NC trend: Good medicine
By Jane Duckwall
Cecilia Becoat needed a doctor. She had moved to Cary from Richmond, Va., in January “for a fresh start in life,” she says. But she didn’t qualify for insurance coverage through her new job as a shift manager at McDonald’s or for Medicaid. She couldn’t afford private health insurance or the standard out-of-pocket costs for medical care and medications she’d been prescribed for lupus and other health problems.
Fortunately, a friend at Wake Chapel Church told her about Alliance Medical Ministry, where she is now a patient. Her doctor, Tara Burnett-Lewis, discovered other health issues, including congestive heart failure, that had gone undiagnosed by previous doctors. Becoat, 33, says her doctors in Richmond would simply “throw medication at me, not really testing to see what’s going on.” Some of her medications hadn’t been adjusted since she was 10 years old, she says.
Burnett-Lewis is one of three doctors on staff at Alliance, a faith-based organization founded in 2001 to provide affordable health care to low-income, uninsured, working adults in Wake County. A network of more than 300 active volunteers steps in as translators, gardeners, office staff, nurses, therapists and doctors, including cardiologists and other specialists who donate their time and expertise.
“We still have a huge gap in our state because they didn’t expand Medicaid,” says Megg Rader, Alliance’s executive director. “There’s still a lot of need out there.”
North Carolina is among 19 states that didn’t expand Medicaid in concert with Obamacare, the federal plan to insure more people. As many as 600,000 North Carolinians are caught in the Medicaid gap, including about 126,000 Wake County adults. Rader says Alliance serves nearly 4,000 of them, patients who pay an average of $20 to $25 per visit, depending on their household income. That cost includes medical care, lab work and any necessary follow-up.
There are at least 70 similar clinics across the state that are members of the N.C. Association of Free & Charitable Clinics. Some, like Alliance, have physicians on staff. Others depend solely on volunteers. All have guidelines for what services they provide and what patients they will accept based on criteria such as age or income.
Less than 10% of the clinic’s annual $1.46 million budget comes from patient payments, according to Alliance’s 2014 annual report. The rest comes from churches, individuals, corporations, grants, fundraising events and contract fees. For example, WakeMed Health & Hospitals may reimburse Alliance for follow-up care for indigent patients who have been released from the hospital. Alliance also partners with UNC Rex Health Care, which does all of the clinic’s laboratory work, and Duke Raleigh Hospital, which provides financial and volunteer support for Alliance’s diabetes programs.
Michelle Turner signed up for Cooking Matters, a six-week cooking and nutrition class, and Alliance’s diabetes prevention program, which includes a six-month pass to a nearby YMCA. The 44-year-old certified nursing assistant says she’s lost more than 30 pounds and her blood-sugar levels are now normal.
“A year ago, I could run only 1 mile,” Turner says. “Now, I’m preparing to run my first half-marathon.”
Becoat says Burnett-Lewis and others at Alliance are working to wean her off some of the medications she was prescribed in Richmond. She says she’s grateful that Alliance’s partnerships with other organizations enable her to purchase her nine prescriptions for $85 a month instead of the usual $500. But the connection she’s built with Burnett-Lewis has an added benefit. They share a strong faith, Becoat says, and she sometimes gets a few lines of scripture written on a prescription pad.
“I really believe that coming down here has saved my life,” Becoat says. “It’s because of the level of care that [Burnett-Lewis] provides.”