Running on Faith: Flagler County’s Free Clinic Is a Refuge For Health Care’s Untouchables

Faith Coleman is a nurse practitioner at Palm Coast’s Ardent Family Care, and a cancer survivor. She was uninsured when she found out she had kidney cancer in 2003. She was forced to mortgage her home to pay the $35,000 bill for her treatment.  The experience inspired her to co-found the Flagler County Free Clinic to help other uninsured get access to health care. “I was given another chance, and I felt that I wanted to give back,” said the mother of six. “It’s a commitment I made. I know what it’s like to have nowhere to go.”

Florida has the third-highest rate of uninsured people in the country, after Texas and New Mexico. At 21 percent, more than one in five Floridians is uninsured. The national average is 16 percent, the same rate as in Flagler County, according to the latest Census figures. The local rate is deceptively low: A quarter of Flagler’s population is 65 and older (compared with 13 percent for the nation), almost all of whom are on Medicare, the insurance program for the elderly. That skews the numbers downward. When only those 65 and younger are considered, the proportion of the uninsured rises to 22 percent—and to 24.5 percent for those 18 to 64.

When Coleman, 56, recovered from cancer in 2004, she approached Dr. John Canakaris. A local physician with 60 years of experience treating the poor. He was eager to reach more patients in need so Canakaris and Coleman worked together toward their common goal. The free clinic opened in February 2005.  The Flagler County Free Clinic at 700 East Moody Blvd. in Bunnell (across from the Post Office, and a block away from Canakaris Ave.), opened its doors to low – income, uninsured residents in February 2005, with eight volunteers treating eight patients. Since then, the clinic has treated more than 8,000 patients and has expanded to 120 volunteers, operating on an annual budget of less than $10,000.

The clinic is open every 1^st and 3^rd Thursday and Saturday of the month. Doors open at 8 a.m. on Saturdays and 5 p.m. on Thursdays, though patients beat the doctors there and line up hours before the clinic opens to make sure they get a spot, some bringing their own chairs and blankets to sit on while waiting their turn. Waiting in line overnight is common on Saturdays but on Thursday’s patients usually line up outside the clinic around 2 p.m. The clinic operates out of a building donated by Dr. Canakaris and other local doctors. It’s not affiliated with any hospitals. The local Rotary Club, churches and private contributions help fund the operation.

Coleman says that times are tough and many people are having trouble getting Medicaid, the health insurance program for the poor, which Florida has been cutting back severely. “We have seen an increase in the number of patients,” Coleman said. “We see about 20 patients every other Thursday and 80 patients every other Saturday.”

Oleg Romanovskiy was among 40 patients who arrived one Thursday afternoon at the clinic, hoping to receive care. “I got here around 2:30 p.m. and I got number 15,” he said. The clinic usually only see about 20 patients on Thursday evenings, depending on the staff situation. He’s at the clinic once a month. “Not sure what I would do without this place,” he says. Romanovskiy, like many others in Flagler County, lost his job about two years ago and hasn’t had health insurance since. “This is a good place and the people working here are very knowledgeable,” he says, thankful of their presence.

Coleman’s goal is to have a free clinic open daily someday in the future, to help more people. The need is there. The resources are scarce. But people are willing to help. “It’s amazing what we have accomplished so far, Coleman said. “We have so many wonderful volunteers.” In 2004, Janet Powell of Flagler Beach nominated Coleman to be a CNN Hero. The network  features one such hero every week. Coleman was it in mid-August 2009. (See the CNN video to the right.) Three months later, Coleman was named the Business and Professional Women of Flagler County’s Woman of the Year.

Much of the work depends on volunteers.

Kennya Costa, 25, is one of the office volunteers at the clinic. “I came here with my parents because they don’t have insurance,” she said. “I realized that I wanted to help the people here.”

Coleman said their team generally treat common illnesses like diabetes, hypertension and other chronic diseases. “We see everything here,” she says. The free clinic has become the primary care office for many of the uninsured but sometimes, the clinic has to turn people away since it is on a first come first served basis.

