Local churches provide health care for needy

Dozens at a time lined up outside the door to the gymnasium on a cool and sunny Tuesday morning, waiting their turns to see the doctor or nurse practitioner.

Seacoast Church's Dream Center, now in its new digs on North Rhett Avenue, includes a free health clinic set up to serve residents of North Charleston and Hanahan who have no health insurance and don't qualify for Medicaid.

That's a lot of people: all those who have fallen through the cracks -- the indigent and homeless, substance abusers, the unemployed, the self-employed who cannot afford to buy an insurance policy, temporary or part-time workers, immigrant families and, increasingly, some who have endured sudden financial hardship, who once were members of the middle class but have lost what they had.

Nurse Practitioner Dawn Heyward visited with a woman complaining of abdominal pain.

Cheryl Robinson, who complained of high blood pressure, arthritis and a troublesome metabolism, was there to meet with Dr. Jepta Cobb.

In the reception area, patients sat at tables across from clinic volunteers who verified eligibility and collected information. One man came in not for medical care but to find someone with whom to pray. Butch Trentacosta, a lay minister at Seacoast and longtime volunteer, quickly obliged the man.

As the nation grapples with proposals for health care reform and recessionary times are swelling the ranks of the uninsured, churches and faith-based organizations in the Charleston Metro area are filling the gaps, opening and sustaining free medical clinics for those who have no insurance and cannot afford to purchase any.

Seacoast is one of at least three local churches providing health care. St. Andrew's Church in Mount Pleasant runs a free clinic on Tuesday evenings, serving at least a dozen patients each week, according to communications director Greg Shore. And the Church of the Holy Communion on Ashley Avenue offers medical services twice a week to uninsured, low-income patients.

Additionally, faith-based organizations such as Our Lady of Mercy Outreach's Wellness House on Johns Island and Harvest Free Medical Clinic on the old Navy base in North Charleston provide free medical care to qualified patients. East Cooper Community Outreach in Mount Pleasant and Crisis Ministries' homeless shelter downtown, each founded by or with significant support from area churches, also run medical clinics that offer free care.

Expanding the dream

Bill Bartoccini, executive director of the Dream Center Clinic, which opened for business in January, said the operation "couldn't be more timely given the economic situation."

He and Sam Lesky, pastor of Seacoast's North Charleston campus, estimated that more than half of the North Charleston and Hanahan population living in the vicinity of the church is uninsured.

Currently open two days per week in the mornings and evenings for a total of 12 hours a week, the clinic receives between 450 and 500 patient visits each month on average, Bartoccini said. Last month, 520 came. The goal is to expand the clinic's operating hours to four days a week, he said.

Patients pay a $20 fee upon registration and get one year's worth of health care and medicine (excluding cancer drugs) at no cost, Bartoccini said. The majority of patients complain about diabetes, hypertension, upper respiratory disorders and high cholesterol, conditions broadly associated with poverty. A dermatologist, two cardiologists and three ear, nose and throat doctors are on-site once per month; chiropractic services are available once a week.

About 370 people are registered volunteers, and the clinic has about 25 on-site at any given time during operating hours, checking people in, screening them, praying with them, conducting exams and doing consultations.

Without the clinic, many indigent patients would visit emergency rooms, Bartoccini said. The South Carolina Free Clinic Association reported that the average ER cost per patient in 2007 was $1,650, according to Bartoccini. Two years later, it's certainly higher, he added.

The clinic, then, is taking significant costs out of the health care system by providing patients with an alternative to the ER, he said.

Reaping the harvest

Three days a week -- Monday, Tuesday and Thursday -- Harvest Free Medical Clinic cares for those without insurance, many of whom have become regulars. Patients come from all over the Lowcountry and beyond.

Founded and run by Dr. Bob Freeman, the clinic is an expression of Christian mission, he said. He offers to pray with each patient he sees and said he views his work as an opportunity to glorify God and share the love of Christ.

The clinic, which got its start seven years ago in a double-wide trailer on Midland Park Road, moved to the old Navy base four years ago when Loy Stewart, chairman of Detyens Shipyard, offered Freeman space in a 10,000-square-foot building. Half of the building is the free clinic; the other half is the Detyens Medical Center, serving company employees and dependents.

On the free clinic side, Freeman sees about 85 percent of the patients himself, he said. Of the medications dispensed by the on-site pharmacy, 95 percent are generic.

