Patients waiting to be seen at the Arlandria Health Center have to make do with about a dozen chairs, and often it's standing room only. Each year, thousands of people -- most of whom lack health insurance -- go to the full-service medical clinic at 3804 Executive Ave. in Alexandria for physical care and mental health services. An adjoining office provides a range of family and social services used by about 80 percent of the patients.
Yet the entire office on the ground floor of three converted apartments is just 2,100 square feet and has five examination rooms.
"No one gets turned away, but we have longer waits than we would like," said Steve Hart, chairman of the board of Alexandria Neighborhood Health Services, the nonprofit organization that oversees the center.
Patients and staff will get some relief later this month, when a second, 4,500-square-foot clinic opens at 2 E. Glebe Rd. to alleviate the space crunch. The center will hold an open house tomorrow to introduce the new location, which will focus on providing care to adults. In coming weeks, the original center will be closed briefly for refurbishment as a pediatric facility. Mental health and social services will be offered at both locations.
The Arlandria Health Center has been serving low-income residents of Alexandria for 12 years, first serving women as part of the Alexandria Health Department. Then the center began seeing children, with a focus on preventive care.
In 2004, a three-year, $1.95 million federal grant allowed the center to expand its services to anyone, regardless of income, sex or where they live. It is now one of 73 "federally qualified" health centers in the state, which means it gets federal money to provide care for the uninsured and is recognized by Medicare and Medicaid.
Many of the clinic's clients do not speak English; others lack transportation to see medical professionals elsewhere. About 73 percent are uninsured; patients who lack Medicaid or other coverage are charged on a scale from $10 to $50 per visit. The service helps patients at up to 250 percent of the poverty level.
"A lot of time people think Alexandria is such an affluent area, but we have both sides of the dollar bill here," said Beth Knisley, who has served on the board of Alexandria Neighborhood Health Services for three years. "We wanted to stay in the community because that's where the bulk of our clients are located."
When the medical equipment and furniture have been moved in, the expansion into the leased space will cap several years of frustrated efforts by the board to buy an additional building. While the federal money allowed the clinic to expand its services, the expanded service strained the facilities and the $3.4 million annual budget. Alexandria Neighborhood Health Services is trying to raise an extra $2.4 million over three years to make up the difference.
In addition, the clinic has seen its patient load increase, because more people are seeking treatment for chronic illnesses.
"People come in for a cold with undiagnosed hypertension," said nursing supervisor Dee Moellering, who has worked at the clinic since 2004. "Every time we need to do a blood pressure check and it's still uncontrolled, people have to come back week after week."
In 2003, the clinic had about 9,500 patient visits, both for medical treatment and family services. Last year the number increased to more than 10,500, and at the end of October, the number had climbed to nearly 14,500. Projections indicate that the clinic will tally more than 19,000 patient visits by the end of the year.
In the meantime, the staff of 35 -- with just a single full-time doctor and several part-time providers -- has been overwhelmed by the workload. Dr. Roger C. Chinery, the clinic's medical director, sees 25 to 30 patients a day.
Kristin Langlykke, a registered nurse who is acting executive director of the clinic, would like to add about five staff members.
"Equipment such as a lab bed is fine," Langlykke said. "But if you don't have the people, you really can't take care of the patients."
The new location will offer eight additional exam rooms, more than doubling capacity. It also has space that Langlykke would like to see become a working pharmacy someday. There is a triage area for nurses to perform preliminary exams, as well as space for personal consultations.
At the original location, nurses sometimes had to take patients outside to speak privately and to obtain detailed medical histories.
"Here we'll be able to sit down with a patient and get a good assessment," Langlykke said.
Ken Kozloff, administrator of Inova Alexandria Hospital, said the clinic serves a vital function in the community by providing care for those who are ill but don't require hospitalization and by providing follow-up care for those who have been discharged from the hospital. "They provide a safety net to the residents in the community who do not have a primary-care physician and might not be able to afford one," Kozloff said. "It really is a total continuity of patient care."