ELLSWORTH — Without the arrival of a large grant or donation, administrators at Ellsworth Free Medical Clinic (EFMC) are worried the facility won’t be able to stay open for the rest of the year.
According to Rita Seger, a physician who volunteers at the nonprofit clinic and serves as president of its board, the organization’s funds could fall into the $15,000 range in the next month or two.
At that point, Seger said, her board would probably close the clinic and advise its 400-plus patients to seek care elsewhere.
If that news gives you déjà vu, it’s because the clinic was in a similar situation last year — when a $25,000 grant from the Maine Community Foundation and two $10,000 donations arrived at the 11th hour and allowed its doors to stay open.
The clinic’s greatest costs are the salaries it pays to a handful of part-time, administrative employees. The physicians and nurses who work there all do so voluntarily. Another sizeable cost is the rent for its space at the Mill Mall.
“When we get a good grant, that’s everything for us,” Seger said. “But when we don’t, we’re pretty hand-to-mouth.”
The lean times come during a greater period of transformation in the American health care industry. The Affordable Care Act (ACA), aka Obamacare, was passed in 2010. In the last enrollment period, almost 75,000 Mainers got onto health insurance plans created under that law.
EFMC serves adults who don’t have health insurance or can’t afford the out-of-pocket expenses — called the deductible — required before their insurance plans kick in.
The clinic’s doctors provide primary care, write prescriptions and screen for some acute illnesses. They steer patients to the cheapest available options for lab work and generic medications. They also help qualifying patients to enroll in ACA-subsidized health plans, among other services.
But many of the clinic’s uninsured patients fall into the so-called “coverage gap” that was created when Governor Paul LePage refused to expand the number of individuals who qualify for Medicaid, known here as MaineCare, Seger said.
As originally passed, the ACA required states to allow adults below a certain income level to get on Medicaid, then offer insurance plans to all the rest. But a 2012 decision by the Supreme Court made Medicaid expansion optional for states.
LePage has vetoed several attempts by the state legislature to approve those federal funds, citing costs that would fall to the state and eventually grow. That’s left an estimated 70,000 low-income Mainers without health insurance, as they make too little to qualify for subsidized plans created under the ACA, yet too much to qualify for Medicaid at its pre-expansion levels.
Another free clinic in the area, Peninsula Free Health Services in Blue Hill, serves a similar group of uninsured patients, according to Administrator Pat Saunders. In January, it reopened at a new location at 26 Hinckley Ridge Road after operating at the First Congregational Church of Blue Hill. It’s now open every Monday afternoon from 3 to 6.
Both Saunders — the lone employee at the Blue Hill clinic —and Seger stressed that they’re always looking for volunteer doctors, nurses, assistants and administrators — in addition to grants and donations.
If the needed funds don’t materialize, Seger said, she’d recommend that her clients turn to MCMH for primary care. According to state law, hospitals must provide coverage to patients below a certain income level.
Charlie Therrien, president and chief executive officer at MCMH, said he was aware of the Ellsworth clinic’s tough financial situation. If closure looks likely, he said he’d try to coordinate with health care providers around the area — possibly Blue Hill Memorial Hospital and Mount Desert Island Hospital — to see if they could take any of the new patients.
“Having said that, the majority [of EFMC patients] do come from the Ellsworth area. We’d have to figure out how to absorb them into our system,” Therrien said.
Although financial screenings would be necessary to determine whether patients qualify for free or subsidized care, Therrien added, “We take care of anybody who presents to us.”