Certified medical assistant and pharmacy technician Patty Webb turns to her computer monitor as she fills a prescription recently at Health Care Access, 1920 Moodie Road. Because of space issues, Webb’s desk has been placed in the room where supplies and medicine are stored at the clinic.

While the building at 1920 Moodie Road may be small, the nonprofit agency located inside has a big job.

Health Care Access provides medical care to Douglas County’s uninsured, which is estimated at 12,000 people.

During the past year, it served 1,703 patients and provided more than $4 million worth of care through collaboration with volunteer doctors, donated services from Lawrence Memorial Hospital and more than 30 pharmaceutical companies.

Health Care Access saw an 11 percent increase in clients during 2008, and it expects the volume to rise this year.

“We are preparing for more and more people to lose their benefits and for more who can’t afford their portion of the premiums,” said Nikki King, executive director of Health Care Access. “Employers are making hard decisions about whether they can even offer that benefit anymore, so we are expecting an influx.”

But the agency has run out of room at its 3,200-square-foot office. The average wait for a routine office visit is about four to six weeks, and that’s mostly because there are only five examination rooms. The agency got creative and divided one room into two by using floral bed sheets, so now they have six.

“It’s not ideal,” King said, “There’s much less privacy.”

Two of the six rooms don’t have sinks and three of the rooms have carpeted floors, which isn’t good for sanitation reasons.

The agency also lacks space for its 11 employees and approximately 20 on-site volunteers. There is no meeting space, no storage space and no place for employees to eat lunch.

‘Up against a hard wall’

During a recent afternoon, two volunteers — Fred McElhenie and Ed Quick — were crammed into a small room working on files. Sometimes, the volunteers said, they have to work in the hallway or work standing up.

McElhenie has been a volunteer for eight years and spends between four and seven hours a week helping the organization. He does chores such as watering trees, sending letters and fixing things. In his time there, he has seen the space get eaten up.

“Frankly, it just gets smaller and smaller,” he said. “We are kind of up against a hard wall.”

King would agree. Armed with a $96,000 state-funded capital improvement grant, she has been looking for space to expand. She has until June 30 to match that grant in either in-kind or actual dollars.

“That’s our time crunch. If we can find a publicly owned property that reaches that same value, then our job is done,” she said.

If not, the agency may have to look to the private sector and do fundraising — something King hopes to avoid.

The agency pays the City of Lawrence $1 per year for its location. Among the options that have been considered in the public sector is the Community Health Facility, 200 Maine, which is owned by the city. But that option has raised eyebrows among Lawrence Memorial Hospital leaders and the Lawrence-Douglas County Health Department board, and it’s mostly because of the lack of available space. The building is used by the Douglas County Visiting Nurses, Rehabilitation and Hospice Care; the health department; and Bert Nash Community Mental Health Center.

“Those three agencies have been very open to the idea of collaboration and what can we do to synergize our services for our patients,” King said. “There’s nothing definite now.”

‘Campus of care’

Judy Bellome, VNA chief executive, said she thought locating Health Care Access in or near the building made sense because Health Care Access could share clinic and meeting space with those in the building. It also would be near the hospital and other health care providers such as the Douglas County Dental Clinic, 316 Maine.

“It just seems to make sense to be a campus of care,” she said.

King also would like to see Health Care Access on property closer to the hospital for a number of reasons:

• It would remain in their patient demographic. They did a survey of where most of their patients reside. Thirty-eight percent live in the ZIP code 66044 and 29 percent in 66046. Those ZIP codes represent mostly eastern and northern Lawrence.

• It would increase visibility for patients and volunteers.

• It would be easier for patients to get lab work, X-rays and follow-up care. They could be referred to other health agencies, and those agencies could refer patients to Health Care Access.

• It likely would be along a bus system route.

Challenging situation

King said the ideal location to expand also would include at least 5,000 square feet of space, which would be enough for 12 examination rooms, a meeting room, and educational space for classes on topics such as nutrition, diabetes and smoking cessation.

“It would be nice for the nurses not to eat at their desks,” King said.

They also hope to keep rent payments to a minimum.

“If we have to get into paying $3,000 to $5,000 a month, that’s going to hurt our staffing capabilities. We don’t want to have to make those sort of choices,” King said. “That’s why we have pushed real hard on some of these publicly owned properties.”

While King wouldn’t reveal other possible locations, she said they have looked at 20 locations.

“This is the hardest part right now is just identifying where it is going to be,” King said. “None of our challenges in this process have been unreasonable because everybody’s in agreement that we need to try to find the most amount of space at the right price, so that we can continue to serve this hole in the health care system and that our ER is not overpopulated with primary care issues by the uninsured.”