It could have been your basic health care nightmare.
In January 2009, Charles Meadows began having seizures. The diagnosis? Diabetes — a condition that requires constant management and can cause a host of medical complications.
The diagnosis was bad enough. The bigger problem was that Meadows and his wife, Robin, didn’t have health insurance. They, like millions of other Americans, made too much to qualify for Medicaid and other forms of government assistance, but too little to pay the hefty insurance premiums leveled on men and women in their 50s.
Again, it could have been your basic health care nightmare. But it wasn’t, thanks to the Catholic Charities Free Health Care Center in the Diocese of Pittsburgh.
Just a few short months before Meadows’ seizures began, he and his wife had become patients at the center. There, he’s been able to receive all the ongoing care he needs — from endocrinology to podiatry — free of charge.
Wide range of services
Pittsburgh’s Free Health Care Center is the only free Catholic Charities clinic in the country, offering a wide range of medical and dental services at no cost to people like the Meadows — low- and moderate-income individuals who fall in between the cracks of the current health care system.
Dr. Ed Kelly, who helped found the center in 2007 and now serves as its volunteer medical director, jokes that when people hear about the clinic they envision “a couple of bombed out rooms in a church basement.” But that could not be further from the truth.
The Free Health Care Center occupies three floors of Catholic Charities’ downtown Pittsburgh headquarters. From the spacious waiting room to the conference room and examination rooms, almost nothing visibly distinguishes the office from the suites of doctors in private practice.
What you won’t find in most private offices, however, is the wide range of services the center offers.
There, specialists provide care in everything from cardiology to ophthalmology. Any service provided in a primary care office is provided at the center, and any screening that can be performed in a specialist’s office can likewise be performed there.
What can’t be done on site free of charge is done at Pittsburgh area hospitals. And, with the help of the center, patients obtain free care there as well. Volunteers and staff walk them through the process of applying for what’s known as “charity care” — something every hospital provides but that many people don’t know about.
“Two weeks ago, a young man came in with back problems,” said Dr. Kelly. “Everything that could be done had been done, and it was clear he needed surgery. In six days he had it.”
Low overhead costs
No patient who comes to the Free Health Care Center walks away without receiving the care or the help he or she needs. Which is exactly what the Diocese of Pittsburgh and Catholic Charities envisioned when they opened the health center in 2007.
The idea for the Free Health Care Center began in 2005. It took two years, a lot of fundraising and two very generous grants from the commonwealth of Pennsylvania to turn the idea into a reality. When the offices first opened, patients could only come on three half days a week. The demand for its services, as well as the number of volunteers, grew so rapidly, however, that the center — which sees only preapproved patients by appointment only — is now open five full days a week and two nights a month. Since it opened in November 2007, more than 11,000 people have received care. And all that’s happened with an annual operating budget of only $800,000.
“Just to walk through most emergency room doors, it costs $550 per patient to provide care,” said Sister of Charity Carole Blazina, clinical director. “Here, at most it costs $150.”
The No. 1 ingredient for keeping those costs so low are the 150 volunteers who make the center run. Only six positions — an administrator, the clinical director, office manager, volunteer coordinator, dental manager and dental assistant — are paid. The rest — every doctor, nurse, receptionist and dentist — are volunteers. That list of volunteers also includes a faculty member, internist and students from Duquesne University’s Mylan School of Pharmacy, who are on hand daily to help patients with medication management.
According to Sister Carole, the center receives in-kind donations totaling more than $1.2 million in volunteer services and supplies every year. Many of the doctors who volunteer are retired, but the majority of specialists still maintain their own practice. Most of the specialists who volunteer bring their own equipment. Other retiring doctors have donated the more expensive equipment that fills the exam rooms.
Surprisingly, attracting those volunteers hasn’t been hard.
“People call us,” said Kelly. “Once word got out, they would come down, check us out, and as soon as they saw what we have going, they signed up.”
“People want to do good,” he added. “They just need to be given the opportunity.”
Another key ingredient in keeping the budget so low is that the center never charges anyone for its services. All care, all the time, is free. In practical terms, that means two things.
First, it means there is no medical billing. Because they don’t charge, no one has to submit reimbursement forms to health insurance companies. Accordingly, said Sister Carole, “we don’t have to pay coders, billing agents and all those people.”
Second, it means that all volunteers are covered by the Federal Tort Claims Act of 1994 and don’t have to pay for medical malpractice insurance. Those still in practice must maintain their coverage for the work they do in their own offices, but everyone, when they’re working on-site at the clinic, is free from liability. If a patient ever wants to sue, they have to sue the federal government, not the volunteers.
The Free Health Care Center receives no federal assistance. Rather, its $800,000 budget — which primarily covers salaries, lab fees, prescription assistance, rent and basic medical supplies — is funded by private donations. Occasionally, some donations even come from former patients.
“Those aren’t usually large donations, but they’re significant,” said Sister Carole. “They get a special thank-you note.”
The center has been such an overwhelming success, in part, because of its low operating costs. Also, Kelly pointed out, it helps that it’s centrally located and right across the street from a Pittsburgh subway station. It likewise leases 12 parking spaces so volunteers don’t have to pay for parking downtown.
Health care ministry
But practical considerations aside, what really makes the center work is the attitude that underlies everything that takes place there.
“We believe that the caring nature of health care is just as important as the quality of medical care,” explained Sister Carole. “So doctors get to take their time with patients here. They don’t have someone standing over their shoulder telling them they need to move on. If a doctor wants to schedule 30 minutes with a patient, he can have it here. The doctors love that.”
So do the patients.
“Everyone is so friendly,” said Robin Meadows. “Everybody knows who we are. Everybody calls us by name. It’s not like the normal visit to your doctor. They take the time to listen to you and to explain what’s going on and walk you through what you need to do. It’s been such a blessing.”
Even more fundamental to the center’s success is the attitude that led to its creation, an attitude that looks back to how the Church used to approach the problems of sickness and disease among the poor.
“From the earliest days of the Church, it was the Church who took care of people, who founded hospitals and took in the sick,” explained Sister Carole.
“Health care isn’t simply the government’s problem,” she concluded. “It’s the people’s problem. And the people belong to the Church. All those who come here are God’s people. And all the volunteers who serve here, whether they’re Catholic or Jewish or Hindu, are God’s people too. They’re giving back the gifts they’ve been given. It’s the perfect blend of health care and ministry. This is what we’re supposed to do.”
Emily Stimpson is an OSV contributing editor.
Primary, specialty services (sidebar)
At the Catholic Charities Free Health Care Center, working, low- or moderate-income individuals who do not have employer-covered health insurance, cannot afford private insurance and do not qualify for Medicaid or other assistance receive the following services free of charge*:
Primary care services: chronic disease management; health education; medical screening; medication therapy management.
Specialty services: cardiology; dermatology; endocrinology; gynecology; ophthalmology; orthopedics; physical therapy; podiatry; psychiatry and mental health services; rheumatology; urology; ear, nose, and throat.
Dental services: Exams; X-rays; cleanings; fillings and extractions; periodontal treatment.
Through an arrangement with one of the local grocery store chains, patients receive their medication prescriptions for a mere $4 a month. When inexpensive generics aren’t available, the health center works with pharmaceutical companies to get their patients the medication they need for free through the Pharmaceutical Assistance Program.
*All patients are seen by appointment only and must be preapproved for meeting all the necessary income and age restrictions.