Charity got too expensive.
When it opened a year ago, the Leo Center didn't charge for its medical clinic's services. Poor people were seen for free, and a gap in the city's medical services was at least partially filled.
That's changed. Now, some patients are being asked to pick up part of the tab.
"I'm not saying I shouldn't have to pay something," said a 47-year-old woman patient who lost her health insurance when she and her husband recently divorced. "I don't blame them for charging," she said. "I'm just saying when you're poor, $28 (for a doctor's visit) is a lot of money, and I don't think they should be telling people they're there for the homeless and low-income when people like me can't afford to go there."
The Rev. Paul Gray, whose Heartland Community Church runs the Leo Center, located on the eastern end of the first level of the former Riverfront Mall, says it's true the clinic is no longer free for all. And he wishes more people knew that. People show up expecting that things have not changed and then go away peeved when they learn they now must pay.
But the clinic's initial goal of caring for all comers for free became unsustainable.
"Our expenses -- utilities, staff salaries, insurance, remodeling costs -- are right at $30,000 a month," Gray said. "And we get no government money."
Each month, Gray said, the clinic takes in about $10,000 in fees and $10,000 in contributions from local churches, including Heartland, and private individuals. The remainder, he said, is raised through foundations, grants and donations.
Gray said the Leo Center was in the black.
The clinic provided free care for five years before moving to the mall in April 2004. It began charging for services in January.
Gray said the clinic only charged those who are employed and, in the staff's opinion, able to pay. Patients who say they are homeless or unemployed are expected to provide proof.
"We are not in this to make money," Gray said. "We'd like not to charge, but, unfortunately, to do what we're trying to do -- to give poor people access to a doctor -- costs money."
The Leo Center is named after the late Leo Beuerman, a longtime Lawrence resident who, despite being deaf, nearly blind, 3 feet tall and unable to walk, maintained his independence by selling pens and pencils on Massachusetts Street. A devout Christian, he died in 1974.
Care for the poor
Some of the clinic's patients -- there isn't an exact count -- have switched or returned to Health Care Access, the other charitable clinic in Lawrence.
"We've had a lot of people come in who've said they can't afford the Leo Center anymore," said Health Care Access Executive Director Nikki King.
At Health Care Access, 1920 Moodie Road, patients are asked to pay $10 when they leave.
"We don't turn away people who say they can't afford the $10," King said. "And we don't bill them."
The Leo Center does bill for lab work. Patients are expected to have made arrangements to pay their bills before their next visit.
Unlike the Leo Center, most of Health Care Access' services are provided free and offsite by more than 70 doctors and by Lawrence Memorial Hospital.
But Health Care Access is only for the uninsured who earn less than 150 percent of the federal poverty guideline -- about $1,400 a month for a three-person household -- and live in Douglas County. It does not, for example, see patients who are poor enough to qualify for Medicaid, or HealthWave, the state's health insurance program for children in low-income families.
Gray said most of the Leo Center's patients were on Medicare, Medicaid or HealthWave and couldn't find a doctor who would accept them. A few, he said, have insurance.
"We see a lot of people who are covered by (the U.S. Department of Veterans Affairs) but don't have a way to get to the VA hospital in Topeka or the one in Leavenworth," Gray said.
Though the fees have upset some clinic patients, demand for care has hardly lessened.
"Things have slowed down some," Gray said, "but they needed to slow down. If it hadn't, we would had to hire more people -- another doctor -- to keep up."
Paula Gilchrist, social service director for the Salvation Army, 946 N.H., defended the clinic's decision to charge.
"When you give something away, everybody's happy," she said. "When you charge for it, someone's going to complain. It's human nature."
She added, "Twenty-eight dollars is reasonable."