"If patients don't pay anything, they're supposedly going to be more compliant," pharmacist Debra Gaskins said. And the clinic keeps its drug costs low.

About 40 volunteers work there, Freeman said. And they have access to state-of-the-art equipment, including a high-powered digital X-ray machine ($100,000) and a Basal Metabolic Profile machine ($10,000) that tests thyroid and kidney function.

The more in-house tests and labwork that can be performed, the less money gets sent into the black hole of the U.S. health care system, Freeman said.

"We try to be independent of anybody who adds cost to health care," he said. The X-ray machine paid itself back in about one year.

Freeman, who worked at the Medical University of South Carolina and the V.A. Medical Center for 30 years before being diagnosed in 2005 with Stage 4-B lymphoma and receiving chemotherapy for one year, said he approaches his work with a clear sense of purpose.

"To provide for the needs of the poor is absolutely a vital component of my faith," he said. "It's not a responsibility so much as it is an opportunity."

The staff at Harvest Free Medical Clinic had nearly 6,300 patient visits and wrote more than 25,000 prescriptions in 2008.

Small but committed

St. Andrew's Church started its free clinic in 1983, according to communications director Greg Shore. In 2008, the clinic saw eight to 10 patients during the night each week it was open to the public. This year, as many as 15 are seen in an evening, several of whom are new patients.

Staffed with a doctor, physician's assistant or second doctor and two nurses, the small clinic treats a lot of diabetes, hypertension and other ailments, but increasingly, people are visiting with acute conditions that require referrals, Shore said.

Patients tend to show up an hour before the doors open at 7 p.m. Tuesdays and are seen on a first-come, first-served basis.

The Church of the Holy Communion, an Anglo-Catholic parish on Ashley Avenue, runs a free medical clinic twice a week.

Dr. Bill Prioleau, a cardiothoracic surgeon who retired from Roper Hospital in 1996, took the helm at the prompting of his wife, Patsy, beginning a second career as a medical volunteer.

Today, he uses a small kitchen at the church and visits with about 70 regular patients and a number of walk-ins whose annual income qualifies them for free care.

Early practitioners of Anglo-Catholicism were ostracized by the Church of England and often left with little funding. As a result, Anglo-Catholic leaders took their theology to the slums, where expenses were low and need was great.

Holy Communion inherited this tradition, and it is in this historical context of service to the poor that the parish runs its medical clinic, according to its rector, the Rev. Dow Sanderson.

Charleston Outreach, an affiliate of the Charleston Baptist Association, operated a free health clinic at First Baptist Church in North Charleston for nearly 11 years. It closed in April 2008, partly because of the success of the nearby Harvest Free Medical Clinic, according to Executive Director Chuck Coward.

Now, plans are being laid to open a free dental clinic on Grayson Avenue in North Charleston, Coward said. The dental clinic will be a stand-alone nonprofit, the result of a collaboration among various area churches and charities, he said.

If all goes well, the clinic could open during the first part of 2010. At the moment, only tooth extractions are likely to be performed, "but if we can bring more players to the table, then the effectiveness of what we're doing can be significantly increased," Coward said.

'Hope and dignity'

The Dream Center Clinic, a large enterprise by most standards, has an annual operating budget of about $90,000, Bartoccini said. A stand-alone nonprofit, it raises money through private donations.

Like Harvest Free Medical Clinic and other providers, it negotiates favorable financial arrangements and third-party medical services with area specialists, labs and pharmacies.

Cobb, the doctor on duty on a recent Tuesday morning, moved to the Charleston area from Mobile, Ala., in August 2008. He said he knew of no free clinics in Mobile, and that the generosity of the Charleston region was something to behold.

Heyward, nurse practitioner, said she has volunteered at the clinic since it opened and sees the work as an opportunity to practice preventive medicine helping patients avoid the emergency room or hospitalization.

Doctors and administrators at both the Dream and Harvest clinics noted that it has been easy to form relationships between providers and patients. These relationships engender trust and help ensure that patients follow doctors' advice, they said.

Bartoccini described the clinic as a place informed by faith that promotes a "culture of caring."

"We don't have to work hard caring for people who come here," he said. "Our responsibility is to demonstrate to our patients that they are no different than we are. They are entitled to hope and dignity regardless of circumstances."

Reach Adam Parker at 937-5902 or aparker@postandcourier.com.

Earlier versions of this story online misidentified Esperanza Riols. Riols is an interpreter at the Dream Center Health Clinic. The Post and Courier regrets the error.