Joyce, a prediabetic 62-year-old, recently has been unable to afford her blood pressure medication.
Joyce said she lost her job in the clinical research industry last February. Then, both her parents died within seven months of each other. This is the first time in her career she’s been without insurance.
“I’ve been applying, but nobody’s hiring,” said Joyce, who asked that her last name not be published. “I know they say age doesn’t matter, but it really does. They know if they hire me, I might have a lot of health issues, I won’t be there too much longer. I’m a risk, I guess.”
Her next option was Advance Community Health, a nonprofit clinic that opened a new branch Jan. 3 in Cary’s Dorcas Plaza. She visited about two weeks after it opened for a check-up and a blood lab to find out what kind of shape her cardiovascular health is in after going without her blood pressure medicine for so long.
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Stories like Joyce’s are common among those who seek Advance’s services, as well as those who come to Dorcas Ministries, a faith-based crisis-relief organization, for other reasons. Dorcas Plaza also contains a Habitat for Humanity Restore, as well as a variety of other social services.
Even in affluent areas such as Cary, those with strong employment histories can unexpectedly fall on hard times for a variety of reasons, especially when they’re caring for aging parents while growing old themselves.
“We have clients who come in for what I’d call a short-term crisis,” said Howard Manning, executive director of Dorcas Ministries. “Maybe it was a high medical bill or a car repair. Then we have people in a more permanent state of crisis. We try to give them what we call wraparound services, using the skills and talents God has given them to make a living.”
In 2008, Dorcas purchased the old Cary Plaza, which is off High House Road and along a bus line, with the intention of rehabilitating it as a social services complex for the area. The new Advance location, next to a preschool, is just the latest addition to the center.
Dorcas reached out to Advance last year and offered clinic space to the nonprofit rent-free for a year. Advance, a private nonprofit, operates five branches around Wake County: in Southeast Raleigh, Apex, Louisburg and Fuquay-Varina.
It receives about $3 million in federal grant money each year due to its designation as an FQHC, or Federally Qualified Health Center. The remainder of its $13 million annual operating budget is funded by Medicaid, Medicare, private donations and the out-of-pocket fees uninsured patients pay on a sliding scale according to their income. The average visit costs $124, according to Advance’s website.
Joyce – with no job and her savings depleted from caring for her parents – said she has been unable to qualify for Medicaid. Her husband, a welder making about $13 an hour, earns too much for them to meet North Carolina’s eligibility standards.
“They fall into that gap,” said Wilma Metcalf, communications manager for Advance Community Health. “If North Carolina had expanded Medicaid (under the Affordable Care Act), she wouldn’t be in this situation.”
Joyce was quick to criticize the Affordable Care Act’s insurance exchanges, though, which she said only offered her high-deductible plans with unreasonable monthly premiums.
“That’s not a discount,” Joyce said.
The need for such a clinic in Cary, which is among the most affluent parts of the state, isn’t immediately obvious. Cary’s median household income – about $90,000 per year – is more than double North Carolina’s.
For those who aren’t well-off, though, the suburbs can be a particularly hard place to live.
Away from urban centers, access to necessary social services, such as health care, can be difficult. Many social services offices are in downtown Raleigh and Durham, requiring those who often are without reliable transportation to make long journeys to reach the offices they need.
Manning said that Wake County’s Human Services presence in the area is structured differently from those in other parts of the county. Where brick-and-mortar centers in Zebulon, Wake Forest and Fuquay-Varina offer a full array of social services, the western part of the county relies on nonprofits and faith-based organizations. Together, they form something called the Western Wake Network of Care.
“Organizations like Dorcas have been standing in the gap,” Manning said. “We’ve been doing it for 48 years – providing those services that other citizens have through the government of the county.”
It is because of this that poverty in western Wake County, where it does exist, tends to be less visible, Manning said.
Like Dorcas, Advance Health takes a multi-faceted approach to the health services it provides.
“We are trying to treat our patients as more than the medical condition that walks through our door and trying to look at them as a whole person,” Metcalf said.
“If I have someone who is being seen because of diabetes, someone is going to stop and say, ‘Wait a minute, let’s see if your diet has anything to do with it,’ ” added Sherri Williams, practice manager for Advance’s Dorcas clinic. “ ‘Let’s pair you up with our dietitian.’ ”
Metcalf and Williams declined to say what they think of the Trump administration’s intention to repeal the Affordable Care Act might mean for their patients. But they both said they are determined to keep fighting for those in need.
“Even right now, we see an incredible number of people who are uninsured or underinsured because they can’t afford their health insurance already,” Metcalf said. “That demand might go up, but we don’t know. No matter what happens, we’ll be here providing that care for anyone who walks through our doors.”
Gargan: 919-460-2604; @hgargan
Advance Community Health-Cary at Dorcas Ministries Plaza is at 173 High House Rd., Cary. Call 919-833-3111 to schedule appointments. Hours are 8:30 a.m. to 5 p.m., Monday to Friday. For details, go to advancechc.org.