Ensuring that the needy get health care; Grants help clinic provide free aid to poor, underinsured


David Weatherholtz sat quietly in the Columbia health clinic's gray-carpeted waiting room, ignoring the scattered magazines and toys as he listened for his name.

The 39-year-old Elkridge resident suffers from diabetes and sinus problems, and he depends on the clinic's staff for health care.

There's no place like it in affluent Howard County. The clinic provides free care one night a week to people such as Weatherholtz, who is waiting for health insurance to take effect at a new job, and others who can't afford to pay.

Staffed by volunteers enlisted by the Health Alliance for Patients in Need (HAPIN), the clinic recently received a financial boost that will enable it to serve more people. Horizon Foundation of Howard County awarded a two-year, $264,000 grant to HAPIN, which also has received $20,000 from Howard County General Hospital.

With the money, the clinic can stop being a seat-of-the pants organization, said Dr. Gary Milles, an Ellicott City internist who is the driving force behind HAPIN.

The money will pay for a full-time administrator and allow the clinic to open at least one more night a week, he said. It also will help buy medicines and allow the clinic to begin formal fund raising.

Other ideas include starting a dental clinic and providing malpractice protection for retired physicians who volunteer.

Milles would like to open the Cedar Lane clinic five days a week, he said. Now it is open from 6 p.m. to 9 p.m. Wednesdays. It is usually staffed by one or two doctors, two nurses, a nurse practitioner and a receptionist, all donating time on a rotating basis.

"The goal will eventually be that anybody who needs health care will be able to get it," Milles said. "Nobody will fall through the cracks."

The money brings some worries: Will volunteers remain as eager to donate their time and services? Will specialists start to question how many cases they can handle?

"If you stop worrying about the details so much, things start to work out," Milles said.

That philosophy has served him well. In 1994, when he was president of the medical staff at Howard County General Hospital, he began urging physicians and specialists to donate services to needy patients.

Milles examined the program's first patient in November 1994, recalled Karen Nicholson, who was HAPIN's coordinator from 1994 to 1998 and continues as a volunteer. There was no clinic then; volunteers used their offices for the examinations.

That first patient had many medical problems, including a cyst on his back. Milles referred him to Dr. Michael Macon, a general surgeon. The cyst called for outpatient surgery, but because the man had no fixed address, follow-up care would have been difficult.

"We arranged to have him admitted [to the hospital] for one night. Then Dr. Macon arranged to have him visit his office on a daily basis," Nicholson said.

It was all very informal, with volunteers finding help for patients on a case-by-case basis. "All we were doing was saying, 'Hey, go to this doctor, he or she will take care of you,' " she said.

Said Macon: "Dr. Milles really deserves a tremendous amount of credit for getting the ball rolling, but I think it's safe to say he didn't have any trouble at all getting volunteers. When he made it easy to do, everybody jumped on the bandwagon."

American Radiology Services Inc. and Quest Diagnostic Inc. donated their services. Drug companies gave free supplies. "The most exciting part is the spontaneous generosity of people," Milles said.

Success stories piled up. A child received a hearing aid. A simple operation allowed an asthmatic man to return to work. However, the logistics of getting the correct specialists, tests and supplies for each patient were growing cumbersome.

Last year, HAPIN became a nonprofit organization. On Dec. 2, the clinic opened in a building owned by Johns Hopkins Medicine. Ninety-four people have been treated since then, many of them several times, for a total of 322 appointments during the past 11 months.

Patient criteria remain unchanged. To qualify for care, a patient must be a Howard County resident, be referred by a social service agency and have a chronic condition. Appointments are required.

Many people involved with HAPIN were initially surprised by the need for such a service in Howard County, one of the most affluent jurisdictions in the United States. "It has been a real eye-opener to a lot of us," Nicholson said.

Patients include immigrants, the working poor and the elderly. "It's moms who [are] single, no husband at home, and they're working at a fast-food restaurant," said Kathy Nevin, who helped set up the clinic and is one of two part-time coordinators.

Victor A. Broccolino, president and chief executive officer of Howard County General, estimated that about 6.5 percent of the county's population either has no insurance or is underinsured.

The hospital has given cash contributions to the program, he said, adding, "We think it's a very worthwhile effort."

Horizon Foundation was formed last year as a result of a merger between the hospital and Johns Hopkins Medicine. The grant was announced last month.

On a recent Wednesday night, patients were being treated by Dr. Julia Bonacum, a specialist in pulmonary disease and critical care who was serving as a general practitioner. She volunteers at the clinic once every month or two.

There's a lot of satisfaction in helping uninsured people, Bonacum said -- people such as Julia Howard, who recently moved to Columbia from Liberia and has been coming to the clinic since April. Like many patients, she was referred through the county's Foreign-Born Information and Referral Network. Her back problems have kept her from finding a job, but thanks to HAPIN, she has been receiving therapy twice a week, she said.

"They are very nice people," Howard said. "Loving and warm."

Weatherholtz would agree. The free care has helped him turn his life around, he said, noting that he has landed a job at a hotel. "I've been doing nothing but improving my life because of this," he said. "Now I'm back on my feet again."

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