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Volunteers in Medicine preparing to expand to second clinic

Dr. Florence Jameson, a veteran OB/GYN in town, is also the volunteer CEO of Volunteers in Medicine, which opened its first clinic a few years ago to serve uninsured patients on Wednesday, September 3, 2014.

In 2008, Dr. Florence Jameson celebrated more than 20 years as a valley OB/GYN by taking on a new part-time job: CEO of Volunteers in Medicine of Southern Nevada, which provides primary health care to low-income, working adults and their families.

Jameson, who is not paid for her work with the nonprofit, opened a clinic for the uninsured that sees about 2,600 patients a year. With that need showing no signs of abating, Jameson now is preparing to expand the clinic. Volunteers in Medicine has raised more than $2 million and will break ground this fall on a second clinic that Jameson expects will serve as many as 10,000 people annually. It will be downtown at Martin Luther King Boulevard and Madison Avenue.

“The clinic will be in the heart of the highest poverty ZIP code and greatest need area in our community,” she said.

Jameson and other nonprofit groups increasingly are stepping up to provide health care in Las Vegas. Although the Affordable Care Act reduced the number of uninsured Nevadans, nonprofit operators say a large population remains without coverage. And all indications are the need will continue to grow.

At her clinic, Jameson asks medical professionals to contribute a three- to four-hour shift per month. Many retired physicians donate their time, as do students in local residency programs.

“Even for those who are stretched for time, they still find that service to those in need is so unbelievably rewarding,” she said.

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The state Health and Human Services Department estimated there were 620,000 uninsured Nevadans in 2013. The Affordable Care Act, through expanded Medicaid and the Silver State Exchange, has put a dent in that number. Medicaid enrollment expanded by about 150,000 and about 41,000 people have opted for plans through the exchange.

But that still leaves more than 400,000 Nevadans uninsured.

Another nonprofit helping to fill care gaps is Touro University Nevada, which launched a mobile health care clinic this summer. The mobile unit works downtown, performing about 25 wellness checks daily, four or five times a week. Third- and fourth-year physician assistant students provide care, and Zappos.com, the Findlay family and the Junior League of Southern Necada helped fund the project.

“It’s taking care of the health care needs of the people who will never sign up for Obamacare but who surely need the care,” said Shelley Berkley, CEO and senior provost of Touro’s Western Division.

The services are important because that population — mostly homeless — often ends up in University Medical Center’s emergency room for care, Berkley said.

“(Emergency) care is at an astronomical cost to the taxpayers,” Berkley said. “These nonprofits are serving a need in this community that has reached crisis proportions.”

Tanitsha Bridgers is a licensed social worker and CEO of Mobile Mental Health Support Services. She also runs the Nevada Improvement Project, a nonprofit that offers mental health services and basic skills training to help people become more self-sufficient.

“We saw people who really wanted counseling but just did not have the money,” Bridgers said.

The program serves about 150 families per year, almost all referrals from Bridgers’ for-profit business, which also funds the bulk of the Nevada Improvement Project. Students pursuing mental health degrees at UNLV and the University of Phoenix, as well as local professionals, donate their time at the organization.

• • •

The Nevada Primary Care Association counts 200 safety net providers in Nevada who provide care regardless of people’s ability to pay. Some of the providers are eligible to become Federally Qualified Health Centers, meaning they can access grants that allow for higher Medicaid and Medicare reimbursements.

The program began in the 1960s to serve medically underserved areas. Other grants are available to help centers expand. The clinics, in exchange, must have sliding fees based on patient family size and income and a leadership board that represents the population the center serves.

Last year, FirstMed Health and Wellness, near Eastern Avenue and Desert Inn Road, was granted Federally Qualified Health Center status. The clinic provides primary and preventive care, but its patients, 60 percent of whom are uninsured, rarely come in for routine checkups, CFO Virginia Lara said.

“We find most of the patients who come to our clinic have multiple health concerns,” Lara said. “Many come in and have never seen a doctor before.”

FirstMed sees about 3,000 patients a year at its 3,200-square-foot site. With the federal designation, by 2015, it should provide care to about 7,000, Lara said. FirstMed also is applying for funding to build a second location, with the goal of eventually having five or six centers in Southern Nevada.

More immediately, FirstMed wants to open a pharmacy at its clinic. FirstMed can get prescription medication at a deep discount, which can be passed on to patients in a convenient location.

“If you can go to one place, see your doctor, have the kids see a doctor, pick up your prescriptions and get all that you need, then you find more success,” said Marya Shegog, director of health programs at the Lincy Institute.

But there are only 24 Federally Qualified Health Center clinics in Nevada, with six in Clark County. Utah has 46; Arizona 134; Colorado 151.

Why so few here? Lara described a cumbersome application process. Shegog said some nonprofit groups may struggle with the required board structure. Both said there’s little knowledge of the program locally.

“Legislators didn’t even know,” Lara said. “Leaders couldn’t help because they knew nothing about it.”

A $3.6 billion national funding boost for community health centers is on the horizon for next year, and Shegog expects more local nonprofit groups will apply for Federally Qualified Health Care status.

Meanwhile, at Volunteers in Medicine, Jameson looks toward opening her second clinic and enjoys a small victory in her effort to help the uninsured: There’s a shorter waiting list at her clinic on Harrison Drive.

“Before, we had such long waiting lists of about three months,” she said. “The beautiful thing about the ACA is it has taken away that long list. We can get people in a lot faster.”

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