“We’re looking more for a partnership than just a grant,” she said.
Since the free clinic was launched in 1995, the health care landscape has changed, including Ohio expanding Medicaid eligibility to cover more people and the growth of federally-qualified health centers, which are geared toward low income patients and charge patients based on income.
“With the influx of Medicaid expansion, a lot of communities have tried to transition their free clinic support to models that receive reimbursement, because it’s a stronger operation and a more sustainable platform to provide those medical services and it allows them to operate from a medical home model,” said Sarah Hackenbracht, president and CEO of the Greater Dayton Area Hospital Association.
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But Sherlock said their steady stream of visits to the clinic show that there are still gaps in the system and that the free clinic is still a needed safety net. The 2018 annual report said the clinic had 2,937 clinic visits and, 11,630 follow-up encounters and 11,325 volunteer hours.
Some patients make too much for Medicaid but can’t afford marketplace insurance or a copay. They help people get signed up for Medicaid or Medicare if patients qualify, but she said people might need immediate health care while they are having an insurance gap.
“I call us Gaps R Us,” Sherlock said.
There had been a meeting scheduled for Aug. 29 where leaders from hospitals, government, nonprofit and other groups were going to meet with Reach Out, and Hackenbracht said the goal was to have a conversation about how to have a strong and sustainable health safety net.
Sherlock said Reach Out cancelled the meeting because of the impression that the goal of the meeting was going to be to move away from the free clinic model, when free clinic care is important and needed.
While Dayton clinic hours stopped, Reach Out’s other services are still open, including their Bettman Charitable Pharmacy, physical therapy appointments, behavioral health sessions, the community paramedicine program, and Yellow Springs clinic.
Sherlock, who just retired from her assistant professor position with Wright State University, said one of the financial challenges is that her executive director position with the clinic was paid for through her Wright State salary and now her position is unfilled.
Seth Bauguess, spokesman for Wright State, said “It is the understanding of the Boonshoft School of Medicine at Wright State University that the Board of Directors of Reach Out has been developing a strategic plan to guide their future operations. We, along with other community stakeholders, are waiting to hear their future plans.”
Sherlock said the clinic also received a letter from Grandview Medical Center, which is part of Kettering Health Network, which said in July it was ending its $24,000 annual donation. Kettering Health referred questions back to GDAHA.
Premier Health said “As long-time supporters of Reach Out, Premier Health and Miami Valley Hospital would like to see all stakeholders come to the table to determine the best path forward for the organization. In the absence of a publicly funded hospital in Dayton, it is important that these conversations be part of a broader community conversation about how best to care for our most vulnerable friends and neighbors.”
Sherlock said Reach Out has a lean operation and already meets the community need by relying heavily on volunteers such as students with Wright State University. Reach Out had about $1.1 million in a total budget including in-kind donations including $360,000 in cash from grants from different organizations in 2018.
She said the clinic also provides a return on the donations by keeping patients from the high cost emergency room.