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Health care law could increase client list for Butler County health clinic

| Sunday, Sept. 8, 2013, 12:59 p.m.
Dr. James Rathfon and Dental Assistant Jo Anderson volunteer their time to work on patient Doris Pintea of Butler Township at the Butler County Community Health Clinic Thursday, August 29, 2013.
Nurse Educator Linda Reichart explains how she uses visual aides to teach people how to eat healthier at the Butler County Community Health Clinic Thursday, August 29, 2013.

For the working poor of Butler County, the Community Health Clinic of Butler County is a safe place to land in hard times.

“If it wasn't for the clinic, I wouldn't be able to get my medications,” said Doris Pintea, a 59-year-old Butler resident, who lost her health insurance in 1998 when her husband died.

The clinic, which provides free health care to age- and income-eligible county residents without health insurance, helped 2,085 people last year — the highest number in its five-year history. But changes in the health care landscape nationally are expected to affect the clinic and the people it serves.

Cecelia Foster, the clinic's executive director, expects more people to become eligible for clinic services under the Affordable Care Act, or Obamacare, but that some current clients may be able to afford health care plans offered under the law and leave the clinic.

The enrollment period begins Oct. 1.

The law mandates that most individuals have health insurance; it provides subsidies to help pay premiums and penalizes people who can afford coverage but don't get it. It imposes penalties on businesses with 50 or more full-time workers that don't offer coverage.

There is a misconception that the law will ensure health care for everyone in the U.S., said Beth Foringer, the clinic's director of case management.

“There are going to be subsidies for people within the federal poverty guidelines, but individuals earning zero to $11,000 a year do not qualify (for subsidies),” Foster said.

“Or people might be able to afford it, but if there's a choice between buying food and paying for health care, which are they going to choose? They're going to feed themselves,” Foringer said.

Critics of the law say some businesses are reducing numbers of full-time workers to part-time to avoid penalties.

The clinic, which opened in 2008, is part of the Volunteers In Medicine alliance, a network of free, primary health care clinics for the uninsured. Jean Purvis, secretary of the Butler clinic's board of directors, led the charge to open the clinic, along with other community leaders. Purvis toured a Volunteer in Medicine clinic in Hilton Head, S.C., and felt the model would work well in Butler County.

“This is a shining example of what's right with health care,” Foster said.

Physicians, dentists, nurse practitioners, nurses, pharmacists and medical administrators donate their time. Last year, their hours were worth an estimated $198,000, according to the clinic's annual report.

The clinic has three full-time paid administrators.

It offers diabetes education and management and behavioral health care. It supplies patients with prescriptions through the Prescription Assistance Program run by pharmaceutical companies. More than $476,000 in prescription medications were dispensed in 2012 at no cost to the patients, according to clinic data.

Judging from a patient satisfaction survey conducted in May, the clinic has helped keep people out of emergency rooms, which can be expensive for the patient and the hospital, Foster said.

Patients typically stay with the clinic from 18 months to two years, but there are no restrictions. It works to find jobs for patients that offer benefits, or helps to get patients into a federal or state assistance program that fits their income, Foster said.

Foster said the clinic is funded by grants, corporate giving and private donors. It receives no federal funding. It is one of two free clinics in Western Pennsylvania that belongs to the Volunteers In Medicine alliance. The other is in Downtown Pittsburgh.

Pintea said she would like to get her own health insurance and hopes the Affordable Care Act will make that possible. Before the clinic opened, she said, she paid out of pocket to her family doctor and avoided visits to the dentist or any specialists.

Since being a patient at the clinic, she has seen primary care physicians, dentists, a dermatologist and a podiatrist.

“Most of our patients want to buy insurance,” Foringer said. “They don't want to rely on others.”

Rachel Farkas is a staff writer for Trib Total Media. She can be reached at 724-779-6902 or rfarkas@tribweb.com.

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