Patrick Johnson, Flagler County Health Department administrator and vice chairman of the free clinic, said the Health Department wants to open a federally funded community health center in Flagler County to serve the uninsured population. The center would treat Medicaid and Medicare recipients, with a focus on the poor and working poor, including the uninsured. If the application is granted—a laborious and very competitive process—the health department would get a grant worth approximately $650,000 a year for five years.  “You have to have a number of things in place,” Johnson said, “community interest, a clear direction and you have to show your open daily, some weekends and evenings.”

Last year the federal government initially stated it would grant 200 community centers around the country. Only 87 applications were approved, two of which in Florida, out of 800 applicants.

The local health department recently received a community health planning grant, which means the department can hire someone to put together the complete application. “We are planning to hire someone soon with broad experience and background with the application process.” The plan is to file the application by December 2012 with the help of a new staff member, with hopes of hearing back from the federal government by July 2013. “If the application is granted we have to open the community health center within 90 days,” Johnson said. “This is all a couple of years down the road.”

If a community clinic would to open in Flagler County in the fall of 2013, this health clinic would collaborate with the existing Flagler County free clinic in Bunnell, Johnson pledges. “Some patients might be moved over from the clinic in Bunnell to the community clinic, depending on the patients needs,” he said. “It would not be a duplication of services, we would complement each other.”

Coleman has her doubts. She said she does not expect the proposed community health clinic to help out with the uninsured population much. “The requirement for this clinic is that they only have to see 10 percent of the indigent uninsured population,” she said. “That’s nothing. People who are on Medicaid will benefit from the clinic but I don’t see this clinic making a dent in our underserved population”

And that’s in two years, anyway. For now, the uninsured have two choices. They can crash the ER at Florida Hospital Flagler, which they often do, getting billed and letting the bills go unpaid, or they can go to the free clinic in Bunnell. That makes the hospital and the Canakaris family the two big health care providers, in money and services, for the  county. The hospital has been a big help to the free clinic, for obvious reasons: the clinic provides services at far lesser costs than the hospital does, and the more people opt for the clinic, the fewer people the hospital has to treat, expensively, without hopes of getting paid. “I can call David Ottati any day and he will help out,” Coleman said of the Florida Hospital Flagler CEO.

On Oct. 29, the free clinic presented its Second Annual Gala “Monster Mash” at the Palm Coast Yacht Club. Last year the event raised more than $10,000, which allowed the clinic to add an ophthalmologist to the team. “This year we raised about $15,000 to  $18,000 and our goal is to expand our dental program so patients can get both fillings and cleanings,” Coleman said. “Right now, they only perform extractions.”

There’s an unfortunate turn to this story. Coleman’s cancer has returned. And because of her previous cancer diagnosis—and because the business end of the country’s health care system is still in the stone age—no insurance company will cover her: she is among America’s untouchables, having a pre-existing condition. Coleman again faces high medical bills. Kathleen Brady is launching the “Got to have Faith” Project to support Coleman and raise funds for her cancer treatment.

“It is our turn to take care of her and assist in ensuring the future of the clinic,” Brady wrote in an email to friends and supporters. “In keeping with Faith’s ability to dream big and make things happen – we want to create something big that will snowball into an annual event.  I’m talking big here – let’s put something together that Lifetime television will want to make a movie about!  Let’s show the world what people can do when they want to keep Faith!  Let’s show Faith how much she means to this community and how much support is out there for her.”

Brady continued: “What we are envisioning is a ‘Gotta Have Faith Festival’ that will raise funds for Faith’s cancer treatment as the primary goal but can mushroom into much more.  It can become an annual fundraiser for the clinic as well as a medium to promote community involvement and cohesiveness.  We will need lots of help to get this organized and all types of talent, resources and contacts are needed.  We need organizers, sponsors, entertainers, food, games, prizes, banners, marketing, publicity – anything that will get this out of the idea phase and into the planning phase.” (You can contact Brady to get on “Team Faith” and make this happen: [email protected]).

Coleman is still working at the free clinic and said as long as she is able, she will be there. “Unless I am next to death, I am going to be here at the clinic, helping people,” she said. “Better me than somebody who does not know how to navigate the health care system.”