Faith-based health care provides benefits for unemployed

For the millions of Americans who have lost their jobs, seen their insurance benefits trimmed or both during the recession, basic health care costs have become a major issue. Options for people to still receive the medical care they need exist, but often tapping into resources such as discounted or free clinics are difficult for people who have always relied on employer-based health care. Among this menu of options are Christian faith-based clinics which may provide everything from dental exams to basic primary care needs. Four Indianapolis area faith-based clinics discussed what they’ve seen during the recession with Everyday Christian. One constant is increased traffic and patients running a gamut of emotions over being thrust into unfamiliar territory. “They had no idea how much their insurance was paying,” Margaret Charnoski said. “Their medicines are more expensive than they thought and were amazed when their primary care physician said they had to pay up front.” Charnoski is the executive director of Trinity Free Clinic in Carmel, Ind. The Indianapolis suburb is most identified as a hub of upper income Hoosiers and pricey real estate, but Charnoski and her staff sees a much a different side of suburban life. “The cost for a well-baby check runs about $280, an office visit alone could run $100, these people are caught off guard,” Charnoski explained. “They are unaware of clinics like ours, or those with sliding fees. Many are dealing with many different emotions — embarrassment, anger, resentment, and sometimes have just given up. “One woman who called asked about a hygiene appointment, she has never missed her 6-month cleaning and her mouth is spotless. She was flabbergasted that we serve those who have acute conditions.” The clinic, located on the campus of a Catholic church opened in October 2000 with acute care on the third Saturday of the month. Since 2007, Trinity has added an additional monthly women’s clinic, and two additional acute clinics to help with the overflow. The clinic saw 400 more patients in ’09 than it did in ’07. “Aside from acute medical care our dental services by far, we are the only dental clinic in this county and there are only a few in Marion County (where Indianapolis is located) who will see outpatients,” she said. “Our women’s clinics are also popular and can account for the fact that 60 percent of all patients are women. We are the only eye clinic in the county and we see about 20 patients a month but we turn away from 5 to 10 patients at each clinic. “We wish we had more resources. Turning away people is the hardest thing we do.” Good Samaritan Health Clinic on the east side of Indianapolis is an extension of Good News Ministries, which also operates homeless shelters and youth camps in the same neighborhood. Executive Director Dan Evans said that volunteer hours have remained even while the amount of people the clinic serves has ballooned. In 2009 Good Samaritan saw just over 1,000 new patients. Evans said that accounted for a staggering 55 percent of their overall client base, many of whom were recently unemployed. And although early in 2010, comparing the number of patients this January compared to last year points to another steep increase. It is difficult for people accustomed to only having regular health insurance through an employer to understand the complexities of accessing care for the unemployed, Evans said. He described a fragmented system than can lead to uneven care of patient needs. “First of all when you do not have health insurance you cannot get assistance always when you need it,” he explained. “Obstacles include lack of resources to pay minimal co-pays, lack of knowledge of where to go for medical care and long delays to get an appointment. Many of these patients remain untreated for extended periods of time until their condition gets to the point that requires urgent care. Even for those patients who are trying to take good care of themselves, keeping all the appointments and taking medicines properly, it is hard when they are dealing with a chronic disease. They don’t always have the ability to see their doctors frequently.” What often results, he said, is patchwork care from different sources that aren’t able to piece together a complete picture of patient history. “Those that are assisted by the county indigent program, Wishard Advantage, get to see their doctors probably twice a year and it is very easy to get lost in the system,” he said. “If they get sick between visits they probably will end up in the emergency room or in free clinics like ours where the doctors do not have the medical history of the patient. Without the whole picture of the patient, the continuity in the treatment sometimes is missing. The same patient can be seen by more than five different doctors in one year and have a portion of his medical history in five different facilities. Many of the insured patients use the emergency room as a doctor’s office.” Kingsway Community Care Center in Avon, bordering the city’s west side, has been serving low-income residents with scaled-down fees for six years. Executive director John Mollaun said that for people without regular access to health care, taking care of themselves often becomes a low priority compared to the needs of family and having a roof over their heads. He said dental care and extractions are their most popular services sought from the