A free medical clinic opened in Lincoln this week to address what its organizers say is an urgently underserved population that can't afford physical and mental health care it needs.
The People's City Mission opened its clinic Monday in a building just north of the mission at Second and R streets.
"We hope to serve 15,000 to 20,000 people a year, without a dime to the taxpayer," said Tom Barber, executive director of the mission. "With volunteerism we can do a lot of things. We were entrepreneurial, creative and innovative about getting this done."
The clinic eventually will offer mental health services, as well as optometry, dentistry and general physical health care.
For now, it is staffed by three full-time employees - two administrative and one nurse practitioner - and it is open weekdays, 8 a.m. to 5 p.m.
Barber said the clinic was funded by a single anonymous gift of $200,000. Labor, medical equipment and supplies have been donated.
The opening follows three years of planning, necessitated by a lack of services of this kind in Lincoln, he said.
"I've had four people die (because they didn't have medical care) at the mission since I've been here," Barber said of his four years with the organization. "People are using the emergency room as their only care provider, and they often wait until the situation is serious."
Barber and others involved in improving public health in Lincoln agree the need for indigent health care is pressing.
"Even if people qualify for indigent medical care (through Medicaid), the paperwork is sometimes too onerous for them to apply," Barber said. "Or people don't have cars - unless the clinic is in direct proximity to where they live, they don't go."
What they do not agree on is how to create services - from urgent care clinics to general practitioners offering a full range of care, including preventative - so that people who are on the margins of society can access them.
"There is a huge need ... it has to be met in a coordinated effort," said Joan Anderson, executive director of the Lancaster County Medical Society, a group that represents doctors. "We don't want clients going from one clinic to the next and getting a Band-Aid."
Doctors want to see free and sliding scale clinics coordinate their efforts so requests to donate time aren't duplicated, Anderson said.
Barber said there is a gap in Lincoln for people unable to pay for health care, even with other clinics already in operation.
At Clinic with a Heart, a local cooperative effort based out of the Center for People in Need, doctors are donating their services for two hours a week.
The People's Health Center, 1021 N. 27th St., provides free and sliding scale care, but the earliest a new patient can see a doctor is October, Executive Director Deb Shoemaker said.
"In the beginning there may be some confusion with what a person can receive (at the People's Health Center versus the People's City Mission clinic)," Shoemaker said.
Nonetheless, she said, the need for free medical care is significant in Lincoln, so much so that it overrides any concern about competition for limited resources.
Shoemaker said her staff will refer people to the mission clinic for more immediate services, while they wait for appointments with doctors at her center.
Therein lies an important distinction for public health experts, said Bruce Dart, health director of the Lincoln-Lancaster County Health Department.
Fundamentally, the mission's model is different than the continuing care offered by doctors who work full time at the same office and see the same patients with some regularity, Dart said. Those doctors can often spot when a medical situation is more serious than a one-time visit may imply.
"(The People's Mission clinic) is not going to be a medical home. With volunteer clinics, patients jump around; it causes fragmentation," he said. "Whether that's going to happen there, I don't know."
Both Dart and Anderson serve on the board of the People's Health Center.
Barber said the mission's clinic will be staffed by doctors who will be asked to volunteer for three hours an evening every other month. In this regard, the mission clinic will function more like Linc Care or other urgent care clinics than a typical family doctors' practice.
All agree that keeping people from using emergency rooms for nonemergency needs or as de facto primary care is a worthy enterprise. This exhausts hospitals' charity care funds and drives up costs for insurance companies and policyholders.
"People in Lincoln are underserved medically," Shoemaker said. "The People's Health Center is part of the solution."
Barber said he hopes the mission's clinic can be, too.
