by Shannon Blosser

REGIONAL WRITER

CLARKSBURG -- Carolyn Churchill stands outside, in the bitter cold holding a cigarette and pacing back and forth, waiting for her daughter to arrive.

"She doesn't know this, but when I go to Ohio, I'm not coming back," said Churchill, who lives in Jane Lew.

For Churchill, Ohio represents a life she does not have in West Virginia.

In Ohio, Churchill believes she will find a job that will provide medical benefits to help pay for her regular prescriptions to treat her osteoporosis. Churchill does not own a car. She is unemployed and does not have insurance coverage to pay for her medical bills.

Health Access in Clarksburg is the only place Churchill can go to receive medical treatment and prescriptions.

"I have no money," said Churchill. "They pay for my medication. I cannot afford to go anywhere else."

Churchill came close to not having a place to go for medical treatment because of the state's medical malpractice crisis.

'It almost shut us down'

When insurance providers, such as St. Paul, decided to stop insuring doctors and hospitals in the state, coverage to free clinics such as Health Access was also denied, said Kathleen Wilson, the clinic's director.

"It almost shut us down," said Wilson.

Earlier this year, Health Access was given notification from St. Paul that the company would no longer provide medical malpractice insurance to the clinic. Without the insurance, the clinic would not be able to provide medical care to more than 800 patients per month, Wilson said.

The clinic came within weeks of closing its doors, she said.

"We have to stay open," said Wilson. "We are the lifeline to these people."

Health Access turned to the state Board of Risk Insurance Management and its medical malpractice insurance coverage. Other free clinics in the state, as well, have turned to the state program for medical malpractice insurance, according to Joni Costante, director of Morgantown Health Right and president of the West Virginia Association of Free Clinics.

In joining the state-run insurance program, Wilson learned the clinic would have to pay a higher premium than it had with St. Paul. The clinic, with a budget of only $200,000, did not have the money to pay the higher premium, Wilson said.

That left the clinic with a choice -- pay the higher premium and raise the additional money or close operations. Wilson chose paying the higher premium, which was $6,000 more than the St. Paul premium.

"By just some miracle, the United Way and the Harrison County Commission came to our aid," said Wilson.

The two organizations, in April, donated Health Access a total of $20,000. The funding was enough for the clinic to pay its premium.

"It was a no brainer," said United Way Executive Director Marie Battles.

Since that donation, Health Access has scheduled bingo games at the Village Square Conference Center. The proceeds from the games go to the clinic, with most of the money going toward medical malpractice premiums.

"Our hope was that it would be enough to pay the premium," said Wilson. "It was enough."

Troubles continue

Even though Health Access is covered by the state's medical malpractice insurance plan, it is still affected by the state's crisis, Wilson said.

Doctors who care for free clinic patients, like Churchill, are scaling back or are no longer providing free service, Wilson said. That is because doctors are paying higher premiums, as well, with the state program and can no longer afford to provide service to free clinic patients, she said.

"We've been fortunate that we have doctors who have not denied to work with us," said Wilson.

Free clinics across the state have not been so lucky. Clinics in Wheeling and Bluefield have been affected the most by doctors pulling out of free clinics, Costante said.

"Our patients have a limited amount of options," said Kathie Brown, director of Wheeling Health Right. Brown said some patients have been sent to West Virginia University Hospitals in Morgantown for care because of the crisis. "These patients have no other options."

Clinics are dependent on the services that physicians provide for free, Costante said. Health Access, for instance, staffs only the director, nurse practitioner, receptionist and pharmacists.

"We are dependent on the physicians to volunteer at the clinics," said Costante.

At some clinics, nurse practitioners are providing more medical care than they once were because of the lack of physicians at some clinics, Brown said.

"We are not able to provide some services," she said.

Future of free clinics

When the Legislature opens the 2003 regular session, medical malpractice is anticipated to be one of the key issues legislators are to discuss. The future of free clinics in the state may also be determined based on the outcome of any medical malpractice reform legislation.

"I don't think (state leaders) realized the seriousness of it at first," said Brown, who serves on a committee with the Board of Risk Insurance Management.

Wilson said she hopes Gov. Bob Wise and others take free clinics into consideration when debating medical malpractice reform. A section should be included that would allow free clinics to operate without medical malpractice insurance, said Wilson. Health Access has never had a medical malpractice claim in its 10 years of operation, she said.

"They need to develop the laws to make the system work," said Wilson.

Without some kind of medical malpractice reform, free clinics will continue to struggle to meet the needs of their patients, Brown said.

"They don't have a voice out there advocating for their needs because they are poor," said Brown.

Patients like Churchill are the ones hurt the most in this situation, Brown said. Without free clinics, patients would be left without medical care and prescriptions to treat their conditions, she said.

"They're doing a good service," said Churchill.

Regional writer Shannon Blosser can be reached at 626-1404 or by e-mail at sblosser@exponent-telegram.com