Providing Free Healthcare to the Uninsured Working Poor https://grants.dudleytdoughertyfoundation.org/proposals-2011/providing-free-healthcare-to-the-uninsured-working-poor https://grants.dudleytdoughertyfoundation.org/@@site-logo/sitelogo-75x75.png

Providing Free Healthcare to the Uninsured Working Poor

Additional Information
Used for	Grant funds will be spent on providing free healthcare and free prescription medications to the uninsured and under-insured working poor. We will do this on a regularly scheduled basis (once or twice a month) at our five mobile clinic sites in Orange Grove, Robstown, Bishop, Flour Bluff, and Corpus Christi. We will provide diagnosis, treatment, and follow-up care for acute and chronic conditions such as high blood pressure, high cholesterol, and diabetes at no charge to our patients.
Benefits	Funds received will provide healthcare to people who work, cannot get health insurance, and because they earn income cannot qualify for public assistance ( people commonly referred to as “falling through the cracks” in the healthcare system.) Because our patients receive treatment on a regular basis, they no longer depend on hospital emergency departments for care, reducing unreimbursed medical costs that are passed on to the rest of the community. Based on a study by The Robert Wood Johnson Foundation, for every dollar invested in proven community-based disease prevention programs, the community saves $5.60 in healthcare costs ($280,000 based on our grant request of $50,000).
Proposal Description	The Mission of Mercy Texas Mobile Medical Program has four components: Clinic Operation: Mission of Mercy Texas Mobile Medical Program provides mobile clinics at four churches and one community center in South Texas. At each location, facilities are used for patient registration, patient waiting, and meetings with nurses. Patients are seen by physicians, physician assistants, and nurse practitioners on our mobile clinic, which has three exam areas and a pharmacy. Clinics are set up like a primary care physician’s office except that no billing office is required. After registration, patients meet with nurses for evaluation. Nurses, who can perform a broad range of tests from our onsite laboratory, screen patients for diabetes, high blood pressure, and other diseases. Ongoing and chronic illness can create anxiety and depression in patients. Through our routine care, as patients feel better physically, their overall mental health improves. We see their anxiety lessen, their depression recede and, at times, see complete wellness return to mind, body, and spirit. Our physicians monitor our patients’ mental and emotional well-being and prescribe antidepressants and anti-anxiety medications when appropriate. More than 50% of Mission of Mercy patients suffer from chronic illnesses, including arthritis, high blood pressure, diabetes, asthma, and depression. Thirty percent of patient visits are coded as diabetes related. Our patients depend on Mission of Mercy for ongoing treatment and prescription medications. Patients return for regularly scheduled appointments, allowing physicians to monitor their condition and provide medicine. Patients who require specialty care are referred to doctors in the community who provide free services to patients. Prescription Medications: Our mobile clinic serves as both a doctor’s office and a pharmacy. Patients receive free prescription medications dispensed by a registered nurse under the license of or medical director. Mission of Mercy’s formulary contains more than 225 medications. On average, each patient leaves with one prescription per visit. To preserve our resources and empower patients in their own care, we provide patients with free medications until their condition is stabilized and, whenever possible, write prescriptions for follow-up medications from reduced-cost programs. A vast majority of patients want to contribute to meeting the cost of their care. We also enroll patients in no-cost, prescription medication programs offered by pharmaceutical companies. We provide medications at no charge to patients who are unable to pay; write low-cost generic prescriptions for those who can afford to purchase them (helping us stretch our budget for medications while empowering patients, and provide assistance for patients who require name-brand drugs by helping to enroll them in indigent drug programs sponsored by pharmaceutical companies. Clinic Volunteers: Thanks to our volunteer-based, physician-centered model of service, Mission of Mercy is able to treat large numbers of patients in a dignified and comprehensive manner with a small paid staff. All volunteer medical professionals have an active license and are either already insured or covered through Mission of Mercy’s medical malpractice policy. They volunteer because it allows them to practice what they deem to be “pure medicine.” Mission of Mercy’s physician volunteers often sign up to work at the same clinic each month, allowing for development of a strong doctor/patient relationship. In addition to doctors, physician assistants, nurse practitioners and nurses, other volunteers include interpreters, registration workers, hospitality workers, drivers, and data entry personnel. Currently, 135 lay and professional volunteers donate