Although the Affordable Care Act is providing health insurance to many previously uninsured persons, recent estimates suggest that as many as 500,000 Cook County residents remain without coverage. Because of a variety of factors, many of them cannot gain access to medical services for neither prevention nor management.
It is likely, therefore, that volunteer clinics,supported by not-for profit organizations,will continue to play an important role in the health care system. But these critical health care delivery “safety nets” have a variety of unmet needs and challenges, such as:
- Struggling to pay for personnel, salaries, rent, utilities, and medicines;
- Treating large numbers of diabetics but have no access to insulinor volunteer nurses required to teach the patients how to administer it;
- Limited numbers of participating physicians and administrative workers;
- Helping to apply for grants; and
- Developing/accessing an organized referral system of primary care patients to specialized treatment.
There are also educational and outreach needs, which include:
- Helping patients manage their chronic illnesses;
- Developing self- management programs;
- More extensive production and distribution of information about health conditions such as pregnancy, hypertension, or diabetes;
- Monitoring and tracking pediatric patients; and
- Reaching out to patients who have dropped out from the clinics or are not taking their medicines.
This is in addition to volunteer clinics that already or need to contact community groups to identify further needs such as improving health literacy; making healthy life choices with respect to nutrition, sleep, exercise, and work; providing health care-guest speakers, or working in smaller groups, if necessary.
Many medical students, some organized into voluntary groups, have become actively involved, working under the supervision of experienced volunteer physicians who help with administrative duties and even raise funds through gala events. In some clinics, on certain days, all the work, patient care, and administration is already done by volunteers, in a refreshing model that does not depend on big government or insurance companies.
For several years, the Hektoen Institute of Medicine has supported such voluntary clinics through physicians volunteering to see patients and supervise medical students in clinics; making available small grants; attempting to raise funds, obtaining grants, and/or securing private contributions; and gaining a greater understanding of what some of the needs of these clinics are. To-date, relationships have been established with:
- The Community Clinic of Old Irving Park;
- The Indian American Medical Association Free Clinic;
- The Community Clinic;
- The Prieto family Health Center;
- The Proviso – Leiden Council for Community Action;
- The Instituto Latino; and
- The New Life Organization of Medical Students.
One example of Hektoen’s efforts to help volunteer clinics is its work with the Supporting Initiatives to Redistribute Unused Medicine (SIRUM) organization. Hektoen is creating a coalition with SIRUM (www.SIRUM.org) of Illinois public health care advocates and State of Illinois legislators to promote changes to the Illinois “Good Samaritan Law” that would mitigate barriers for volunteer clinics to receive free pharmaceutical donations, which would ultimately help them reduce their operational costs and serve more patients.
More recently several not-for-profit organizations have formed a discussion conclave,the Foxglove Forum. For the Volunteer Clinics Initiative,this offers the possibility of achieving some degree of coordination, with pooling of resources, staff, know-how, and funds, or offering grants for specific functions such as screening for certain diseases. The five member organizations of the Forum are:
- The Institute of Medicine of Chicago;
- The Hektoen Institute of Medicine;
- The Michael Reese Research & Education Foundation;
- The Portes Foundation, and
- The Public Health Institute of Metropolitan Chicago.
At the last meeting it was decided to explore ways forsome members of these organizations to participate in this project to further the initiative. A recommended plan of action might include providing an inventory of volunteer clinics and opportunities for physicians, nurses and other health care professionals to donate their services; helping clinics collaborate and share their successful practices and connecting volunteer clinics with needed community resources.