Missouri Free Clinic Association Annual meeting
May 11, 2012
Meeting held at Primaris, 200 N Keene, Columbia MO 65201 10 AM-1PM
"The purpose of the Missouri Association of Free Clinics is to form an
alliance of free clinics across the state to combine resources and work
together to improve the delivery of health care to the uninsured and
underinsured."
Charitable Purpose:
To promote access to basic health care services for the underserved/indigent population of Missouri
To Provide networking and education opportunities among the Association members that are nonprofit entities, in
order that such entities may create a strong organizational structure and provide for efficient and effective health
care services to their target populations.
Attendees: John Bailey (West Plains Christian Clinic , West Plains, MO), Linda Judah (Social Welfare Board), Bridget
McCandless (Shared Care Free Health Clinic Independence MO) , Carolyn Stoner Bowling and Stacey O’Neal (Medical
Missions for Christ in Camdenton MO), Sharon Webster (Hannibal Free Clinic).
Linda Judah called the meeting to order at 10 AM.
Minutes:
Minutes from the March 18, 2010 meeting were accepted unanimously.
Treasurer Report:
Revenue consisted of membership dues of $800.
Current balance of funds $153.99. Expenditures were for the website build out, domain registration and hosting fees.
Financials were accepted for audit.
Current membership dues of $100 to be paid yearly. Clinics will be invoiced for dues with 30 days to pay dues.
Account held at US Bank in St Joseph. Signatories Linda Judah, Bridget McCandless, Sheri Wood.
Operations:
Discussed no show policy at different clinics. No show rate ranged from 5% to more than 20%.
Discussed issues around medication programs.
Discussed EMR. Bridget uses MedServices. Linda was discussing Practice Fusion which is a free resource. She will send
out information.
Malpractice
Difficulty with some networks who won’t let their employed physicians volunteer. Some medical malpractice providers
have riders that prevent physicians from doing volunteer work. Will look into legislation to preclude the malpractice
companies from forbidding volunteerism.
NAFC
Encouraged comments for the eligibility and enrollment processes for Medicaid expansion. Interim final rule is open for
comment.
South Carolina has a house resolution that there was free clinic day. We discussed approaching the legislature regarding
free health clinic day for Missouri.
Free vs Charitable Clinics
Should we change our mission and name to be charitable rather than free?
Motion made by Bridget to change name to Missouri Association of Free and Charitable Clinics
Sharon seconded the motion after thoughtful discussion the motion was unanimously
accepted.
Made no changes in the bylaws at this time but will need to examine the definitions and language in the current bylaws.
The question was raised—could an FQHC then be considered a charitable clinic?
New application form
Hours of operation include the days that the office is open even if there is not a provider on site.
Motion by John and Sharon to accept the new application form with modification for the
definition of free and charitable clinic to include those clinics that serve patients that are
uninsured or underinsured but requiring that less than 50% of those patients be covered by
third party payors.
Next meeting requires that we look at Bylaws again for definition of free clinics.
Survey
Linda reviewed the survey results from 7 clinics that turned in their data. The 8th arrived
Data submitted by Good Samaritan, West Plains, KC Free, Shared Care Free Clinic Hannibal, Social Welfare Board ,
Medical Missions and Community Health - in – partnership.
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15,770 patients served
28,218 medical visits 2011
5,925 dental visits in 2011
6,269 mental health visits in 2011
 57,105 prescriptions dispensed
 Total operating expenses: $10,763,124.00 *
 Total Value of mental health, dental services, medical and specialty: $18, 657,216.00 **
* Please note $8,276,264.00 represents the KC Free Clinic ; ** value of Billable services = $1,979,977
Excluding KC Free for every $1.00 that is received by MO Free Clinics, they leverage a minimum of $ 7.90 worth
of care.
On an average $203.00 will sponsor a patient for an entire year at the free clinic.
Medicaid
Discussion was held about the possibility that additional clinics will be taking Medicaid after ACA.
