Pulse
Caring Collaborative
How residents of one Minnesota county joined forces to provide free medical services.
It’s a frigid Tuesday night in December, and the basement of Little Prairie United Methodist, a white clapboard-sided church in the town of Dundas, an hour south of Minneapolis, is humming with activity. The coffee is on, and a physician, nurse, interpreter, and several other volunteers are busy caring for patients. In the small waiting room filled with children’s books and decorated with handmade posters displaying bilingual health information, three women chat in Spanish while a baby girl plays on the rug. Down the hall, in one of the clinic’s two simply furnished exam rooms, a young woman waits to see the doctor.
The picturesque church is home to the HealthFinders clinic, a twice-weekly community effort to provide free medical care to people who live in the region and have no health insurance and meet certain income guidelines. The clinic was established after a series of conversations that began in 2002. Latino leaders at St. Dominic’s Parish in nearby Northfield had learned that access to health care and medications was the No. 1 concern of the church’s nearly 1,500 Hispanic parishioners. Rice County is home to a number of Latinos, many of whom work in low-wage positions that offer no health insurance or are undocumented immigrants and, thus, cannot receive government assistance for nonemergency medical care.
The following year, those leaders began talking with physicians, nurses, public health officials, social service providers, clergy, and other citizens throughout Rice County. The result was establishment of the HealthFinders Collaborative. Recognizing that it was centrally located between Northfield and Faribault, Little Prairie United Methodist Church stepped forward to offer a physical home for the clinic, which opened its doors in 2005.
A Community Endeavor
According to clinic director Angie Koch, the collaborative modeled itself after the St. Mary’s Health Clinics run by the Sisters of St. Joseph of Carondelet in the Twin Cities. Now it has become an example for other communities such as Red Wing and Litchfield that are trying to start their own free clinics. “We have proven to be sustainable and are fully staffed by volunteers,” Koch says. She credits their success to the civic-mindedness of Rice County residents, many of whom are affiliated with St. Olaf and Carleton colleges in Northfield. “I think the colleges play a big role in this,” she says.
HealthFinders has logged approximately 5,000 clinic visits and served about 2,600 patients since opening its doors. Most of those patients come from Northfield, about six miles north of Dundas, and Faribault, about 11 miles to the south.
The clinic is staffed by approximately 200 volunteers including doctors, nurses, interpreters, clerical workers, and students from St. Olaf and Carleton, some of whom are planning to go into medicine or nursing. Equipment and supplies are mostly donated. Pharmacies in Northfield and Faribault provide many medications at cost, and Koch has negotiated discounts with some pharmaceutical manufacturers. Area residents often donate toys or books for young patients or, in winter, hats, mittens, and scarves. “This is an investment of the whole community,” Koch says.
From Colds to Chronic Ailments
On a typical evening, providers will see six to 10 patients, Koch says. Most of the cases are straightforward—well-child visits, rashes, and colds. Some patients have chronic conditions such as diabetes and asthma. Roughly 40 people turn out one or two Thursday nights each month for diabetes education and counseling facilitated by Northfield family physician Marshall Hansen, M.D., one of about 40 physicians who volunteer at the clinic. Like many other chronic ailments, including hypertension and depression, diabetes tends to be associated with—and exacerbated by—the stresses of poverty, Koch notes.
The need for the HealthFinders clinic has grown perceptibly during the economic downturn of the past year, Koch says, with swelling demand among formerly middle-class families, making the wait times for care longer. The construction industry, long a key employer in Rice County, has been particularly hard hit by the recession, Koch says.
“We’re seeing more young Anglo families, single-income families. We used to work mostly with patients who never had health [coverage], but now we’re hearing more and more stories of people who’ve lost it.” Koch says all patients are screened initially to see whether they qualify for government assistance.
HealthFinders receives much of the funding for its $140,000 budget from the Healthier Minnesota Community Clinic Fund. Support also comes from the United Way, the Medica Foundation, several fraternal organizations, and the Rice County Medical Society. Koch says she spends a significant portion of her time looking for new sources of support and admits the organization was in “scramble mode” last year.
Relevant Work
For the health care providers and students who volunteer at the clinic, the chance to make a difference in the lives of those in need keeps them coming back. Hansen, who retired from the Navy in 2000, and Faribault family physician George Wagner, M.D., have both been part of the effort since its inception.
“In the Navy, I worked in many developing countries with limited resources and sometimes out of tents or broom closets … and you’re treating everyone, without regard to whether or how much they can pay you,” Hansen explains. “This feels pretty natural.” He enjoys the challenges associated with practicing without the latest technological innovations. “You really have to figure out how to practice medicine.”
Wagner, who volunteers at the clinic monthly, agrees. “You depend more on your exam skills, your interviewing skills.” A heart murmur, for example, must be diagnosed with careful listening through a stethoscope, not with a CT scan or MRI, he says.
For some, serving the clinic is a family affair. One physician volunteers with her mother-in-law, who is a nurse. There’s also a mother-daughter receptionist-interpreter duo.
Hansen says the clinic’s volunteers have similar ideas about what the world needs and what they can do to help.
“I think we all want to do things that are relevant,” he says. “These patients are all part of our community, and they contribute to our community. Taking care of them is worthwhile, whether they have a Social Security number or not.”—Susan Maas