Free clinics step up as unemployed Americans lose insurance due to pandemic

Carley Lovorn, the youngest Tree of Life Clinic volunteer on duty on April 18, 2020, takes medication out to patients who have been waiting in their cars instead of in the clinic lobby. Lovorn, the clinic's Spanish translator, also took on the task of cleaning pens after patients sign in.

Tupelo, Mississippi (Kaiser Health News)Joe Delbert hadn't needed the Tree of Life Free Clinic in three years.

The 55-year-old man, who moved to Tupelo from Georgia to take care of his dying father nearly four years ago, found manufacturing work that came with health insurance. But last month, he joined 26 million other Americans who have lost their jobs because of Covid-19 in the past five weeks.
With the job went Delbert's health coverage — and the money to pay for medications to control his diabetes and cholesterol. Insulin alone would cost him $600 a vial. Delbert said he would be sunk without the free clinic, which opens twice a month to provide health care at no charge to anyone without insurance.
"My medications are so expensive," Delbert said. Because of the medication assistance, he added, "I can keep my head above water."
    Typically, three rows of benches outside the clinic are filled hours before it opens. Forty volunteers coordinate paperwork, eye screenings and prescriptions. A dental clinic performs extractions based on referrals from the clinic. Through the eight hours it is open each month, the Tree of Life provides basic medical care for 175 patients, fills around 700 prescriptions and provides dental services for 30 patients.
    But at the beginning of March, Dr. Joe Bailey, the clinic's founder, consulted with local infectious disease specialists and pulmonologists to figure out how the clinic could continue to safely care for its patients as Covid-19 spread.
    "They advised us to close, but I didn't have the heart to do that," Bailey said. "We came up with a workable compromise."
    Now, though the Tree of Life continues to open twice each month, its operations are far from routine. Patients wait in cars for the volunteer physicians to review their charts and pull together prescription refills. Volunteer medical staff cannot do physical checkups. The dental clinic is closed because the state health department ordered all elective dental care to be deferred.
    Joe Delbert of Tupelo, Mississippi, is relying on the Tree of Life Free Clinic for access to diabetes and high blood pressure medicine for the first time in three years. He lost his health insurance when he was laid off from his job manufacturing car parts.
    The same 10 volunteers handle each session to minimize exposure for others. Six of them are over 50, with Bailey and retired cardiologist Dr. Mike Boland both 73. They've tried to get coveted N95 masks but do not have any personal protective equipment, known as PPE, beyond gloves and two boxes of basic disposable masks.
    Across the country, other free and charity clinics are facing similar challenges as the need for them will only grow larger as more people lose their job-based insurance and struggle to pay their bills.
    To adapt, the clinics are turning their delivery models on a dime, said Nicole Lamoureux, president and CEO of the National Association of Free & Charitable Clinics, which represents 1,400 organizations. Some clinics are like the Tree of Life, focusing on medication refills. Some screen patients for fever before they come in for appointments. Others are trying to establish telemedicine options, even as such clinics have been left out of federal relief packages thus far.
    "It doesn't matter if they have a $1 million budget or $95,500," Lamoureux said. "There's no federal funding and no access to PPE."
    Still, charity clinics are finding ways to continue their free care.
    "Our role is to help people stay as healthy as they can during a scary time," Lamoureux added. "Without that service, they would be going to the ER, no question."
    Surge of need looming
    The Tree of Life operates out of a West Main Street building provided rent-free by neighboring Calvary Baptist Church in this city of 38,000 in northeastern Mississippi. It sees anyone without public or private insurance, regardless of residency, work requirements or immigration status, drawing patients from around the region. In 10 years, the clinic has recorded more than 22,000 patient visits.
    Banned from nursing homes, families need to know if their loves ones are safe