Two months after arriving from Germany to be with her new American husband, Alexandra Thomas was stunned to discover she was pregnant. With no Social Security card, green card, job or health insurance, she turned to the Johnnie Ruth Clarke Health Center for help.
That was in 2007, before the economic meltdown that has brought unprecedented layoffs. And it was before small businesses started dropping employee health insurance in a frantic attempt to stay afloat.
The Johnnie Ruth Clarke Health Center in St. Petersburg and its four sister sites in Pinellas Park, Largo, Clearwater and Tarpon Springs are struggling to keep up with the growing ranks of uninsured and underinsured. For the first time in their 24-year history, the facilities, known collectively as the Community Health Centers of Pinellas, are making a public appeal for financial help.
In 2007, the centers, which provide primary health care, saw 22,456 patients. In 2008, the number grew to 24,154. A steady rise is expected this year. What's troubling is that more patients — who pay on a sliding scale — are saying that the minimum $25 office visit fee is beyond their reach, said Cheryl Crenshaw-Robinson, managing director of the Johnnie Ruth Clarke facility in St. Petersburg.
"If you're trying to keep a roof over your head or food on the table and you need a blood pressure pill, we're finding more and more people are opting not to buy that blood pressure pill,'' she said.
Community health centers around the country are facing similar scenarios. The centers, which got their start during the Johnson administration, have a mandate to provide health care to the poor in underserved urban and rural areas. They got a boost in federal funding during the recent Bush administration and could benefit from a $1.5 billion infusion proposed in President Obama's economic stimulus package. The bulk of the money would go to renovating and repairing the nonprofit centers and funding health information technology systems.
Meanwhile, Community Health Centers of Pinellas County is searching for ways to overcome funding cuts from Pinellas County Health and Human Services. The county previously covered the salaries of doctors and nurses, but now pays for only office visits and prescriptions for eligible patients.
"It does change how the cash flows,'' said Joseph Santini, the center's director of business development.
While the center has cut some support staff, reduced hours and delayed plans for extended hours, there are other factors outside its control that make things even more difficult for clients.
"We have found that some of the referral specialists are no longer available to see our patients. That number is growing. They need to stay in business, too,'' Crenshaw-Robinson said.
The health centers have started a fundraising campaign, asking people to buy bricks engraved with their names. The brick initiative will support the Johnnie Ruth Clarke Health Center — the original and largest center — and a facility being built for the Tarpon Springs center. Bricks cost $100 each.
Most of the centers' patients are the working poor, Santini said. Additionally, about 45 percent of patients are on Medicaid, while about 36 percent of those seeking treatment have no health insurance.
John and Dara Knight, who are unemployed, are grateful for the care they get at Johnnie Ruth Clarke. John Knight, 59, had open heart surgery last May. His wife, 54, has had surgeries stemming from a ruptured appendix and a rare tumor.
"This center is like a family to us,'' John Knight said.
German-born Alexandra Thomas, 38, and her husband, Maurice, 41, met in Germany, where he had settled after serving in the U.S. Army. Her pregnancy shortly after arriving in St. Petersburg with her 10-year-old daughter, Lisa Maria, was a shock. Money was tight.
"I was scared. … I was always able to care for myself. I was insecure and I needed some support and I think Maurice felt the same,'' she said.
"When we got into the clinic, the first moment, it felt strange that I was there to ask for help,'' said Thomas, a substitute teacher at the Wellington School. "Everybody was nice, positive. … It was just the best thing that could happen to us, because these were the first people who really cared about our whole situation.''
As they told their story last week, she and her husband took turns holding 10-month-old Angeleena Janay — their smiling, babbling surprise.
Waveney Ann Moore can be reached at firstname.lastname@example.org or (727) 892-2283.