The Montgomery County Free Clinic Fund
This fund was established to endow the ongoing operations of the Montgomery County Free Clinic. Our goal is to reach $1,000,000 for endowment. At a yield of 4%, this endowment once achieved would provide the clinic with $40,000 per year operating funds. We are pleased that this is now a regular fund at MCCF.
What is the impact of the Supreme Court Decision regarding the Patient Protection and Affordable Health Care Act (ACA) on the free clinic?
The Board of Directors of Montgomery County Free Clinic, Inc. believes that the Dr. Mary Ludwig Clinic will be needed indefinitely to continue to care for those who remain uninsured, who fall through the cracks or are unable to afford services not covered by their insurance (see http://bit.ly/PQNssv). We base this belief on the following:
- The Supreme Court affirmed the constitutionality of the Patient Protection and Affordable Care Act (ACA) but gave states the option of not extending Medicaid to cover the uninsured (see http://bit.ly/PQQGfy). Since the Indiana legislative leadership believes that ACA is too big a burden for Indiana taxpayers to bear, it seems unlikely that Indiana will extend coverage to those not covered by Medicaid (see http://bit.ly/PQNv7B).
- Those currently uninsured may find that the options available through the State Health Insurance Exchange, which is yet to be developed, are unaffordable and the penalties, if applicable, are lower than the cost of insurance.
- Should Medicaid be extended to greater numbers of those now uninsured, the number of doctors and nurse practitioners available to treat them in Montgomery County will be insufficient to meet the need (see http://bit.ly/PQNxwj).
- Since the ACA does not cover dental care, the Montgomery County Free Clinic will provide basic dental care for the uninsured.
- The Montgomery County Free Clinic will continue to collaborate with local school systems and with the Montgomery County Health Department to provide immunizations.
- The Montgomery County Free Clinic will provide health education — smoking cessation, diabetes counseling, hypertension management, women’s health issues, etc.
- The Montgomery County Free Clinic will continue to support and operate Meals-on-Wheels in collaboration with Franciscan Alliance St. Elizabeth — Crawfordsville.
- The Montgomery County Free Clinic will continue the mission of Christian Nursing Service to care for our neighbors, to be a “Matthew 25 solution” (See http://bit.ly/PQOnsZ).
Why does Montgomery County need a free clinic? Who will it serve?
About 4,100 adults (ages 19-64) in Montgomery County lack insurance and as a result do not receive proper medical care. These individuals are not eligible for Medicaid and have incomes less than 200% of the federal poverty guidelines - $44,700 for a family of four. Most of these residents are employed; however, unless their employer provides insurance, medical insurance is prohibitively expensive. (http://www.countyhealthrankings.org/node/894/3),
Forty-two percent (2,680) of the 6,240 students in Montgomery County qualify for free or reduced-cost lunch. For a family of four this is an income below $41,348 a year. While some of these children may be covered by Children’s Health Insurance Program (CHIP). The clinic also will serve as a primary immunization site in the county.
The clinic will not serve those who are covered by Medicaid. The St. Clare Neighborhood Clinic, operated by Franciscan St. Elizabeth Health – Crawfordsville will continue to serve Medicaid patients.
Where do the uninsured get care now?
The uninsured are the hidden population. Most of them do not seek medical or dental care unless it is an emergency. Then, they appear in the emergency room. Some of them do come to Christian Nursing Service’s (CNS) Adult Clinic or the Well Baby Clinic, but since CNS has neither physician nor nurse practitioner, they receive minimal care. For these individuals, there is no preventive care and little or no follow-up care.
How will you decide who gets care and who does not get care?
New patients will be interviewed to determine (1) if they are residents of Montgomery County; (2) if they are not eligible for Medicaid; and (3) if their income is less than 200% of the federal poverty guidelines.
Doesn’t the Well Baby Clinic and the Adult Clinic of CNS already serve these clients?
Yes, but with severe limitations. Since November 2007, CNS has had neither a physician nor a nurse practitioner. Today, the CNS facility serves primarily as a vaccination center for children. Adults, with only minor problems, are treated and CNS attempts to link them with other physicians. CNS does not provide dental care. For the patient, there is no continuity of care and no medical home.
