As health care options narrow, RotaCare Clinic provides medical safety net to Richmond residents
on October 21, 2014
The gardener inspects his hands, flipping them to reveal palms callused from decades of moving rocks and digging in people’s yards. He wiggles his fingers with ease, looks up, and smiles.
A few months ago, José Rodriquez’ hands were so red and swollen the 57-year-old couldn’t hold a glass of water. “I didn’t have the strength,” he said. “I would drop it.”
Doctors had diagnosed Rodriguez with severe arthritis a year before, but despite spending hundreds of dollars on prescribed drugs, tests, and out-of-pocket office visits, his symptoms worsened.
The inflammation spread to his knees, making it hard for him to walk and impossible to work. “Have you seen a newborn horse?” he said, mimicking the stagger of a foal’s first steps. “I was like that every morning until I warmed up.”
A doctor in San Rafael referred him to RotaCare, a free health clinic in Richmond, where a volunteer arthritis specialist, Dr. David Stone, began aggressively treating Rodriguez for rheumatoid arthritis— a chronic autoimmune disease that attacks joints and organs, causing painful, incurable inflammation.
After eight appointments, Rodriguez now has a treatment plan that works to keep his inflammation and pain controlled. The injectable drug he uses to reduce the swelling in his knees is so expensive—$1,000 a month— that without RotaCare’s help connecting him with the Patient Assistance Program, he would have been unable to afford it.
“José was one of our first success stories here,” said Drea Riquelme, a RotaCare site administrator.
Rodriguez is once again working full time in his one-man gardening and landscaping business. For the uninsured immigrant, the free Richmond clinic has been the only effective and local affordable healthcare option.
The safety net’s safety net
The façade of the RotaCare and Brighter Beginnings clinic looks deceptively nondescript and small. The glass entrance, stenciled in white with the clinic name, hides behind a tree on MacDonald Ave. The office space on the right is vacant. Down the street to the left, you can buy a wedding dress or learn martial arts at a “Fight Club.”
Inside, the RotaCare building opens to a maze of hallways and rooms that provide care to hundreds of uninsured in Richmond. The current waiting room is temporary: although the clinic opened only a year-and-a-half ago, it is already adding three more examination rooms and expanding into the vacant space next door.
According to the Health Department, RotaCare is the only free clinic in West Contra Costa County. For the growing immigrant population— some undocumented or waiting for Affordable Care Act benefits to take effect— the weekly clinic has filled a need for local and affordable health care.
“It costs $60 just to be seen by a doctor at other clinics,” Riquelme said. “Things rack up with appointment visits and medicine costs. Here, the only eligibility requirement is that the patient be uninsured, and then everything is free.”
According to volunteer medical director Dr. Pate Thomson, 90 percent of the patients that RotaCare treats live below the poverty level, and two-thirds are Hispanic. He says the clinic is a safety net for people who have “no other recourse.”
“If they get thrown into the hospital over night, they may come out with oppressive debt,” Dr. Thomson said. “You and I don’t pay those prices. Medicare doesn’t pay those prices, and your insurance company doesn’t either; they pay greatly reduced rates. So we try to keep them out of the hospital if we can, and find little ways to help people protect their pocket books.”
RotaCare is open once a week on Tuesday nights between 4:00 and 8:00 PM. Although the hours are limited, patients can make an appointment, rather than waiting all day in an emergency room for non-emergency treatment. Doctors at the clinic also typically spend 20 minutes with each patient, getting to know detailed medical and family histories.
Riquelme said most of the clinic’s patients have treatable but chronic health problems, like diabetes, hypertension, and musculoskeletal issues caused by manual jobs. Many also suffer from financial and familial stresses that can aggravate their physical ailments, she said.
RotaCare’s $100,000 a year budget is funded entirely by grant money and donations rather than government money. This allows the organization to provide health care without collecting or reporting the immigration status of its patients.
Barbara McCullough, the executive director of Brighter Beginnings, a sister-clinic that shares space with RotaCare, said that both clinics are dedicated to serving the uninsured, regardless of their official status. “Immigrant populations are very much a part of the fabric of life, but when it comes to health care they have real challenges,” she said. “They’re our neighbors and they are really, really discriminated against.”
Doctors Medical Center closure and the future of RotaCare
As of August, RotaCare had served 747 patients and over 1,200 appointments. The clinic volunteers believe that number may increase substantially if and when Doctors Medical Center (DMC), the only public hospital in West Contra Costa County, closes next year due to insolvency.
The DMC has long been an important source of healthcare for the most vulnerable populations in Richmond. Most of its patients have insurance through Medi-Cal or Medicare, and 11 percent are uninsured. In the wake of the 2012 Chevron fire, 15,000 people streamed to the hospital’s emergency department with respiratory complications.
The hospital’s reduced ambulance services have overrun the Kaiser Richmond emergency department this year, forcing ambulances carrying patients in critical condition to drive to other hospitals in the area, sometimes up to 30 miles away.
Three deaths have already been blamed on delays in emergency care from diverted ambulances.
If DMC closes its doors completely next year, RotaCare may find itself filling an even larger hole in the available health care services in Richmond.
Dr. Thomson said the clinic needs more primary care doctors to volunteer in the coming years. “Since January, we have turned away over 150 people because we were at capacity,” he said.
At 6:45 PM last Tuesday, ten people sat in the RotaCare waiting room. Two mothers held babies, a young woman checked her phone, a man slumped in his chair— all waiting for access to affordable health care in their neighborhood.
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