Some clinics ask patients to apply for Medicaid at the time of visit to the free clinic.. Some help with the application
others just refer to Family Support office.
Linda says that a clinic can apply through the division of family services to query EMOMed to see if the patient has an
active Medicaid number. Likely that the clinic or a provider would need an active Medicaid number to have access.
Discussed the difficulty of transitioning patient’s care to Medicaid because of lack of participating providers to accept
them at present.
Website
Linda walked us through the prototype website. We have a 5 year contract for maintenance.
Site will link to the various free clinics in state.
Site has a member’s only section that will house the minutes, bylaws, shared resources.
Has a donation function that has a 5% fee attached to it. Auto-generates a thank you note.
Will allow for multiple people to have administrative access. Linda does not want to be the only one with administrative
access to the site.
Logon will be the member’s email address and the password Free123
Direct Relief and AmeriCares as resources
Volunteers in Medicine
John Bailey West Plains Christian Clinic
No paid staff but hoping to hire. Offer medical 2 sessions per month (registered patients 281, 577 patient visits, 21
volunteer physicians in 6 exam rooms). Working toward dental. Patient Assistance program and volunteer pharmacists.
Has a nurse who covers calls. Supported by Ozark Medical Center through labs and radiology. Income criteria of 133%
FPL.
Bridget McCandless Shared Care Free Health Clinic Independence MO
12 years operation. Uninsured adults with chronic illness, 200% FPL. 550 active patients, 2500 visits last year, primary
care and mental health. $1.2 million in donated medications through PAP. Added Mental Health services. Purchasing
dental for patients. 1 part time physician and 8 volunteer providers. Access to a Specialty Care Network.
Linda Judah--Social Welfare Board in St Joseph MO
99 years of operation, uninsured, 200% FPL, 6507 patients, 8958 medical visits, primary care, GYN, full dental, Small
homeless program. Collaboration with the local FQHC. Specialty care network. 45 employees 9 volunteers. 40% of funds
from City and County. 19% from the FQHC for their homeless program. Susan G. Komen and SMHW funds for GYN care.
Use PAP Rx. Have a Foundation called friends of the Free Clinic to support the clinic. Level III NCQA accreditation.
January 2011 implemented Success Electronic Records Systems.
Carolyn Stoner Bowling, Medical Missions for Christ in Camdenton
6 years operation, Serving Morgan, Camden, Miller counties. Uninsured 200% FPL. Medical and dental. Have lost their
volunteer mental health counselor which has been a great hardship. Eye exams and chiropractor therapy. Mobile
mammogram through Ellis Fishcel. 300 0 patients in the data base. 800 unduplicated per year with 2000 patient visits
(down from 3500). Very stressed by being able to get volunteer providers so have had to cut hours. 300 patients on their
waiting list and have had to suspend taking new patients. Very large increase in the number of new applicants Lake
Regional Health Center provides their space and limited referral ability. Working on paper records and they are looking
at EMR.
Sharon Webster, Hannibal Free Clinic
Opened May 2007. 11 physician volunteer providers in 2 exam rooms. Looking at expanded space. Supported by
Hannibal Regional Hospital. Sharon paid by the hospital. Open 12-16 hours per week based on provider availability. Tries
to keep patients with the same provider. Scheduled appointments only. 600 unduplicated patients, 1700 visits.
Uninsured 150% FPL. Medical and dental. 150 patients on the waiting list for dental. Serving Northeast Missouri. All
volunteers.$ 1.7 million in donated services. Extensive PAP program through PAP Rx. Challenges: mental health access.
Limited specialty access. FTCA for malpractice. Last year the Salt River Community Health Center closed due to lack of
funding. Very limited mental health access in their area. Hannibal closed their inpatient psych unit. Nurse provides triage
when provider not available.
Next meeting to be determined
NAFC in San Antonio--October 22 2012
Bylaws review at next meeting
Adjourned at 12:45