Originally created 12/26/96

SC clinic faces dollar shortfall, crowds



HILTON HEAD, S.C. - The Volunteers In Medicine free clinic is growing more popular than it can afford.

It costs more than $1,800 per workday - about $470,000 a year - to keep the doors open at the 30-month-old facility. That's about $130,000 more than the clinic took in as donations this year.

Trish Heichel, director of development for the nationally acclaimed clinic, said the shortfall will be made up this year through a contingency fund begun for just such emergencies when the clinic first opened.

But that contingency fund, she said, will soon be outstripped by the growing needs of the bustling clinic.

The private, nonprofit clinic founded by physician Jack McConnell accepts no tax dollars or United Way funding, so it is entirely dependent upon local and national private donations.

The clinic's target clientele - people who live or work on Hilton Head and can't afford to pay for health care - is using the clinic now more than ever, said its medical director, Barry Hellman.

Usage increased almost 65 percent in the last year for a variety of reasons, he said. Chief among these factors, he said, are initiatives to remove people from welfare rolls.

"It doesn't take a rocket scientist to figure out if you're going to take large numbers of people off Medicaid rolls, these people are still living somewhat on the fringe," Dr. Hellman said.

"Medical expenses are still outside their realm. They won't be able to purchase health plans at $300 a month, so they will still need to go to charities. There's a direct correlation between the numbers we're seeing and the costs."

And more patients means more lab tests, X-rays, medicines and dental supplies, he said.

Fred Washington, director of Beaufort County's Department of Social Services, said recently that welfare reform or not, the community needs to do everything in its power to keep the clinic thriving.

"VIM fills a tremendous void that exists in our community," Mr. Washington said. "Whether the patients are our clients or not, they are our citizens, and they're not being served medically when they cannot afford it."

Clients who are removed from welfare rolls eventually will lose their health care benefits, he said, thus exposing a "far more vulnerable population out there - children."

"We need to make sure VIM will meet the need until they are no longer needed," Mr. Washington said.

Dr. Hellman said another reason for the upsurge in the clinic's popularity is that it has become well-known and respected in the community. Word on the street used to be that you don't get something for nothing, but the medical professionals and volunteers at the clinic have been able to overcome that misconception, he said.

The waiting room on a typical morning is filled as soon as the doors open, Ms. Heichel said. According to clinic records, doctors in a morning session typically see almost 50 patients. At a typical daylong session, more than 85 patients are seen.

When the clinic first opened its doors on June 9, 1994, the $500,000 structure was fully paid for, thanks to the major grants of the Duke and Everett foundations and a myriad of local contributors.

"We have no endowment," Ms. Heichel said, "but we're trying to put one into place so that we won't have the problems in the future we're having now."

The clinic is in the midst of its 1997 fund drive, she said. Letters have gone out to area employers, especially those that do not offer health benefits, seeking financial support for the facility that helps keep their employees well.

Has it worked?

"Not real well," Ms. Heichel said.

Some small businesses give in-kind donations of supplies or services, she said. And some former clients who have gone on to better-paying jobs remember the service they received at the clinic and send checks from time to time, she added.