she was a patient.

Eagle worked as a nurse in a family practice for 21 years and has been with the Good Shepherd Clinic since its inception 14 years ago. She loves it.

People need care, Eagle says — not just health care, but also a sense that someone will give them attention and act as their advocate.

"It's such a needed service," she says, "that you get so much more from it than you ever give."