Nancy McAvoy and her husband, Tom, have never made much money — not 20 years ago when he worked as concrete finisher and they had their first of six children, and not more recently when an injury took him out of the workforce. Worker's compensation meant the couple makes too much to qualify for many forms of medical assistance but not enough to pay for Nancy's chronic medical conditions.
She might not be here today were it not for Mission of Mercy, a 21-year-old, faith-based nonprofit that provides free health care to those in need in Maryland and Pennsylvania.
"It's been a godsend. If it [wasn't] for Mission of Mercy, I would really be in bad shape. I'm in bad shape now, but I would be in really, really bad shape," she said. "I have high blood pressure. I have heart problems. I have arthritis. I come every month. … Sometimes my blood pressure is really, really high .... but here they regulate it. Thank God."
Nancy was one of more than 50 people who arrived at Trinity Evangelical Lutheran Church in Taneytown at 8 a.m. Wednesday, Feb. 11, for a medical appointment in Mission of Mercy's brand-new Mobile Medical Unit, a recreational vehicle fitted with three examination rooms and a full pharmacy.
"We see the need for health care that's both affordable and accessible across all of the communities we serve. … A mobile clinic also allows us to serve six communities with one to two clinic days a month," said Mission of Mercy Executive Director Jennifer Charlton. "We provide the continuity of care that keeps these people out of expensive emergency departments."
Mission of Mercy has served the area — including Brunswick, Frederick and Reisterstown, and Gettysburg, and Harrisburg in Pennsylvania — on a monthly basis with a mobile clinic since 1995, according to Charlton.
The Mobile Medical Unit that Nancy stepped into Wednesday, however, was brand-new, a much-needed replacement for the older unit.
"We are looking at if there is an opportunity to expand our services here in Taneytown. We can add a second day here and we can take on more patients," she said. "There are many chronically ill people in the Taneytown area that if they knew we were there, that we would accept them. It is no longer the case that they have to be uninsured to access care. I think changing that message to the community will make a difference."
The Taneytown clinic site could handle more patients right now, and Charlton said those in need should call 301-631-2670, ext.110, and make an appointment. The clinic schedule is available online at amissionofmercy.org and there are no fees or co-pays for those who are accepted.
"It's completely free. We will never ask anyone their need. If you show up, if we can care for you, we will do so," Charlton said. "You can't restore someone's dignity while you're asking them to prove their poverty. It just doesn't work."
The new Mobile Medical Unit has three sliding sections that expand from the center of the vehicle, compared with a single slider on the older unit. This alone will make it possible to see more patients, according to Dr. Michael Sullivan, Mission of Mercy's chief medical director.
"It's a tremendous difference in space and hopefully it will also be attractive to volunteers, especially volunteer practitioners," he said.
Medical and dental professionals who volunteer their time, as well as hospitals that donate X-rays, MRIs and complex blood panels, are essential to keeping Mission of Mercy going, according to Sullivan. Dentists and oral surgeons are a near-constant need for dental services, but he said there is also a need for other practitioners on a less intensive volunteer basis.
"What we probably need more than anything is … different specialists in private practice that might see one or two patients a month," Sullivan said. "Things like a chiropractor, podiatrist, dermatologist, a cardiologist that could do stress tests in his office."
To Sullivan's list, Charlton would add a physical therapist. Many of Mission of Mercy's patients are longtime physical laborers who worked hard and whose bodies show the associated wear and tear.
"If you are a physical therapist that can give us one day a month, we would love to hear from you," she said.
In addition to serving more patients with the new Mobile Medical Unit and potentially adding a second clinic day in Taneytown each month to reach even more, Sullivan said that what Mission of Mercy would really like to do is add a second vehicle, a dedicated mobile dental van.
"If we get the dental van, that would certainly allow us to expand our dental services as we would have two dentists working in a fixed space," he said. "We wouldn't have to waste an hour and half setting up and breaking down dental every day. That's time that could be spent taking care of the patients."
Mary Ann Turner arrives at the church as early as 5 to 6 a.m. on mobile clinic days. A member of Trinity Evangelical Lutheran and a retired nurse who is passionate about providing health care to those in need, Turner is the on-site coordinator for Mission of Mercy, and she arrives early because prospective dental patients arrive early too, and she has the key to the building.
"Some of them get into our church parking lot at 4 to 4:30 a.m., since dental is first come, first served," she said. "That's why I try to get there really early to let them in, especially in this weather when many of them don't have the money to spend for the gas to sit in their car."
Many dental patients, along with many medical patients, wind up sitting at the church for much of the day, and Turner and a group of residents from Carroll Vista Community provide coffee, water and lunch for those patients. It's all volunteer-based, and the funds for the food items come out of their own pockets.
A second clinic day and a mobile dental van would mean more patients and more work, but Turner said that it's work she is excited to support.
"Everybody that has jumped on this bandwagon has gotten extremely passionate about this. I have been passionate about this from the start," she said. "The need is there. The need is desperately there."
The need is not only there, but increasing, according to both Sullivan and Charlton. With the passage of the Affordable Care Act, many of Mission of Mercy's patients got health insurance for the first time and left to find primary care doctors on their own, only to find they could not actually afford to see their new doctor.
"The deductibles were too high, so that they were essentially uninsured," Sullivan said. "If you have a $4,000 to $5,000 deductible, most people, unless they are hospitalized, are not going to spend that much. So basically everything is out of pocket and they can't afford it."
In other instances, according to Sullivan, former Mission of Mercy patients went to primary care doctors who refused to prescribe any controlled medications, anxiety medications like Valium or pain medications such as Vicodin.
"They'll say, 'I'll take care of your heart disease and your diabetes, but I will not prescribe any anxiety medicines. I will not prescribe any pain medications, regardless of if you're broken up from being hit by a cement truck,' " Sullivan said. "They make the decision they will not prescribe any pain medications because they don't want the hassle, the inconvenience. That's a huge problem."
Mission of Mercy verifies that patients have valid medical reasons for taking controlled medications by examining their medical records, and checking and reporting to Maryland's electronic Prescription Drug Monitoring Program, according to Sullivan, making an individual decision about each patient rather than categorically refusing to prescribe controlled medications. The result, he said, is that many former patients are coming back to Mission of Mercy.
"That is making things much more difficult and it's, in a way, crowding out people that have nothing, people that have no insurance," Sullivan said. "We're having to adjust to that because people find themselves in hopeless situations and then we do what we can."
That's not to say he is hopeless. Sullivan is optimistic that Mission of Mercy will be able to continue to expand its coverage as well as handle returning patients, if just because there's more to care than stethoscopes and prescription pads.
"All I can say to wrap it all up is the fact that our product is love. Medical care is just one of the tools we use to deliver that love," he said. "I think the people that come here realize that, yes, we are trying to take care of the health need, but there is something else going on here. Something intangible."
Reach staff writer Jon Kelvey at 410-857-3317 or firstname.lastname@example.org.
For more information about Mission of Mercy, to donate to its capital campaign or to volunteer time or expertise, call 301-682-5683 or go to aMissionofMercy.org/maryland-pennsylvania.
To make an appointment for the next Mission of Mercy Taneytown clinic date, at 9 a.m. to 4 p.m. Wednesday, March 14, call 301-631-2670, ext.110.