time and services to Mission of Mercy patients. Donated and In-Kind Services: Mission of Mercy would not be able to provide no-cost medical care without collaboration from a wide range of community partners. These include four churches, one community center, an array of medical specialists, hospital and private laboratories, and pharmaceutical companies. Storage space for our mobile unit, medications, and supplies also is donated. We anticipate receiving $358,000 in donated goods and in-kind services in 2011 (and that much or more in 2012), comprising 41% of our $853,976 operating budget. Although Mission of Mercy focuses on providing primary care, we have established a wide network of specialists who offer their services free to many of our patients. The following is an example of how our staff and volunteers work with the local healthcare community to help our patients: Orlando, who came to Mission of Mercy two years ago for help with his diabetes, suffered a stroke a few months ago that caused him to lose sight in his “good” eye. A cataract had long ago reduced the sight in his other eye to almost nothing. Unable to work, Orlando went to another non profit that helps the blind and was told that he was not blind enough to qualify for help. Feeling hopeless, Orlando returned home to wait until February 2012 when he would qualify for disability and surgery to remove the cataract. Mission of Mercy’s nursing director, Lynette Navar, was touched by Orlando’s story and related his plight to her husband, John Navar, a local anesthesiologist and volunteer administrative medical director for the Texas program. John Navar offered to donate his services and convinced Orlando’s eye doctor to donate the surgery for free. The surgeon, in turn, convinced the lens manufacturer to donate a new lens, and a local hospital offered to provide its services at no cost. Orlando, who had come to Mission of Mercy to pick up insulin for his diabetes, could not believe it when Lynette telephoned him with the news. His voice broke as he repeatedly thanked her for what Mission of Mercy had done for him. Orlando recently underwent cataract surgery and called Lynette to tell her that the surgery had gone well and that for the first time in months he was able to see his grandson. With his improved vision, he will be able to return to work for a local construction company. Population and Number Expected to Benefit The population that will benefit from the program is the medically underserved patient population that breaks down by race as follows: • Latino/Hispanic, 74% • Caucasian, 20% • African-American, 4% • Asian–American, 1.8% • and Other, 0.2%. Our population closely reflects the population of the Coastal Bend. Ninety-nine percent of our patients report that they have no health insurance and cannot afford to pay for healthcare on their own. Our patient population also breaks down as follows: • Adult Female 62% • Adult Male 35% • Children (under 18 yrs.) 1% • and Elderly (65 and older) 2% The areas we serve report poverty levels above the state average of 16.3% and the national average of 13%, according to figures released by the U.S. Census Bureau in 2007. In any 12-month period, we expect to provide 2,800 free physician visits and 3,000 free prescription medications to our patients. Statement of Need: Lack of access to quality healthcare is a major problem for many Americans. The U.S. Census Bureau reports that, in 2008, 46.3 million people representing 15.3% of the U.S. population lacked health insurance, and many of these people do not qualify for public assistance and cannot afford to pay for healthcare on their own. Texas had the highest rate of uninsured residents in the nation at 24.8%. In South Texas, lack of access to quality healthcare is even greater. The United Way reports that healthcare is one of four major needs in South Texas, and the U.S. Census Bureau reports that the percentage of uninsured residents in the five counties where most of our patients live is as follows: • Aransas, 30.6% • Jim Wells, 24.9% • Kleberg, 24.7% • Nueces, 21.7% • and San Patricio, 22.8%. Among the uninsured, 90% are employed, according to a report from the Texas Health Institute, Kaiser Family Foundation (State Health Facts). Some who work and have access to employer-sponsored health insurance can either not afford the premiums or cannot afford the premiums for both themselves and their family members. Expected Outcomes: The following is the impact we expect to have in 2012: (1) to provide free physician visits and prescription medications to the following population groups: Q1 2012 Q2 2012 Q3 2012 Q4 2012 Total Women/Children/Elderly* 492 568 462 442 1,964 Chronic Condition Patient* 373 430 350 335 1,488 Minorities* 596 688 560 536 2,380 Total Physician Visits 745 860 700 670 2,975 Total Free Prescription Medications 745 860 700 670 2,975 *Many patients fall into more than one category. (2) to provide free healthcare and free prescription medications to a minimum of 1,000 patients; (3) to operate a minimum of 70 clinic days; (4) to reduce emergency department usage among patients by 50% as measured by patient health surveys (past surveys have shown at least a 50% reduction in emergency department usage); (5) 90% of patients will report that they are satisfied