A grant renewal that was anything but a sure thing, but was essential to Shepherd’s Care Medical Clinic’s ability to operate, proved to be a sigh of relief last summer.
The clinic had already expanded into the second half of the building it occupies off Pony Road without knowing as late as June that its main lifeline, a three-year N.C. Office of Rural Health grant for $150,000 annually, would be awarded again in July.
That was one obstacle down for Shepherd’s Care founder and director Leona Doner, but obstacles seem to be a constant for the free medical clinic that serves the uninsured.
“Rent went from $750 to $2,000 and operational costs went from $191,000 to $210,000,” Doner said of the expansion, noting that more space and more offerings – adding behavioral health, gynecological and medical nutritional counseling to the menu – paved the way for more patients, and with them, more expenses.
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While expenses rise, Doner said other sources of revenue, like funding passed through the N.C. Association of Free & Charitable Clinics, may be fading.
As it stands now, she said the clinic would be lucky if it received $10,000 per year in donations, which are vital, but even they don’t go far compared to the operational needs.
“If that money stops and we don’t get churches or foundations to keep supporting us, what we have keeps getting smaller,” Doner said. “Because of the lack of funds that are coming in, we had to make changes.”
Adding ‘charitable’ to the title
Effective in January, Shepherd’s Care scaled back on its range for patients to qualify for free service.
The clinic formerly only served those within 200 percent of the poverty level, asking only for a $5 administrative fee but seeing patients whether they could pay that fee or not.
The new cutoff for free service is 184 percent of the poverty level and the administrative fee is now $10 for those who can pay it.
Shepherd’s Care has also changed is designation from a free clinic to a free and charitable clinic, and has added new service tiers charging a $25 copay for those between 185 and 200 percent of the poverty level and a $35 copay for those within 201-225 percent of the poverty level.
Doner said a vast majority of the patients the clinic sees fall at or below the 184 percent mark, estimating 10 or fewer patients would be affected by the new structure.
The clinic had to acknowledge the difference in some of the services it now offers, Doner said.
“It costs the clinic (for patients) to take advantage of things like drug tests, which are not a necessity like treatment for chronic diseases,” she said.
Enjoying new space
Wendell resident Deborah Hilliard said paying a little more to be seen is still a fraction of what she would pay elsewhere, and for that she is thankful.
“This place means everything to me,” Hilliard said Thursday during a visit for a checkup in the new side of the clinic.
She said she has tried to pay the maximum she can afford every time she’s gone to Shepherd’s Care of the past couple years.
“It allows me to get medical care at a price I can afford and the doctors here have found things about my health I didn’t know I had,” she said. “They’re great. I just wish they could find more help, more financial donors to keep them going.”
The clinic essentially shifted intake services from the right side of the building to the left side in the expansion. Health counseling services, retinal eye exams, “anything we bring in that doesn’t involve a health exam,” now take place in the rooms where the clinic got its start, Doner said.
The paid staff, composed of Doner, a bilingual receptionist, a physician and a nurse has remained the same.
“We need to add more physicians, but they’d have to be volunteer because we don’t have the money to pay anybody,” Doner said.
Act of trust continues
Doner has more than once said Shepherd’s Care was founded on faith. Despite repeated uncertainties at the clinic, she says she is able to conceal the chaos because she believes the clinic serves a divinely-prescribed purpose.
“I trust the Great Physician,” Donor said. “It’s His, not mine. “Have we always not run on faith? Our doors probably should’ve been closed several times. He always sees our needs through.”
When people don’t see Doner panicking, however, she thinks they might interpret that to mean the clinic has all the support it needs, when that is anything but the case.
In January, the clinic had 122 unique visitors. It had 104 total medical visits, but also 31 medical no-shows; 16 nurse visits and four nurse no-shows; and 54 lab visits and seven lab no-shows. The clinic also had four nutritional health visits and 11 behavioral health visits.
People setting up appointments, but not showing up for them, is something Doner wishes would stop, since it hinders possibilities to serve other people who could make it and need to be seen.
How you can help
To make a donation to Shepherd’s Care Medical Clinic, call 919-404-2474.