Closing of clinic elicits rainbow of emotions

The pale white walls and beige cloth desk chair pretty much sum up the decor of the medical director’s office at the Shared Care Free Clinic of Jackson County in Independence.

Yet just inside the doorway, underneath a seat for visitors, sit two bundles of fluorescently colored socks. The director, Dr. Bridget McCandless, keeps the ankle-highs there because some people come in sockless.

For patients like Andrea Squires, 44, of Grandview, McCandless epitomizes the type of care provided at the clinic, which is scheduled to close in July after nearly a decade and a half of caring for uninsured adults with chronic diseases.

“She cares for your health, your well-being and your whole everything,” said Squires, who clinic staff is transitioning to Truman Medical Centers, one of three area safety-net providers that will be absorbing patients from the clinic, located at 17611 E. U.S. 24 Highway.

Two jobs

McCandless has been medical director from the beginning, and she has been pulling double duty since the fall, when she took over as CEO of the Health Care Foundation (HCF) of Greater Kansas City. (HCF is a major underwriter of health coverage at The Hale Center.)

Board members Jonathan Zerr, who is president, and Nancy Lewis said the departure of McCandless did not drive the decision to close the clinic. They said the board had been contemplating the future of the clinic for about a year before the foundation hired McCandless.

Health care reform, they said, was the biggest factor in the decision to close the clinic.
Some of the clinic’s patients have obtained health insurance through the Affordable Care Act, they said.

And, if Missouri ever expands eligibility for Medicaid, which is also encouraged through the ACA, they said another portion of the clinic’s patient base would have health coverage.

Founders established what was then known as the Jackson County Free Health Clinic in April 2000. The clinic adopted its current name four years ago, according to its website, to better reflect its partnerships with patients, providers and community supporters.

In-kind help

The clinic began as an initiative of the Truman Heartland Community Foundation after a needs assessment in eastern Jackson County highlighted a gap in available care for low-income patients with expensive chronic illnesses.

Before it stopped accepting newcomers in August, McCandless said the clinic had about 650 patients.

It has an annual operating budget of about $233,000. But, McCandless said, it received more than $1 million a year in in-kind services, including lab work, imaging and vision care. Physicians and other staff also volunteer their time.

In addition, McCandless said, during its history, the clinic has secured about $8.5 million in free medications through patient-assistance programs run by pharmaceutical companies.

“I think that they saw a need at that time it started, and it was the right thing at the right time to fill that need, and it has been, it has continued to be,” Lewis said. “I don’t think it was ever intended to be a long-term solution.”

The clinic has a number of providers that have volunteered since the beginning. A few were working Tuesday evening: Dr. Gay Purcell, an internal medicine physician in Independence; Vera Doutt, a retired medical technologist; and Dalene Myers, a retired nurse.

Sadness

Purcell said she loved the togetherness of the volunteers, saying the core group she has worked with on the fourth Tuesday of the month has remained largely intact.

“It is just that everyone works as a team to provide continuity to these patients who otherwise would slip through the cracks,” she said.

Purcell said it was also nice to know the clinic was there as a resource for some of her private-practice patients if they lost a job with insurance.

Myers said she knows patients are transitioning to other providers, but she doubted they would find an environment like the one at the clinic. “They can’t replace this,” she said.

Doutt said it’s going to be odd not heading off to the clinic for her appointed shift. “This will leave an empty spot for a while,” she said.

The clinic has been a godsend for Squires, the patient from Grandview. She moved here a few years ago from Illinois so she could care for her husband’s mother, who has since died.

As a diabetic, she gets free insulin from the clinic. Without insurance, she said, that might cost as much as $900 a month.

Squires said she and other patients were initially scared about what they would do after the clinic closed. But staff has made it a smooth transition, she said.

“They have never made you think they are not going to find a solution for you before it is all said and done,” she said.

Major Funding for Health coverage on KCPT provided by Assurant Employee Benefits and the Health Care Foundation of Greater Kansas City.