As economists predict a double-dip recession, Memphis healthcare providers are digging deeper to care for the poor, the uninsured and the underinsured, especially in North Memphis, South Memphis and neighborhoods like Frayser and Orange Mound.

 

But pockets of poverty are also being found in unlikely places such as Hickory Hills, where half the patients coming through the doors of Christ Community Health Services' new 15,000-square-foot clinic that opened in April are uninsured.

 

"That's more than we anticipated," admitted Burt Waller, executive director of Christ Community Health Services (CHS). "The number of uninsured patients at our established clinics is 35 percent. However, it's a challenge for new patients to get on the schedule at established clinics. Only a certain number of new slots are available. At Hickory Hill, because it's new, there are more open spots for appointments. The trend there may better reflect the needs of the uninsured's access to care."

 

Because demand exceeds capacity, Christ CHS has struggled to cover expenses. Fortunately, economic stimulus funds from the American Recovery and Reinvestment Act (ARRA) of 2009 have helped offset the financial burden. ARRA allocated $500,000 to Christ CHS to help support the upsurge of uninsured patients, money that is being used to support the work in Hickory Hills. ARRA funds of $1.4 million have also been allocated to Christ CHS to improve facilities.

 

"We'll use that to expand dental services," explained Waller. "It's more difficult to get dental care than basic medical care because for one thing, dental services are typically more expensive. There are very few places in Shelby County that low-income, uninsured residents can go for dental care."

 

Memphis Health Center CEO William Jackson said ARRA funds helped make it possible to expand the clinic's hours – initially to Wednesday evenings and Saturday mornings. Now, the clinic has expanded its after-hours schedule to include Monday, Tuesday and Thursday nights.

 

"Apparently, there was a need for it," said Jackson, "but we haven't been overwhelmed. We're currently evaluating the cost-effectiveness of the expanded hours to determine whether to continue."

 

Even though Memphis Health Center offers dental services, those services have not been made available on weeknights or Saturdays.

 

"Most of the healthcare community is aware that we're at about the same level of uninsured care, maybe a little worse, but no one's pushing the panic button on how to continue to cover the uninsured," said Jackson. "Hopefully, unemployment will stabilize soon."

Marvin Stockwell, spokesperson for the Church Health Center Clinic for the working uninsured, said the economic downturn has continued to push demand for new patient appointments up 70 percent in 2009 while overall donations are down slightly. The center does not rely on government funds, and did not apply for ARRA money.

"One way of dealing with (the recession) is by continuing to be lean and frugal," said Stockwell. "We're a frugal group anyway. Ninety cents of every dollar raised goes to healthcare; only 10 percent goes toward overhead. People want to see that our work is vital – everyone agrees Memphis needs Church Health Center as part of the metro area's healthcare safety net – and that we're good stewards of the money, plus our efficiency rating is at the top, and that we're creatively stretching our dollars."

 

Last year, Church Health Center's 80,000-square-foot comprehensive wellness and prevention center, open to the public, logged 125,000 visits.

 

"When I first started working here, I thought we helped the poorest of the poor," said Stockwell. "But lately, I've noticed more patients – white males, in particular – coming from the suburbs, even from Germantown. Many said they never thought they'd need us. That's a phenomenon of the recession. Being uninsured was already a problem of the lower middle class. Now it's reaching the middle- and even the upper-middle class."

 

Even though no direct statistics confirm it, Stockwell said his hunch is that stress has played a major role in the increased number of doctor visits.

 

"Everyone knows that stress affects emotional health and therefore impacts physical health," he said. "More companies have been laying off employees, dropping insurance coverage, and cutting hours and therefore benefits. Many people say they thought it would never happen to them. It's all taken a toll."