The current facility for the CNS clinic at Milligan Memorial Presbyterian Church has served this population admirably for more than forty years; however, today this facility is inadequate for the clinic. In addition to space issues, the current facility provides insufficient privacy, poor temperature control, and is difficult to access.
Where will the clinic be located?
We purchased the former MainSource Financial Group Branch Bank located on 816 South Mill Street at the northeast corner of Mill St. and Elmore St. It is just a few houses south of the Milligan Memorial Church, site of the current CNS Well-Baby and Adult Clinics. We soon will begin to transform it into the Dr. Mary Ludwig Free Clinic. The building will be expanded from 3,796 square feet to 5,631 square feet. Click HERE to download the site and floor plans for the new clinic.
What services will be offered?
As uninsured patients experience the “culture of caring” that our clinic offers, we anticipate that more of these patients will come to our clinic rather than to the hospital emergency room. Those uninsured who do enter the hospital will now have a medical home to provide follow-up care when they leave the hospital.
For the uninsured, dental care is a luxury. The Christian Nursing Service (CNS) can only send children and adults to dentists for extractions. We have planned for a dental facility that will enable volunteer dentists to provide examinations and prophylaxis to children and adults. We also plan to provide restorations and periodontal care, which will help to improve patients’ overall health. When combined with dental education, this should reduce the incidence of tooth loss. We also plan to offer simple oral surgery when necessary.
This clinic will become the center for the administration of child and adult immunizations in the community. Working with the Montgomery County Health Department and the local school districts, CNS already administers the majority of immunizations in Montgomery County. This facility will make that process more efficient and accessible.
This facility will become a place where individuals can seek help in addressing chronic problems. Health education will be an important part of this facility. Our plans include a multi-purpose space where health professionals, community members and patients can gather for workshops and other health activities.
Who will run the clinic?
We have structured a collaborative effort between physicians, nurses, dentists, Franciscan St. Elizabeth Health-Crawfordsville, the Montgomery County Health Department, the Crawfordsville Community School Corporation and other organizations within the community. Seeing the successes of clinics in Columbus and Bloomington, we also forged a relationship with the national organization, Volunteers in Medicine. We are a not-for-profit 501(c)(3) organization.
We will manage the new clinic. We anticipate that we will employ a nurse practitioner and a nurse manager. All of the physicians, dentists and other healthcare professionals will be volunteers. We anticipate that many of those who volunteered for the CNS clinic will continue their service as greeters, receptionists and assistants in the new clinic.
CNS’s Meals on Wheels also will be administered from this facility.
What about the hospital?
Franciscan Alliance St Elizabeth Health has agreed to provide up to $100,000 of support services to patients of the Dr. Mary Ludwig Free Clinic. Also, they will provide access to the Electronic Medical Record (EMR) software.
We will provide follow-up care for uninsured patients admitted to the hospital or who have visited the ER.
Franciscan Alliance St. Elizabeth Health – Crawfordsville will continue to operate the St. Clare Neighborhood Clinic for treatment of Medicaid patients.
What happens to Christian Nursing Service?
Our logo contains the phrase, Christian Nursing Service Moving Forward. We continue the Christian mission of CNS of providing care to those in need whatever their faith or their belief. When the Dr. Mary Ludwig Free Clinic opens, the CNS Adult and Well-Baby Clinics will close.
How will you pay for it?
We need to raise $300,000 to obtain $900,000 from North Central Health Services of Lafayette (NCHS). The resulting $1.2 million will be used to purchase and transform the MainSource Financial Group Bank at 816 South Mill St. to the Dr. Mary Ludwig Clinic.
We will need to raise about $175,000 each year for operation of the facility. Currently, operating at a minimal level, CNS has a budget of about $75,000.
We also are seeking $1 million dollars for the Montgomery County Free Clinic Endowment Fund, to support responsibly the ongoing costs of the facility.
What is the impact of the Affordable Care Act?
The recent passage of the historic health care reform legislation will provide relief to some of the uninsured; however, community safety-net clinics will be necessary for many years to come. The escalating cost of health insurance and medical ca re, cutbacks in Medicaid and a decrease in the number of physicians choosing primary care are just a few of the factors that contribute to the growing need for additional VIM clinics (see http://www.volunteersinmedicine.org/challenge.shtml).