Washington Post, July 10, 2008: Two Clinics for the Poor To Consider Merging
By Sandhya Somashekhar
Washington Post Staff Writer
Thursday, July 10, 2008; LZ01
The Loudoun County Board of Supervisors has asked the operators of two clinics for low-income patients to consider collaborating more closely and perhaps merging in the hopes of improving health care for the county’s poorest residents.
The Loudoun Community Health Center and the Loudoun Free Clinic provide medical services to hundreds of uninsured and under-insured county residents each year. The two organizations, along with the Loudoun County Department of Health, are slated this summer to discuss the possibility of combining some operations.
Leaders of the two clinics say that although they are open to the possibility of merging, such a plan could have a host of unintended consequences that could weaken their ability to serve a growing need.
But Supervisor Lori L. Waters (R-Broad Run) said the aim of a merger would be to save money and perhaps expand services. For example, by combining resources, the organizations might be able to save enough money to add a mental health component, she said. Some services provided by the Health Department, such as dental care, might be better provided by a nonprofit group, she said.
“I think it’s a good conversation to have with all three of these entities,” said Waters, who added that the decision is ultimately up to the nonprofit groups. “We can determine who’s doing what [and if] greater things can be achieved by combining forces.”
Health advocates say the need for free and low-cost health care is growing across Loudoun as the population increases. In recent years, the county’s construction boom has brought a flood of low-paid workers, and the loss of many technology jobs has sent some middle-class people into poverty. More recently, advocates say, the need has become more acute with the worsening economy and the foreclosure crisis.
The two clinics have similar aims but serve slightly different populations and have vastly different ways of operating.
The Loudoun Free Clinic, which opened 10 years ago, is run by a handful of staff members and about 70 volunteer doctors who provide their services free of charge. People seeking medical treatment must be between 18 and 64, have no health insurance and earn less than $20,800 a year.
The organization has about 900 patients, many of whom suffer from chronic illnesses such as diabetes and heart disease. The clinic received about $80,000 from the county this fiscal year.
The Loudoun Community Health Center, by contrast, accepts all patients but typically charges a minimum of $15 per visit. The organization has two paid family physicians and one pediatrician on staff and has served about 2,300 people since it opened last year. The center received about $30,000 from the county this fiscal year and hopes to secure federal funding next month.
The center has filled a need in treating children; about 40 babies receive treatment each month, officials said.
Merging the two organizations, which already collaborate closely to serve the county’s burgeoning needy population, “may not be in our or our patients’ best interests,” said Jennifer Montgomery, executive director of the Free Clinic.
“We will certainly look at the recommendations and talk about them, but there is certainly enough need and work for the both of us,” she said.
David Goodfriend, director of the county’s Health Department, agreed that there may be pitfalls in merging operations.
“You would want to have a good reason to merge,” he said. “They each serve primarily a different piece of the underserved population.”
But Stephanie Kenyon, chief operating officer for the Health Center, said such mergers have been successful elsewhere in the country.
“It depends upon the nature of that merger,” she said. “It would have to be complementary.”