Gross and Admire are nurses at the Veterans Administration Medical Center who, after putting in a full work shift there, spent a Thursday night in December volunteering their medical services at The CARE Clinic.
The Fayetteville CARE Clinic is one of Cumberland County’s crowning achievements. The clinic benefits low-income working people who have no medical insurance. Community visionaries established The CARE Clinic 14 years ago to fill that ever-growing divide between those lucky enough to work for an employer who provides health insurance and those who lack this basic and essential quality of life service. In essence, the clinic’s mission is to provide free quality health care to uninsured low-income patients in Cumberland County.
In North Carolina alone, only about 58 percent of the work force had health insurance in 2004, an 8-percent drop from four years earlier. Today, many small North Carolina businesses find it difficult to provide health insurance to their employees because of double-digit increases in health premiums during the past five years. Cumberland County is no exception.
Gross and Admire are regular volunteers at the clinic, as are a number of their colleagues. In fact, December 21st was “VA night” at The CARE Clinic.
Gross, a nurse practitioner, could not put into words the reasons that repeatedly bring her to the clinic to ply her healing skills. “It must be the food,” she joked. Before seeing patients, the volunteer medical providers get a quick meal since they will miss dinner with their families. The meals, as one might guess, are prepared by still more volunteers.
“It’s great fellowship and you meet other medical providers you normally don’t see,” Gross said.
“When we come here, we’re doing the basics. We don’t have to worry about what insurance covers,” said Admire, an RN and patient education coordinator at the VA. “The people who come in here don’t complain and are so appreciative of what we do,” she added.
Gross and Admire see patients with ear infections, upper respiratory problems, high blood pressure and thyroid related disorders. The ailments are usually not trauma-related but can be urgent, Gross said. She recalled a woman coming to the clinic complaining of abdominal pains. Gross diagnosed acute appendicitis and sent the woman to the hospital. During a subsequent visit, the woman came to the clinic with a pale and swollen leg. Once again, Gross sent her to the hospital where doctors found an arterial blockage in her lower limb.
Since its inception in 1986, The CARE Clinic has built its ability to provide services on a foundation of volunteers, many of whom have been with The CARE Clinic since the beginning. They are medical providers such as doctors, nurses and medical technicians. They are civic volunteers who staff the reception area, stuff envelopes, publicize its activities and services, serve on its board of directors or simply put together an evening meal for other volunteers.
Students from Terry Sanford High School’s Global Studies Program, for example, spent some of their required 20 hours of public service stuffing envelopes for an upcoming fund-raising event.
“If people want to volunteer, we’ve got something for them to do,” said Cathy Ory, The CARE Clinic’s executive director. Some people volunteer without even having to come to the clinic by cooking meals or performing administrative duties, she said.
Ory is the clinic’s third executive director. She was a member of the initial steering committee as a Cape Fear Valley Medical Center representative before serving as the clinic’s first president of the board. As fate would have it, the hospital eliminated Ory’s position at the same time the clinic was looking to replace its second executive director who left for another job. Ory, ever the volunteer, was in the right place at the right time and applied for the executive director’s job.
Ory said the CARE Clinic currently has an agreement with Fort Bragg that allows military doctors to volunteer at the clinic to fulfill a portion of their residency requirements. “They say they love working here because of the response they get from patients, she said.
Dr. Tinsley Rucker, volunteer medical director, said that when the clinic started its operations 14 years ago, clinic staff sent letters to doctors throughout the county regarding volunteer opportunities and the response was overwhelming. Dr. Rucker said there are two groups of physicians that serve the clinic, those who come and volunteer at the clinic and those – generally specialists – who take pro-bono patient visits in their office.
Support services are an essential component of operating a medical clinic, Rucker said. One local company provides free medical laboratory testing, while several firms that provide CAT scans and MRIs allocate a number of free procedures each month. Cape Fear Medical Center also provides support services and goes a step further by assigning a nurse practitioner to work with diabetics at the clinic every Thursday afternoon.
Rucker, like most of the people associated with The Care Clinic, is quick to point out that the success of the clinic has been a collaborative effort. “We tapped into the community,” Rucker said.
For example, the clinic staff called on Sen. Tony Rand about 10 years ago to introduce legislation that would allow retired physicians to practice at the clinic and allow military doctors who hold an out-of-state medical license to volunteer at the clinic. Additionally, a medical insurance group provides liability insurance for everyone volunteering at the clinic at what Rucker calls an “unbelievable” low rate.
“We have physicians in just about every category except neurology. Our doctors love volunteering. They don’t have to worry about paper work,” Ory said.
In 1986, a Fayetteville physician, a dentist and an attorney had a vision of serving the low wealth citizens of Cumberland County. The trio, according to historical records, approached Catholic Social Ministries of the Dioceses of Raleigh. Research and investigations into health care issues in Cumberland County followed as did a needs assessment report that pointed to the need of health for low-income citizens.
