No matter what your situation in life, navigating the world of health insurance can be a daunting task. When you are among the uninsured, that task can seem insurmountable. Since 1994, People’s Health & Wellness Clinic in Barre, our Featured Community Partner for May, has been working to support the uninsured people of central Vermont and doing so through the inspiring work of numerous volunteer healthcare practitioners. They now provide free healthcare to many while having few of their own employees and keeping costs low. We spoke with Executive Director Rebecca Goldfinger-Fein to find out more about the invaluable work the clinic and its volunteers do every day.
Who is eligible for your services?
You are eligible to be a patient at PHWC if you are uninsured, underinsured (your health insurance deductible is greater than 7.5% of your household income), or your health insurance doesn’t cover certain services, such as massage, counseling, etc. Additionally, household income must be less than 400% of the Federal Poverty Level ($49,920 yearly income for a household of one, $102,960 for a household of four). We are always happy to discuss eligibility over the phone or in person.
In the time the clinic has been around, has there been an increase in the number of people who are uninsured or underinsured and need your services?
As you can imagine, the insurance status and healthcare needs of the community are strongly influenced by state and national policy. With the implementation of the Affordable Care Act and Vermont Health Connect, we have seen a decrease in the uninsured population, but unfortunately the underinsured population in our state is growing. We see this reflected in our patient data, with increased utilization by patients who have insurance but are still unable to access care because of cost or availability of providers to take on new patients. In the last five years, we have seen approximately an 11% increase in our underinsured population.
Is it more difficult now for our community members to have or find insurance? Or is it easier now?
Now with Vermont Health Connect, people have multiple avenues to access health insurance. Through state subsidies or via employer contributions, many people can enroll in insurance plans without shouldering the full cost. We have a Health Connect Assister onsite who can help patients with the process of enrolling in plans, including Medicaid. While some barriers to insurance have been reduced, we see many patients who still elect to opt out of insurance because of costs or enroll in plans with such high deductibles they are still unable to afford care.
How would you describe or sum up the wide variety of services the clinic offers?
Our services include medical care, mental health care, oral health care, bodywork and movement therapies, and other complementary and alternative services. In addition, we provide tobacco cessation screening and treatment, Vermont Health Connect enrollment assistance, and You First (formerly Ladies First) enrollment, which provides free access to breast, cervical, and heart health screenings for eligible Vermonters. Case management provided by a Registered Nurse and a Registered Dental Hygienist help tie our services together, providing continuity of care and patient support.
Are there services you offer that are the most in-demand or most requested?
Primary medical care is our most utilized service. When people hear “clinic,” that’s what they think of. But as word spreads about our onsite dental hygienist, we have seen an increased demand for dental cleanings and oral health case management.
Are there services you offer that you would like more people to know about?
We offer a really great array of bodywork, movement, and complementary therapies. Many people don’t realize that they can make an appointment for physical therapy, acupuncture, Feldenkrais, reiki, and massage. We are honored to have such amazingly skilled and generous volunteers, and we want patients to fully utilize all that they offer.
What kind of health education do you offer? Is there ever a fee or charge for that?
Health education comes in many forms, but primarily our Case Managers and volunteer providers tie education into each patient visit, whether it’s teaching a patient to monitor their blood glucose or lifestyle strategies to control hypertension. This sort of one-on-one education allows patients to ask questions and develop strategies for prevention at home. Everything we provide at PHWC is completely free. We know that cost is a huge barrier to receiving care and we want our patients to have access to all the we offer. Patient donations are encouraged, but by no means required.
In what ways does the clinic also achieve reducing costs for local hospitals and insurers?
The key is prevention. Most PHWC patients report having delayed care because of costs. At the clinic, patients can seek immediate assistance and treatment before health issues worsen and avoid emergency room visits. Both the hospitals and insurance providers take on the financial burden of this more serious and acute care.
How do you recruit and maintain such a strong team of volunteer health practitioners?
In my experience, the most successful way of recruiting volunteers is by word-of-mouth. Our volunteer Medical Director, Dr. Allan Ramsay, is an amazing advocate for PHWC and has recruited many of our excellent medical providers. Current volunteers, board members, and staff reach out to their contacts as needs arise and we are able to fill gaps in the schedule.
What other ways can people either volunteer or support the clinic in some other way?
We are currently looking for volunteer nurses, mental health counselors, and bodywork practitioners. The volunteer application and link to donate are available on our website, www.phwcvt.org.