The Arlington Free Clinic – Community Care in Action

Part I

By Caryn Sever

In a country where access to health care is hotly debated, even after the Supreme Court ruling on the Affordable Care Act, there are many communities and organizations reaching out to help their citizens in need. This is certainly true about the Arlington Free Clinic.  Located in the heart of Arlington, this clinic “provides free, high-quality care to low-income, uninsured Arlington County Adults”[1]  who meet specific criteria:

• The potential patient must be 18 years or older
• They must reside in Arlington County
• They cannot have insurance
  • Including Medicaid or Medicare
• They must be at or below 200% of poverty (for a family of 4 in 2012 that is $46,100)[2]
• They must reside in the United States for at least a year
•  They cannot leave the US for more than 2 months at any given time throughout the year

Since its birth in 1993, the clinic has evolved exponentially. According to Jody Steiner Kelly, Director of Clinical Administration, the first clinic was held in a middle school nurses office. “On the first night, we had twice as many volunteers as patients, now we have 1,650 patients” with over 500 volunteers in a LEED-CI* Gold certified space.  Furthermore, 100% of the physicians and most of the nurses who work for the Arlington Free Clinic are volunteers, many of whom live in the community.

Arlington community members believe in the clinic, so much so that when Jody Steiner Kelly asked her parish priest where she should

From Arlington Free Clinic Website www.arlingtonfreeclinic.org

volunteer, he steered her toward the Clinic. Kelly was hesitant, afraid she would be stuck in a back office stuffing envelopes.  She asked him if he had any other ideas, but he insisted that it was the perfect place for her to go. That was 5 years ago, and since then Kelly has moved from a volunteer to become a paid staff member, and is now the Director of Clinical Administration.

With its small staff and large number of volunteers, the Clinic is able to provide a wide range of healthcare services to its patients including:[3]

• Primary care
• Specialty medical care in anesthesiology, cardiology, dermatology, endocrinology, ENT, gastroenterology, hematology, nephrology, oncology, ophthalmology, optometry, orthopedics, pathology, podiatry, psychiatry,  pulmonology, radiology, rheumatology, surgery and urology
• Women’s health including annual screening for cervical cancer and access to free mammography for women aged 40 and above
• Mental health
• Physical therapy
• Pharmacy services
• Diagnostic testing

Among its many contributions to the community, the Arlington Free Clinic is probably best known for its monthly lottery.  Amidst the bustle of morning rush hour, about 150 people line up outside the Clinic once a month with the hopes of becoming a patient. Out of the 150 people, 25 are chosen. Kelly explains, “When we first started [the Clinic] we could take everyone who would come in, but when we got beyond our capacity, we moved to a waiting list.” This waiting list, as one would expect, became unmanageable for several reasons; a primary reason being that “we work with a vulnerable population, so by the time we would call people, phone numbers would change; they’d had moved.”  It was at this point in 2006 that the clinic decided to institute a lottery.

The lottery itself has seen a vast increase in participants with a steady growth from 2008 through today, mostly because of unemployment or underemployment in the area. Kelly has been tracking the increase since 2008 and calculates that in Fiscal Year 2010, the number of lottery attendees rose to about 1,300 people, a 100% increase from the previous year. This has steadily increased over the last two years with 1,753 participants in Fiscal Year 2012.

The lottery is just one of the many contributions that the clinic makes to the community. On top of the lucky winners, the clinic accepts approximately 20 patients monthly through what they call “direct access care” which is care for high risk patients who come from shelters, hospital discharges, and other physicians. The clinic also provides breast exams and mammograms through a Susan G. Komen program. If a woman is 40 or older, lives in Arlington, and has not had a mammogram in the last year, she can get a breast exam and a free mammogram  provided that she meets the standard eligibility requirements for the clinic. Additionally, the Clinic gives out flu vaccine vouchers when they can.

The Arlington Free Clinic is an example of community health at its best. Kelly acknowledges that “this is a model that wouldn’t work in every location because we just have a wealth of providers and donors in our area.”  The Clinic relies on private donations and receives approximately 2% of its funding from Arlington County, zero federal funding, and less than 2% from the Virginia legislature for pharmacy services.[4] It depends on the physicians, nurses, and various other medical volunteers who work selflessly to help the community.

This article is the first in a three part series on the Arlington Free Clinic. Part II will detail the clinical aspect of the Clinic, including a visit to a live session in late August.

The Arlington Free Clinic is located on the ground floor of the new mid-rise Halstead Building at the intersection of Columbia Pike and Walter Reed. The front door is on 11th St. South, which is on the back side of the Halstead.[5]

This article was edited by Valerie Bartush of the Department of Health Administration and Policy at George Mason University.

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Evaluating Beacon Communities

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We have 2 active health reform implementation projects:

Technical Assistance to Fairfax County ,

Technical Assistance to the Virginia Health Reform Initiative.

They are briefly described with appropriate links.  Please contact us to learn more about any or all of them.

We have 7 active health policy research projects:

Making Payment Reform Work ,

Payment Innovations Community ,

Evaluating Beacon Communities ,

Developing a Monitoring Strategy for Health Reform’s Progress and Effects at the State Level ,

Making Health Markets Work Better ,

Finding the Proper Role for Government in Health Markets ,

Physician Morale and Engagement with Health Reform .

They are briefly described with appropriate links below.  Please contact us to learn more about any or all of them.

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• Understanding the Science of Narratology
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• Healthcare policy and narrative
• Developing a message, message terminology
• Communicating to different health care communities
• The neurophysiology of narrative, examining how the brain structures narrative
• Counter-narratives

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