with Mission of Mercy’s care as measured by patient health surveys. History & Mission: Founded in 1994, Mission of Mercy is an independent, 501(c)(3), nonsectarian, community-based organization that seeks to restore dignity to the uninsured and under-insured working poor by providing free basic healthcare and free prescription medications. We seek to restore dignity to our patients by being an instrument of “healing through Love,” and by the reciprocal sharing of God’s mercy with those we serve. Nationally, we provide services in Texas, Arizona, Maryland, and Pennsylvania. All funds received from the Meadows Foundation will be spent on providing care to South Texas residents. Mission of Mercy does not charge for its services and does not accept government funding, a policy that enables our patients to receive care without having to “prove their poverty,” restoring dignity to a process that often lacks it. Funding for all Mission of Mercy services is derived from private donations, including individuals, community groups, churches, businesses, and charitable foundations. Mission of Mercy started in South Texas after The Most Reverend Edmond Carmody, Bishop Emeritus of the Diocese of Corpus Christi, saw the tremendous need for healthcare and invited Mission of Mercy to start a program here. Donations from three South Texas charitable foundations and others funded start-up costs, and on September 17, 2007, we began delivering free medical and basic mental health care to the medically under-served. Since our first clinic day and March 31, 2011, the Mission of Mercy Texas Mobile Medical Program has provided almost 9,000 free physician visits and 10,250 free prescription medications. Bishop Carmody’s successor, The Most Reverend Michael Mulvey, embraces our ministry. Accomplishments: Since its inception in 2007, the Mission of Mercy Texas Mobile Medical Program has recorded the following milestones in South Texas: • a 37-foot recreational vehicle was donated, refurbished, and equipped as a medical clinic; • a funding plan to sustain operations is being implemented; • necessary licenses and insurance have been obtained; • partnerships with other medical facilities and professionals have been established; • members of a Coastal Bend Leadership Council have been recruited; • a part-time medical director, nursing director, and executive director have been hired; • more than 50 medical volunteers have been recruited and trained; • more than 85 non-medical volunteers have been recruited and trained; • clinic sites have been established in Corpus Christi, Flour Bluff (a low-income neighborhood in Corpus Christi) and rural communities of Bishop, Robstown and Orange Grove; • administrative policies and procedures have been put in place; • communication strategies to market the mobile clinics are being implemented; • quality healthcare to the uninsured and under-insured working poor has been provided in almost 9,689 patient visits and 10,522 free prescription medications beginning with our first mobile clinic on September 17, 2007, through June 30, 2011; • a fundraising model that seeks to build community support by encouraging long-term financial commitments is being implemented; • selected as the recipient of the 2010 Charity League of Corpus Christi grant, proceeds of which were used to purchase a new mobile healthcare unit to replace the aging unit with which we began. A Critical Juncture Although the Texas program has enjoyed great success in acquiring donated goods and services, building the financial support needed to sustain our program has been hampered by the downturn in the economy and increased competition for fewer charitable donations. Many charitable organizations have focused on helping non profits that are on the verge of closing their doors due to increased demand for services combined with a drop in donations. Mission of Mercy is faced with shutting down its Texas program unless we receive more support from the community. To reduce costs, the Mission of Mercy Texas Mobile Medical Program has eliminated services, cut and frozen salaries, and reduced operations to six days per month. Because we have always operated with very low overhead, there are very few areas where we can further reduce expenses. To cut costs further, we would have to reduce salaries to a level that would likely force workers to seek employment elsewhere, forcing us to further reduce services and threaten our ability to make a meaningful difference in South Texas. The Mission of Mercy Texas Mobile Medical Program is optimistic that, in the long run, we will be able to build the needed support from local individuals and businesses, but we need help. We appreciate the support the Dudley T. Dougherty Foundation has given us in the past and we assure you that we have been good stewards of your donations. However, we are at a critical juncture in our history, and without additional support from the community we may have to cease operations in South Texas. We hope the Dudley T. Dougherty Foundation will partner with us in this important mission and help us continue to serve the 2,400 patients and the families that depend on them. With gratitude for your support in the past and great hope for the future, we respectfully request a grant in the amount of $50,000.