Many West Virginia residents just can't afford health insurance, but still need medical care.
Thanks to the West Virginia Association of Free Clinics, poor underinsured or uninsured people across the state can access quality medical and dental care for free. However, the 10 clinics are facing budget concerns as health care costs continue to rise.
According to Patricia White, executive director of West Virginia Health Right in Charleston, the Association of Free Clinics was asked to cut its $4.7 million budget by 7.5 percent, as were other state agencies. That amounts to a reduction of about $350,000.
"We're hoping to get that money restored," White told the House of Delegates Health Committee during its Feb. 18 meeting.
The free clinics don't depend solely upon state money, she pointed out, but it does help. Free clinics are mostly supported by the community, and pharmaceutical companies donate medicine to the WVRX program. White said the free clinics represent a good return on investment.
"We do care for folks," she said. "Every dollar we get, we're able to generate $30 worth of health care services."
WVRX is a statewide, charitable pharmacy program that allows the underinsured or uninsured to access prescriptions for free. The state has put about $500,000 into the program since its inception a few years ago. But because of Gov. Earl Ray Tomblin's mandated budget cuts, the program may be in jeopardy.
"We have not been able to find … the WVRX program, which is the charitable program, we cannot find in the governor's line item," White told the committee. "That program it appears has not been funded … Former Gov. (Joe) Manchin, now Sen. Manchin, was the one to approach the program to take the program on."
Although the program provides free prescriptions, there are overhead costs, White pointed out. The prescriptions must be checked before they leave the pharmacy. Because so many West Virginians are living with diabetes, insulin is one of the most common drugs the pharmacy supplies. But insulin packaging is "pretty tricky," White said. The program also is subject to audits.
Free clinics throughout the state are strongly supported by the local hospitals, White said.
"It is far cheaper for us to see a patient in a free clinic setting than it is for that patient to go to the hospital," she said.
The free clinics work directly with hospitals, social workers and the Department of Health and Human Resources, who provide most of the referrals to the WVRX program. White said no money is spent on advertising.
"DHHR knows exactly where we are. The social workers and all of the hospitals know where we are. The churches know where we are," she told the committee. "Our outreach is more a grassroots effort and not advertising."
Staff at the free clinics work on a mostly volunteer basis. White said most of the clinics are located near larger population centers so the clinics can recruit volunteers from the community. However, a staff shortage means the clinics often have to turn away patients.
"The clinic operates on a finite budget," she said. "We obviously are able to leverage additional dollars that come in and we're able to bring in additional volunteers to the clinic, but we have a finite number of staff there. You can only provide so many services with so many staff."
Most of the time, dental patients are not turned away because their ailments typically cannot be treated in a hospital. But as with any other doctor's office, time is limited.
"It's like any doctor's office," White said. "When you fill up your schedule, the schedule is full. You can try to squeeze somebody in here and there, and the clinics are known to do that."
Delegate Clif Moore, D-McDowell, represents a large portion of West Virginia's poor population. He said he refers many of his constituents to the free clinics and has seen positive results.
"I love what you guys do and I'm voting to give you guys more money," he told White during the meeting.
White said the program always has been viewed as a public-private partnership, with the state making up the public side of the equation.
"The health care system is very complex and it's very focused on money," she said. "We try to make the health care system really work on behalf of the patients. A dead end is not something we understand."