07/23/12 — WATCH seeking needed funding

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WATCH seeking needed funding

By Phyllis Moore
Published in News on July 23, 2012 1:46 PM

The challenge of creating a sustainable healthcare option in the midst of a budget shortfall and dwindling funding is not lost on Sissy Lee-Elmore, executive director of WATCH, or Wayne Action Teams for Community Health.

Her role centers around writing grants and maintaining the program, which was introduced in Wayne County in 2000.

"We're a free clinic," she said Friday. "So when people ask about sustainability, that's a tough question to address."

Dr. Clark Gaither, medical director of WATCH put it more simply -- the needs in Wayne County continue to climb, requiring services to be expanded.

"Until we see what happens with the health care act, we have got all this need and I think we're addressing it in ways that are very difficult for other counties to address," he said.

Since its inception, WATCH has operated a mobile van that canvasses the county, serving the indigent population. The non-profit option for uninsured residents quickly reached full capacity, twice forcing program officials to announce it was not accepting new patients.

The first time that happened was in January 2006, when the program only had the van. A second, stationary, location was added at the Goldsboro Family YMCA in August 2009 and an additional nurse practitioner was brought on board.

This past February, officials had to again stop taking new patients.

During 2011, WATCH recorded 11,300 patient visits and provided an estimated $2 million in medications at no cost to patients, through collaborative efforts with pharmaceutical companies' patient assistance programs.

Funding has come from a variety of sources -- grants, local county and city government, Wayne Memorial Hospital, United Way, Blue Cross Blue Shield of North Carolina Foundation and other donors. An annual golf tournament has also supported the program.

With each passing year, it becomes increasingly difficult to project which resources will continue and which will not. One glaring example of this occurred last year, when Wayne County's designation by the N.C. Department of Commerce dropped from Tier 1 to Tier 2.

The state annually ranks the state's 100 counties based on economic well-being. The 40 most distressed counties are categorized as Tier 1, with the next 40 being Tier 2 and the 20 least distressed being Tier 3.

Since Wayne County's ranking changed, there is not only more competition for funding but often fewer options for which it is now eligible, Mrs. Lee-Elmore said.

Fortunately, local governing bodies have stepped up.

The city council's current proposed budget earmarked $20,000 to the program, while the county commission again approved $220,000 for the upcoming year.

Another boost came recently in the form of a $199,144 grant from Duke Foundation.

"I can't tell you how hard (it is) in today's climate, how hard it is to get funding," said Dr. Gaither. "A lot of funding sources are drying up so we're eternally grateful to the Duke Foundation for the funds they're providing for us.

"Our boat would float without it, but it would be very leaky. It came at just the right time."

The grant will primarily be used for three things -- two staff positions, a generator and accepting new patients.

"We're kind of changing our staffing patterns," Mrs. Lee-Elmore said, explaining that an additional office clerk will be added at each of the two locations. "We haven't really needed them but now that we have electronic medical records, we need that. With that we should be able to increase capacity."

Starting this month, they have already begun accepting new patients, at a rate of 8 to 10 a week, she said.

The Duke money has essentially "rescued" WATCH again, Mrs. Lee-Elmore said.

"They bought the truck initially and refurbished it later and now they're buying the generator," she said. "The truck's been running since 2000 and it's running all the time -- on-site sometimes eight hours, that generator runs the whole time we're there, 25 to 30 hours a week, 52 weeks a year times 12 years, it's been running.

"Without the generator, we have no electricity, no water and no air conditioning."

She estimated the cost of a new generator at more than $12,000.

It all boils down to one thing -- every revenue source is essential, Mrs. Lee-Elmore said.

"As far as the county money is concerned, we're the provider of primary and acute health care to the uninsured of Wayne County," she said. "It means the health department and the county doesn't have to do it somewhere else.

"We're able to do (things) at a lesser cost to the county because we use this money as matching (funds) to bring in to leverage funds from the outside. ... We're a bargain. I don't think anybody could do it cheaper. Our return on investment, for every dollar that was given to WATCH, we provide $6.76 worth of health care (according to calculations from the N.C. Association of Free Clinics)."

Between the economy and transitions during the conversion to the electronic records, it's been a tense time in the history of WATCH. But Mrs. Lee-Elmore remains optimistic.

"We were operating on a budget shortfall until we got the (Duke) grant," she said. "We didn't have any extra money but we should be able to get through the next year, barring any unforeseen things."