AN OVERVIEW

It has been a known fact that low-income, uninsured residents of Collier County have difficulty in accessing quality medical care. About eight years ago, the Collier County Medical Society created a special committee of physicians to address this problem. A group of Collier County Medical Society (CCMS) physicians, officers of the Collier County Medical Society Alliance (CCMSA), and other community leaders gathered data and explored sites and options that would rectify the situation.

As we proceeded, the Federal Government decided that it would take on all of the nation’s health care woes. We are all aware of the scenario that took place, but the problems in Collier County were put on hold in expectation that we would be getting a federal solution to the local problem.

A few years ago, several community groups explored data and possibilities. These groups included CCMS, FoCuS, Naples Area Chamber of Commerce, Collier County Economic Development Council, a coalition of the EDC/NACC, Greater Naples Civic Association, and others. Although some progress was made in gathering information, solutions have not been forthcoming. It had been determined that approximately 15% of the working families in Collier County were living below 150% of the federal poverty level, did not have health insurance, and did not have access to routine quality health care. These people would ignore their health problems until crisis, then sought help in the Naples Community Hospital emergency room. The disadvantage of our hospital assuming the sole responsibility for providing acute/chronic free medical care are clear. Emergency rooms are extremely expensive to equip and staff. They become the primary treatment facility for minor illnesses, possibly delaying or otherwise interfering with the treatment of life threatening emergencies.

A group of CCMS physicians, the CCMSA, and community leaders decided that it is time for action. This group realized that it had become necessary to provide medical care for Collier County low-income, uninsured working residents when what used to be the "Robin Hood" affect, meaning revenues received from paying patients used to cover loses from "charity care" were becoming more difficult as managed care reduced these revenues. A not-for-profit 501©(3) corporation called NEIGHBORHOOD HEALTH CLINIC, INC. has been formed having as its mission "To provide low cost medical care in an atmosphere of dignity and respect for the low income uninsured people of Collier County using volunteer professional staff."

The NCH Healthcare System has provided space for the clinic in Grand Central Station. They have also contributed used medical and office furniture and supplies to the clinic. Actively licensed Collier County physicians and nurses who are volunteering their services at no cost will provide the professional medical services. These physicians and nurses will be covered under the State of Florida Sovereign Immunity Act. Patients will be asked to pay one hour’s earnings per visit. These limited revenues we collect will be used to cover ordinary expenses of the clinic. We would particularly like to reach those patients with chronic diseases such as Diabetes, Hypertension, Asthma, etc.

Primary care physicians will see the patients and referrals will be made to volunteer specialists as needed. For example, if the patient has appendicitis, that individual will be referred to a surgeon. The specialist would follow the patient with the necessary post-operative care and then the patient would be returned to the primary care physician who would manage their care. Through this collaborative effort, primary care physicians will now be able to see more patients, intervene earlier rather than later and individuals are able to receive proper specialty care as needed. These preventative measures focus on getting people well and keeping them well. "It is much more affordable to provide needed health care early in the course of the disease than to wait until the patient is in a crisis situation and needs to be admitted to the hospital," says Paul Jones, M.D., one of the volunteer primary care physicians.

Many other residents have volunteered their services to help in many ways. Local pharmacist, Tim Hayes of Harrington’s Pharmacy has explored ways to resolve the problems associated with the high costs of some prescription medications. Pharmaceutical houses and physicians’ offices are donating some of these essential medicines. We are also purchasing and dispensing medications so that the patient will be provided medications needed in the majority of cases. Occasionally, there will be medications needed to be prescribed that we cannot provide. In those cases, arrangements are made to have the prescriptions filled by local pharmacies at their cost.

There is a real need for funding to cover start-up costs and to keep the doors open. The clinic is also looking for volunteers to do clerical work, filing, telephoning, etc. The clinic is open Monday and Thursday from 4:30 pm to 7:30 pm and on Saturday mornings from 9 am to 12pm. Our targeted date for opening on April 12 was met.

The community can now boast that it provides innovative health care for its entire low income-working people who do not qualify for government health insurance programs such as Medicare, Medicaid, or other health programs. Volunteerism through the form of the NEIGHBORHOOD HEALTH CLINIC, INC. may not be the ultimate solution to the problem of the uninsured but the quality health care provided in this setting will certainly go a long way toward showing compassion and trust for humanity and a true willingness to care for one another.