Correction to This Article
This article misstated the name of the chief executive of Unity Health Care. He is Vincent A. Keane, not Victor Keane.

Group planning free health clinics objects to D.C.'s $77,000 fee

Every year, a small army of volunteers with Remote Area Medical assembles a field hospital in Wise County, Va., to provide three days of free health care to those in need.
By Henri E. Cauvin
Washington Post Staff Writer
Saturday, December 12, 2009

A nonprofit organization that holds free clinics for people who need medical, dental and eye care wants to stage a three-day event in the District, but its leaders say they cannot afford the $77,000 price tag to set up shop at the D.C. Armory, one of the few public sites in the city large enough for the thousands of people who typically show up.

The Washington Convention and Sports Authority, which operates the armory, has estimated that Remote Area Medical, or RAM, as the charity is known, would have to pay at least $77,000 to host the three-day clinic planned for late January, according to an authority document provided by RAM.

Founder Stan Brock said RAM has never been asked by other site operators to pay anything approaching that fee. The cost is "prohibitively high" and still climbing, Brock said in a telephone interview this week from Knoxville, Tenn., where RAM is headquartered. "We just don't know what the bottom line is going to be. There are things that just keep coming up."

Officials with the Washington Convention and Sports Authority did not return calls seeking comment.

The potential price tag is not the only hang-up. The D.C. Department of Health and others in the public health sector have posed a host of questions about the event, particularly about follow-up care for people who would be treated at RAM's clinic.

Created in 1985, RAM has staged more than 500 clinics worldwide. Early on, it focused its efforts on isolated areas of poor countries such as Haiti and Nepal. In the early 1990s, it began staging clinics closer to home as well, focusing on people in the United States who lack adequate health care. For the last decade, for example, it has hosted an annual clinic in rural southwestern Virginia.

RAM has taken its efforts to urban areas as well. It set up a clinic last summer at the Forum in Los Angeles. Dental and vision care can be particularly hard for the poor to find, and many of those who turn up at RAM's clinics need new eyeglasses or teeth extracted.

Hundreds of volunteer professionals typically participate in the clinics. RAM's work has been featured on "60 Minutes" and elsewhere.

But some local public health leaders say the organization is misguided in wanting to hold a clinic in the District, which they say has created a system that makes basic health care easier to reach than in most jurisdictions.

"Does that mean everyone is coming in? The answer is no," said Vincent A. Keane, chief executive of Unity Health Care, a nonprofit organization that runs about 30 clinics for the D.C. government. But staging a big, one-time clinic isn't the best approach, Keane said. "It kind of creates a hoopla event that really doesn't solve the more systemic problem," he said.

Many District residents have chronic conditions, Keane said. "What they need is comprehensive care, and I think the worst thing you can do to a patient is diagnose his problem and then not be able to treat it over the long haul," he said.

But Brock said the clinic staff would be prepared to direct people who need follow-up and would have help from the U.S. Public Health Service, which makes such links an important part of its mission.

For now, though, Brock said he can't focus on those particulars. "We are so preoccupied with the issue of whether we're going to be able to be there," he said.

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