Patching the Safety Net

Stimulus Money Extends Md. Clinic's Operation, for Now

One in a series on how the recession is touching lives.

Deborah Foerter is a first responder, whether the problem is a broken ankle or an empty pantry at home.

On the table in Foerter's tiny exam room, Barbara Pickle describes numbness in her toes as Foerter, a nurse practitioner by training, checks her vital signs. A day earlier, an illiterate patient needed Foerter's help filling out an application for food stamps. Last year, an 85-year-old woman who broke her ankle walking to her outhouse was given indoor plumbing after Foerter called the local Christmas in April program.

In one of the world's most advanced medical systems and one of America's wealthiest states, Foerter and her clinic are a lifeline for hundreds of poor and working-class residents of Nanjemoy, an isolated peninsula in rural southwestern Charles County. Dozens of people here live without running water, some in unheated trailers or shacks, just 37 miles from Washington. There is no grocery store and no gas station, no Laundromat or restaurant.

This spring, Foerter told them that the clinic's services almost certainly would be ending in the next few months. The recession has hit nonprofit health clinics hard. This one had lost $150,000 during each of the past 14 years, and other grants were drying up. The board of Greater Baden Medical Services, which runs the clinic tucked inside the Nanjemoy Community Center, decided it no longer could be sustained and voted to close it.

And then, just as some patients had given up on the idea of affordable medical care within their reach, they received word of a small miracle: Two weeks ago, the federal government announced that all but a handful of the nation's health clinics would receive a total of $2 billion through the federal stimulus package. Greater Baden was awarded $270,372, enough to keep Nanjemoy Health Services open for two years.

"The fact that someone stepped in and did something about the crisis that this was going to cause is reason for celebration," said Rick Campbell, a longtime patient who has multiple sclerosis. "It doesn't solve Nanjemoy's underlying issues, but it's a start."

At some point, Greater Baden will likely have to move the Nanjemoy clinic to a more central location, where it might attract walk-in patients with private insurance or the ability to pay more out of pocket. But for the moment, Pickle is receiving diabetes treatment just down the road from her house.

"I think for a lot of us, losing the clinic would be losing an important part of our lives," she said. "It's not fair to take it away from people who don't have any other options."

Most of Foerter's patients have no health insurance, unless they receive Medicaid. Their oasis is the clinic, with its harsh fluorescent lighting, uncomfortable waiting room chairs and well-worn equipment.

The scale isn't digital. The exam tables don't move up and down at the push of a button. A doctor is available only on alternating Fridays. But for the clinic's 750 patients, there is simply nowhere else to go.