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Clinic Serves the Uninsured

Andes Clinic has treated more than 8,000 patients

Sun Contributor

November 30,2009 -There are five conditions that the average uninsured patient who comes to the Virginia B. Andes Volunteer Health Clinic in Port Charlotte is afflicted with: high blood pressure, anxiety, diabetes, chronic lower back pain and obesity. These issues aren't just common they're connected.

"It's not unusual for us to see all of the above, all five conditions with one patient," said Dr. Eusebio P. Gonzales, clinic operations manager.

If left untreated, any or all of these health problems will inevitably lead to a trip to the emergency room. And for the uninsured, that's a trip they typically can't afford.

Hospitals in Southwest Florida cover tens of millions of dollars every year in emergency room costs for indigent care. To offset those costs, and to treat those who need help before it becomes an emergency, Dr. Mark Asperilla helped to start the Andes Clinic. Plans to open a clinic in Englewood are under way, and he hopes to have another in Arcadia in the near future.

"It's becoming more like a McDonald's franchise, but instead of doing McDonald's, we're doing a community service," Asperilla said. "In a way, I'm a social entrepreneur."

Since the Port Charlotte clinic location opened in February of 2008, it has already provided more than 8,000 patient contact hours to the community. That's thanks to the work of Gonzales and executive director Suzanne Roberts, along with a number of volunteers who provide their service free of charge.

The clinic is in addition to the St. Vincent de Paul Community Pharmacy, which has given back close to $5.6 million to the community through prescriptions since it first opened in 1999. And all of this goes to blue collar workers, patients who are usually employed in the construction or hospitality industries and have no or little insurance coverage, along with the homeless and needy.

"We're taking care of the poorest of the poor," Asperilla said.

Chipping in

The Andes Clinic truly is a community effort.

Charlotte County's local hospitals have contributed to the operation, which helps to offset their own costs associated with indigent care. Fawcett Memorial, Charlotte Regional and Peace River Regional all contributed $2,500 a month in ongoing funds, and helped to kick start the operation with cash before it opened.

The hospitals also provide in-kind services for costly procedures, ranging from medical imaging to use of the hospitals' surgical rooms. Twice a month, the hospitals provide a surgical room with a visiting doctor for small surgical procedures, as well as some large ones, at a pro bono rate.

"For every individual within our services, their rate would be astronomical," Roberts said. "We save them (the hospitals) to the tune of millions a year with regards to services in the emergency room."

For example, if one person without insurance had a sore throat and went into the emergency room, certain tests would need to be done that would average around $1,500. If the person cannot pay that bill, the hospital must cover the cost on their own.

With 8,000 patients already serviced since the clinic opened in February 2008, Roberts said the savings are huge.

Charlotte County's hospitals said they're happy to give what they can to the clinic.

"I think the clinic does a phenomenal job," said Brad Nurkin, CEO of Charlotte Regional Medical Center. "We've been really proud of our association with the Virginia Andes Clinic. We think that supporting the clinic is a win-win situation."

Charlotte County is in on the program too, contributing $85,000 next year through a grant controlled by the local United Way. And additional grants of thousands of dollars from the Charlotte Community Foundation and the Southwest Florida Community Foundation, as well as individual donors, have helped the clinic to purchase high-tech medical equipment that allows it to provide excellent care for those who need it.

Prospective patients must just meet the poverty level requirements and be a Charlotte County resident.

"We don't refuse anybody," said Gonzales. "We take care of whoever needs care."

Preventative care

The clinic is not intended for long-term care, or for more serious issues like heart attacks. But if Gonzales and his team have their way, they'll be able to detect and prevent most of those situations before they become critical.

To that end, the clinic recently began a new wellness program that will address a variety of health concerns, particularly things that cause the five most common afflictions seen at the clinic. The program teaches patients about smoking, weight control, diabetes monitoring, blood pressure monitoring and exercise.

Asperilla said the clinic also has an advantage because it isn't required to do the usual barrage of tests that are conducted when a patient is taken to a traditional hospital. The clinic is protected by sovereign immunity because it is a not-for-profit providing a community service. Skipping those tests allows both the patient and the clinic to save high and often unnecessary costs.

Having volunteers who are willing to donate their time and services helps, too, he said.

"They have to pay the nurses, they have to pay the doctors, they have to pay everybody," Asperilla said of when traditional hospitals provide indigent care. "And they get nothing."

If the clinic doesn't get paid, he said, it's not as big of a deal, thanks to the efforts of volunteers.

"If the patient doesn't get paid, we don't get paid, but we don't lose too much money," he said.

And in the process, the patient becomes healthier and less likely to end up in the emergency room, thanks to the use of preventative care.

Expanding the franchise

Asperilla just received the final plans from his engineer for the next clinic he's planning in Englewood. Again, the community is chipping in, with labor provided by people in the community and Home Depot providing materials for the building.

"That's why it's low cost, because everything is donated by people in the community," he said.

He and others are also exploring a potential future clinic in Arcadia, where one is desperately needed. The prospect is particularly exciting to Vince Sica, president and CEO of DeSoto County Memorial Hospital.

He said Arcadia has a high number of illegal immigrants who work in the area, and they tend to drive up the cost of indigent care provided by the hospital.

DeSoto Memorial has attempted to make some exceptions and create programs for people who don't have insurance. But people who have insurance with really large deductibles they cannot afford also are a concern that must be addressed.

"We're making progress," Sica said. "It's not an issue that's isolated to here."

Asperilla said he feels confident that his "McDonald's franchise" approach will work again in Arcadia it needs to.

"There is a big need down there," he said.


'We've done it again"

Recently, Gonzales saw one patient at the Port Charlotte clinic who had throat cancer that was undiagnosed and asymptomatic until six months prior to his visit to the clinic. The patient had numbness on the left side of his face, but no pain.

Thanks to the use of the clinic's imaging equipment, they detected a malignant growth. By working with people in local and regional hospitals, the patient was treated with radiotherapy and now is doing well.

It's quite a turnaround for the patient, who hadn't had any decent health care for his condition for a half-year.

Thanks to the use of the clinic's imaging equipment, they detected a malignant growth. By working with people in local and regional hospitals, the patient was treatedwith radiotherapy and now is doing well.

It's quite a turnaround for the patient, who hadn't had any decent health care for his condition for a half-year.

Gonzales likes to think of accomplishments like that every evening when he leaves the clinic and says good-bye to his coworkers and volunteers.

"It's amazing, every night we feel great," he said. "The team shares that same vision, that same inner gratification. As I close to the door to the clinic, I say, 'We've done it again guys. Thank you.' I've lost track of how many lives we've saved, and that's a good feeling."

The Virginia B. Andes Volunteer Health Clinic Location: 21450 Gibralter Drive in Port Charlotte

Hours: 5 p.m. to 9 p.m. weekdays for appointments and walk-ins, free prescriptions from 9 a.m. to noon on Wednesdays. Phone: 941-766-9570. Both appointments and donations are encouraged.

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