Providing benefits like time off and health insurance for hourly workers is a relatively new concept at Charleston restaurants and hotels. Many still do not offer these services for non-salaried employees.
Through its Hospitality Inclusion Project Initiative, the Barrier Islands Free Medical Clinic on Johns Island is helping fill a statewide coverage gap by providing free health care, referrals, emergency care and some prescription services to qualifying uninsured hospitality workers in downtown Charleston, though you don’t have to be a hospitality worker to be eligible to receive regular clinic care.
Those who live or work on Johns Island, James Island, Wadmalaw Island, Folly Beach, Meggett, Ravenel, Hollywood and Walterboro can also receive care at the clinic.
“We want to make a medical home for them,” said BIFMC Medical Director Dr. David Peterseim.
What exactly does that mean? According to Peterseim, clinic nurses and doctors want to establish care with their patients and see them regularly. In addition to primary care, patients have access to doctors in 19 subspecialties, such as cardiology and gynecology. The clinic’s strategic partnership with Roper St. Francis Healthcare means patients can get free lab tests, cancer screenings and X-rays, along with emergency care at Roper, as long as they are enrolled before the emergency.
“You’ve got a quarterback and a quarterback with all kinds of support from pharmacy to radiology to invasive procedures that are all waiting to see what you need next,” Peterseim said. “You don’t have to chase the emergency room bill that’s going to come if you weren’t enrolled.”
A certified nonprofit, BIFMC’s workforce includes nine paid employees and 130 volunteers, including nurses, nurse practitioners and doctors.
“‘What’s the catch?’ is what some people think,” Peterseim said. “There is no bill generated from any care that’s delivered from the 37 doctors that work here every month.”
The center was opened in 2008 by two retired doctors, Arthur Booth and Charlie Davis, who wanted to establish a clinic that could treat working adults. Initially serving the Johns Island community and surrounding islands, BIFMC in 2018 opened a new clinic across the parking lot from the old one. With this state-of-the-art facility that has the look and feel of a normal outpatient doctor’s office, BIFMC has since expanded its areas of coverage, leading about 1,000 patients to its doors each year.
A member of the National Association of Free & Charitable Clinics, BIFMC follows the 299 percent poverty guidelines when deciding who qualifies for care. Uninsured individuals aged 18 to 65 in BIFMC’s service area must earn less than $40,634 annually to qualify, while couples who make $54,746 can visit the clinic. (Each additional person in a household adds $14,112 to the upward limit.) Patients must qualify every year.
BIFMC’s patient population was at an all-time high prior to the COVID-19 pandemic, according to Clinic Director Brenda Falls, who said they’re biggest obstacle is raising awareness that they are there. With seven exam rooms, BIFMC has room to nearly double its capacity.
“We were just making a lot of traction, seeing some of our highest numbers that we’d ever seen, and then COVID hit,” Falls said. “If you’re not constantly creating awareness then people really don’t know that we’re here.”
“One of the biggest obstacles to getting patients is adults not realizing they’re eligible,” said Carrie Moores, BIFMC director of Development and Communications. “In my mind, those who work in the hospitality industry are kind of the perfect example of a person who would qualify in a clinic like ours.”
BIFMC can be a resource for the more than 100,000 South Carolinians who fall in the insurance coverage gap.
A decade has passed since the U.S. Supreme Court first upheld the constitutionality of the Affordable Care Act, but the court did so with a caveat. One of ACA’s central tenets — an expansion of the low-income Medicaid program to cover all adults who fall below the federal poverty line — became optional, with the court deciding states could not be compelled to participate in Medicaid expansion. Many states immediately decided the deal was too good to turn down, while several others, including South Carolina, opted out. The Palmetto State remains one of 11 states that have yet to expand the Medicaid program.
“Typically these lower income adults who rely on our services do not receive healthcare benefits via their place of employment, or they work multiple part time jobs without the benefits of any one full time employment. This is particularly true among those in hospitality,” Moores said. “I would say around 75 percent of our patients currently work at least one job, with many working as many as two to three jobs and still cannot afford to access health care.”
Many of the clinic’s volunteers are retired doctors who still have the urge to help those in need. Peterseim, who previously worked as a heart and lung surgeon at Roper for 15 years, was inspired to do more volunteer work after temporarily living with his family in Costa Rica, where he was performing surgeries at a free clinic.
“There are a lot of people that need care, so I got more involved in this project,” Peterseim said.
Some volunteers are active providers, including a dermatologist who closes their private practice every other week to work at BIFMC, while others are using their clinic work as a technical training ground as they pursue careers in medicine.
Diana Osorio has spent 165 hours caring for patients at BIFMC, work that will soon help her become a full-time nurse practitioner.
“You see everything from just regular visits to, ‘You need to go to the emergency room today,'” Osorio said. “What we do here is so meaningful to the patients that we see.”
Prospective patients can learn more about the clinic and fill out an application at bifmc.org.