Free clinic grows beyond founders’ vision
Photo by Michael Bailey
|Erika Viccellio, executive director of the Charlottesville
Free Clinic, manages 400 lay and professional volunteers
from local hospitals and the community, who provide thousands
of hours of free health care to the region’s working uninsured
By Lauren Fischer
Mo Nadkarni witnesses firsthand the medical nightmares of
During his residency at the University’s School of Medicine, Nadkarni and
fellow medical resident Paul DeMarco met a graduate student with a serious heart
infection, gravely ill because he had delayed seeing a doctor. No longer financially
dependent upon his parents, the student lost his student-based medical coverage
and couldn’t pay for both a new heart valve and tuition. He was forced
to withdraw from school.
Nadkarni and DeMarco considered packing up their medical
bags and heading to the local Salvation Army to help
others who were working and uninsured.
in 1992 they recruited a handful of dedicated volunteers from the U.Va.
Medical School community, and opened the Charlottesville
While the case of the uninsured graduate student was unusual
then, the numbers of the working uninsured have grown
so that such cases have become more common
now and underscore the importance of the clinic’s mission.
The clinic is a nonprofit, community-based organization that
offers free health care to individuals and families who
have no access to medical insurance
who do not qualify for free health services, such as the federal-state
indigent care program, which serves lower-income clients. During the
year, the Free Clinic provided 9,300 hours of service to treat approximately
1,220 patients — an estimated value of more than $1 million, according
to the clinic’s annual report.
Since its founding, approximately 400 lay and professional
volunteers from U.Va. and Martha Jefferson Hospital,
plus many others from the Charlottesville
have donated time in the waiting and examination rooms of the Thomas
Health Department on Rose Hill Drive, where the Free Clinic operates
three nights a week.
The clinic is one of 55 centers within the Virginia Association of
Free Clinics, the largest such organization in the country. The service
vital to Virginia,
which ranks 50th out of 50 states in terms of Medicaid services provided
to adult uninsured, according to the Kaiser Family Foundation. About
25 percent, or 1.6
million Virginians, lacked health insurance for all or part of 2001-02,
Kaiser research shows.
We believe that everyone should have someone to go to,” said Erika Viccellio,
the Free Clinic’s executive director.
At the Charlottesville Free Clinic, no income cap determines
which patients qualify for care, Viccellio said. Even
if a household earns
year, the family
may be eligible. Sixty percent of the Free Clinic’s clients are women who
bring home annual salaries ranging from $10,000 to $25,000, she said.
Nadkarni, now an associate professor of internal medicine
at U.Va., initially envisioned the clinic as a “one-stop shopping” option for local residents:
an uninsured patient suffering from a cold or an acute illness could receive
a referral to a doctor at either U.Va. or Martha Jefferson for follow-up care.
But the Free Clinic quickly evolved into more. For example,
nine of the top 10 diagnoses in the 2002 fiscal year
were for chronic
depression and hypothyroidism, which require more appointments
More maintenance illnesses have changed the nature of what we do,” Nadkarni
Of the almost 11,000 prescriptions filled by the clinic in
2002, the value of medicine for illnesses such as diabetes
an increase of 40 percent over the year before.
The growing demand for services — there is currently a waiting list of
200 people seeking gynecological, dental and psychiatric services — shows
the need for the Free Clinic is greater than ever. Which means that the clinic
requires more support than ever, Viccellio said.
Private sources of funding, especially area individuals,
civic organizations and businesses, footed the bill for
of the Free Clinic’s $381,000
operating budget in 2002, Viccellio said. Through the Commonwealth of Virginia
Campaign, U.Va. and state agency workers pledged close to $60,000 to the Charlottesville
clinic in 2003.
In addition, the U.Va. Medical School has donated up
to $15,000 in free lab work and X-rays, and U.Va. medical
shadow volunteer doctors and make follow-up phone calls.
And night after night, at least six of the 22 medical
professionals volunteering in the clinic are licensed
There are benefits of being in a community with a teaching college,” said
Nadkarni, noting that more than 120 volunteers last year were local doctors,
nurses, pharmacists and dentists.
Volunteer labor multiplies the benefit of financial
donations — each dollar
spent by the Free Clinic translates into $3 in health care services for patients,
In addition to the medical volunteers, Nadkarni
recognizes the dedication and support of many
others in the
Charlottesville community who have
contributed to the success of the clinic. He
noted the family that passed along a $600
tax refund last fall, and patients who return
to the Free Clinic as office volunteers.
Over the years, the program has carved out a
vital and respected niche for itself in the
community. The clinic
part of the health-care
and receives referrals directly from local
social service agencies and primary care doctors.
We’re not perceived as some ‘back alley’ free clinic,” said
Nadkarni. “We provide good, if not better, care than that received at primary