all-volunteer staff and dealing with chronic diseases such as high blood pressure and asthma. “The patients tend to put off any treatment, or fail to take the necessary medication that they know they need,” Mollaun said. “Often the choices are food, rent or health care. Health care is the one they skip. One month becomes two, then things get serious medically (blood pressure skyrockets, blood sugar levels are in the dangerous category.) Desperation sets in where they don’t know where to turn.” Shepherd Community Center on the city’s east side has been in existence for nearly three years and in that short period of time has doubled from two to four the number of Saturday clinics it has each month. Program director Andrew Green explained that for many patients their difficulty of navigating the current system is the largest barrier. “It seems that many people believe that there are plenty of options for health care for those in poverty, which in some respects is true,” he said. “However, it is often about access to those resources and institutional knowledge of how to navigate health care systems that are the true barriers for those in poverty.” Those barriers are compounded by the notion that preventative care – which is constantly advocated as the best strategy to remain healthy – is not an option for many patients. “Our neighbors in poverty tend to live from one crisis to the next in a cycle we sometimes refer to as the tyranny of the moment,” Green said. “Therefore, decisions about health care also tend to be centered around the immediate need. If a health problem can be ignored, it will be, until it becomes more of an emergency. That makes the idea of preventative care basically non-existent.” A faith-based approach to care is a binding element to these centers and similar facilities around the country. Evans said he said it would be difficult to deal with the circumstances he and his staff sees without having a Christian perspective. “In order to serve this kind of population it is vital to have a close relationship with Jesus Christ. That is where all the ability to serve comes from,” he said. “Compassion, endurance when the level of frustration is intolerable, love and proper response toward the patients, only can come from God. It is also vital when we work with people with tremendous spiritual and emotional problems that affect their whole life and physical health. “I don’t think this ministry could function without dedicated and prayerful Christians involved.” Charnoski agreed a sense of spiritual awareness was evident. “Regardless of your beliefs you know that a higher power is making things happen that are outside the normal,” she said. “There was the time we had a recent immigrant from Russia who didn’t speak any English appear at the front counter. What are the odds we would have clerk who spent time in Russia, not only that, but she spent that time in the same community this patient was from? “We have many little stories like that where we know He watches over us and our patients. Our patients are not aware that we are Christian other then we are on the campus of a Catholic Church. We have a few icons in the clinic, but not many, so I am not sure how much our patients know. We treat all our patients with respect and dignity as well as with each other.” “It is difficult to say how many neighbors are drawn to Shepherd because of our Christian background, but I would estimate that it may be about half,” Green added. “For those who may not be initially drawn because of that, I believe they often stay because they see the love of Christ in action. Our mission is driven by the fact that we desire to be the hands and feet of Christ to our neighborhood. We pray that God will continue to give us the opportunities to serve Him and that our neighbors will understand what drives our service.” Opinions were mixed on the impact of possible health care legislation coming out of Congress. Plans for the overhaul are being re-evaluated by Democrats who lost their filibuster-proof majority in the Senate this week with the upset win by Republican Scott Brown in the Massachusetts special election to replace the late Ted Kennedy. “The pluses (of the legislation) are that some of the problems with our health care system have been identified, and there are problems,” Mollaun said. “The minuses are that I do not see anywhere in the U.S. Constitution nor the Bible where health care is to be provided by the federal government.” Charnoski added, “My primary concern with the health care is that those who are unemployed have no money. They never thought they would be without a job for this long. They will not be able to afford the ‘insurance’ package, therefore they will be fined; again they have no money. Others have their retirement still but without employment they will need to cut into that. There needs to be some package for those without the resources to pay and still be able to get coverage. There will always be immigrants and those who chose not to sign up for insurance. “The pluses are for those who have been dropped from their plans will no longer be able to be dropped. Those who are not in a big group will be able to get affordable insurance, something they cannot get today, especially those with pre-existing conditions.” Links: Trinity Free Clinic: Good Samaritan Health Clinic: Kingsway Community Care Center: Shepherd Community Center:

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