Health Care Access Inc. board members say they expect things to get worse before they get better.
The number of people who "fall between the cracks" of having their own health insurance plan or qualifying for public health care assistance is growing, said Tom Wilcox, a Lawrence pharmacist and one of 21 HCA board members.
Started in June 1989, HCA has used volunteer doctors, pharmacists, dentists and nurses, along with donated services from Lawrence Memorial Hospital, to provide free health care services for people whose income is within 150 percent of the federal poverty level and who are without health insurance.
Wilcox said low-income working people without insurance who run into health problems have nowhere to turn unless HCA can fill the gap.
"Most people don't plan on illnesses," he said.
WILCOX pointed to a number of factors that have led to the increase in people needing health care assistance, including businesses laying off employees or cutting employees' hours so they no longer qualify for health insurance programs.
"The system tries to take care of the indigent, but with going into a recession and the federal government trying to balance the budget and Kansas seeing fiscal problems, a lot of people are no longer covered," he said.
Presently, HCA operates two afternoons for a total of four hours a week out of a small office at Babcock Place Apartments, 1700 Mass. The office space was donated to the agency by the Lawrence Housing Authority.
Despite the limited operating hours, doctors have seen 915 patients at HCA; Lawrence Memorial Hospital has donated over $10,000 worth of medical treatment; dentists have treated more than 330 patients referred by HCA for acute problems; and Douglas County pharmacies have provided more than $1,000 a month in prescription drugs at cost to HCA patients since HCA began.
ACCORDING to Betty Smith-Campbell, president of the HCA board and director of the department of nursing at St. Mary College in Leavenworth, the agency has reached the point where it needs a permanent location, along with more permanent funding sources.
"The need, obviously, is getting bigger, not smaller," she said.
Smith-Campbell said the board is searching for a location in central or eastern Lawrence where HCA can offer physician, dental, nursing and pharmacy services for longer hours, including some evening hours at times convenient to working people.
Smith-Campbell also said HCA wants to do its own screening for the HCA services to relieve Lawrence social services agencies, which have carried out the screening to this point.
"Our main focus for the immediate future is finding a bigger space for the clinic where we can handle the application process ourselves and have more flexibility to expand our service," Smith-Campbell said.
SMITH-CAMPBELL also said many of HCA's clients work but don't make enough to pay for health insurance.
For a one-person household, 150 percent of poverty level is a monthly income of $785 a month, while for a family of four, 150 percent of poverty level is an income of $1,587 a month.
"People are making enough to pay rent and buy food, and that's it," Smith-Campbell said.
Barbara Bailey, another HCA board member and a social worker at LMH, said the hospital also is seeing more and more working people who can no longer afford health care bills.
And HCA board member Patty Doria, a benefits advocate at Independence Inc., said many people are "caught between having medical cards and insurance."
"It tends to be younger people," she said. "Elderly people do have screening clinics and Medicare.
"But another issue is dental work," Doria added. "Medical cards do not pay that. Not Medicaid or Medicare."
SMITH-CAMPBELL said the clinic, which is open on Monday and Thursday afternoons, used to average four of five patients during the two hours it was open. But now the average is up to eight or nine patients.
Wilcox, who works at Round Corner Drug Co., said almost all pharmacists in Lawrence have donated their services and provided prescriptions at cost to HCA patients. About 20 area doctors, 15 area dentists and a number of nurses also donate their time.
"It has really been kind of a miraculous thing, the community support," he said.
Emily Bono, a VISTA volunteer working with HCA, said many of the clients referred to HCA have not seen a doctor in a long time.
"We had an older women in here last week who had diabetes, but hadn't seen a doctor in six years," Bono said.
Wilcox said the ultimate goal of HCA is to go out of business. He said the organization advocates access to health care for all Americans.
But until there is such a plan, and Smith-Campbell said she does not see it on the immediate horizon, HCA is the only option available to many.
"Health Care Assess is trying to deal with this in a humane way," Wilcox said.