A social worker moves into the executive director's seat of Douglas County's only health clinic for the uninsured.
Carol Stambaugh grew up without any thoughts of paying for food, clothing, shelter or health care.
She had it all in her comfortable middle class neighborhood in North Richland Hills, Tex., a Dallas suburb, where her father is still an accountant and her mother a school teacher.
But Stambaugh, who could have opted for all the rewards of a lucrative business career after graduating from Texas Christian University in 1988, decided instead to work for those who had less.
She came to Lawrence to earn a master's degree in social work at Kansas University, and in August started as the new executive director of Health Care Access, a clinic for the uninsured.
"I always had a sense of advocacy for those who did not have the resources," said Stambaugh, 30, who replaced Judy Eyerly at Health Care Access. Eyerly left for a job with the Kansas Association for the Medically Underserved in Topeka.
Stambaugh joins Health Care Access at a time of uncertainty and anxiety. Welfare reform legislation signed by President Clinton this summer will force thousands of people off the welfare rolls, and there's fear -- but no firm understanding -- that some will also lose their Medicaid benefits. Medicaid is the government's health program for the poor.
Health Care Access doesn't offer care to people with Medicaid. Instead, it provides checkups and urgent care to the working poor -- those who earn too much to qualify for Medicaid, but who still lack health insurance and can't afford it.
Its five-person staff operates on a shoestring budget of about $187,000 a year, mostly from the state. The clinic's building, at 1920 Moodie Rd. in East Lawrence, is owned by the city and rented for $5 a year.
The clinic depends on the donated services of about 100 doctors, dentists, dietitians and nurses who regularly volunteer there.
"We're a safety net," said Stambaugh, who spent the past 2 1/2 years with the Bert Nash Community Mental Health Center. "The question I think we're all asking is are we going to have the resources to be able to serve the increasing demand."
Even without an influx of new clients tossed off the Medicaid rolls, all signs point to continued growth at Health Care Access.
This week the American Hospital Assn. projected the number of Americans without health insurance will rise from 39.6 million people last year to 45.6 million by 2002.
Meanwhile, the share of workers and their dependents with employee-paid insurance fell from 77.7 percent in 1990 to 73.9 percent in 1995, and it will dip to 70.4 percent by 2002, according to the hospital association's study.
In 1992, Health Care Access scheduled 2,252 appointments for 886 people.
Last year, 1,421 people used the clinic's services in 4,237 appointments. Although the number of individuals served is down slightly so far this year, the number of appointments is up.
"The working poor of Douglas County who don't have any kind of health insurance make their medical home here," Stambaugh said. "Our mission is to provide them with the highest quality care possible and to continue to make that even more available as the need arises."