The Catholic Social Ministries then approached the Daughters of Charity, to see if a sister was available to tackle the prospect of establishing a free heath care clinic. They contacted Sister Jean Rhoads, a service line administrator at Saint Agnes Hospital Cancer Center in Baltimore, Md.
“I vividly remember March 15, 1992, when I was reviewing architectural drawings for our new Cancer Center at Ste. Agnes Hospital. I received a telephone call from my Provincial Leader who asked me to go to Fayetteville to begin a free health clinic,” said Sister Jean Rhoads during a telephone interview.
“It came as a total surprise to me but a key element of our spirit as Daughters of Charity is to listen to God’s call and be available to be sent to where the needs of the poor are. So, I responded ‘Yes,’ trusting that God would help me along the way as He has done throughout my life.”
Sister Jean’s formal education includes a BSN in nursing from Catholic University and a master’s in health services administration from George Washington University. Her ministry experience prior to The CARE Clinic was nursing in medicine/surgery and in the Emergency Room at Sacred Heart Hospital in Pensacola, FL, before becoming an administrator at Saint Agnes Hospital Cancer Center. Her education, according to Sister Jean, had prepared her for ministry in hospitals but not as the project manager for a start up free medical clinic.
So how does one prepare for such a monumental undertaking?
“I prayed daily and this new ministry certainly became a focal point during my remaining months at Ste. Agnes Hospital. I talked with Ken Bancroft, our CFO at Ste. Agnes Hospital, for any pointers he could give me. One significant blessing was I knew enough key leaders in the hospital who I could contact for advice after moving to Fayetteville,” Sister Jean said.
Sister Jean also turned to a manual written by the Free Clinic of Roanoke, Va. The manual gave her insights on how to set up a steering committee, gather community needs information, gain civic and governmental support, draft a mission statement and articles of incorporation, recruit volunteers, communicate the project’s needs to various publics, and identify funds and grants.
“Possibly the biggest blessing at the early start-up phase was that I knew so little and, therefore, had to reach out and discover people who had the heart and expertise to help. And they came through with flying colors and hearts of faith.”
Sister Jean said she could easily name more than 100 people who helped early on to make the project such a success. “One message I know as a Daughter of Charity was that ‘While the poor need bread, the rich need meaning in life.’ Many people can resonate with these needs and so felt connected with this mission,” Sister Jean said.
“The beauty of this effort was that all faith denominations united in the effort to support The CARE Clinic,” she said. “God pulled us all together and we were blessed with the right people.”
Some of the right people were civic leaders such as Ken Lancaster who told Sister Jean she could not continue the project without money. Lancaster in turn introduced her to Marshall Waren. “Marshall opened the door to old Fayetteville,” she said. Old Fayetteville responded with donations and support. “It is quite a privilege to be able to reach out and make someone else’s life a little better. I wanted to share this privilege with as many people as possible.
“The experience for me was nothing less than a miracle from Above and I will always consider it a blessing in my life!”
The life of non-profit organizations, regardless of the benefits they provide, hinges on raising money for operating expenses and capital improvements.
During the heavy rains that fell in Fayetteville days before the Thanksgiving holiday, Ory noticed water puddling in The CARE Clinic kitchen. She initially thought the refrigerator was leaking when in fact rainwater was seeping through the cinder block wall. The telltale water stain remains a constant reminder that the leaking flat roof and the age of the building are issues that The CARE Clinic board must address, and it will probably take dollars to do so.
The CARE Clinic is located in the former D.R. Allen & Sons Construction facility on Robeson Street where it meets Winslow Street. Parts of the building are 50 years old, Ory said, and the original idea of replacing the flat leaking roof with a peaked roof is not structurally possible, according to architects.
The CARE Clinic board of directors will undertake a capital campaign in early 2007 to replace the current building. A new building is slated for an adjacent lot, Ory said. “There will be no interruption in services,” she said. It is important for The CARE Clinic to remain at its current location because that zip code area has the largest number of qualified clients, Ory said.
In early February, The CARE Clinic will hold its 10th Annual Evening of CARE Dinner. Hosts and co-hosts will open their homes to those willing to donate $75 for the opportunity to dine and converse with CARE Clinic benefactors.
Other annual fund-raisers include a wine-tasting event sponsored and hosted by local wine distributors who designate the proceeds to The CARE Clinic. Additionally, there is an annual golf tournament and a number of Cumberland County Churches include an allocation to The CARE Clinic in their budgets.
Jason Brady is a local writer, who has formerly served as the military reporter for the Fayetteville Observer and as public information officer for the City of Fayetteville for many years. Now working in the private sector, Brady still enjoys investigating a good story and writing about it.