December 11, 2018

File Photo/Cassandra Brown

Nurse Practitioner Amanda Brooks checks Sophia Bumbrey’s blood pressure.

The Fauquier Free Clinic on Jan. 1 will begin accepting Medicaid payments for low-income patients in its service area.The Virginia General Assembly in the spring ended five years of opposition and agreed to accept federal funding to expand state-administered Medicaid coverage to an estimated 400,000 more residents.For 25 years , the local free clinic has served qualifying low-income residents of Fauquier and Rappahannock counties at no charge. The clinic will serve an estimated 2,150 people this year.The legislature’s change makes Medicaid coverage available to those with incomes up to 138 percent of the federal poverty level, $16,754 for an individual or $28,677 for a family of three.That means many free clinic patients will qualify. And, under the clinic’s former policy, those patients would not get care there. The clinic’s board recently changed its policy to begin accepting Medicaid reimbursements next year, according to Executive Director Rob Marino.“Our primary goal is to make sure that the people we serve have access to the health care they need,” Mr. Marino said. “Some of our patients have been with us for years. Our clinicians know them well and have developed relationships that allow us to make a real difference in their health.”The clinic’s service area has relatively few physicians who accept Medicaid patients, he noted.“As long as they need us, we will be there for them,” Mr. Marino added. “We will make whatever changes we need to make to respond to changes in the community.”But, the change will present challenges.The clinic probably will hire a couple of part-time staff members to handle compliance and Medicaid reimbursement applications.Virginia’s 60 free clinics have scrambled in recent months to understand and to prepare for the changes. Many, including the local clinic, have adopted a “hybrid” model to accept Medicaid.“Our goal is to provide care without it making a whole lot of difference to the patient,” Mr. Marino said of the changes.Initially, the clinic hopes to cover the costs of staffing for Medicaid.“I do believe in the long run we probably can net a little something from the change,” Mr. Marino said.About 9 percent of Fauquier and Rappahannock residents lack health insurance, according to the clinic. An estimated 2,000 will be eligible for Medicaid coverage.“The clinic will help our patients apply for coverage with information flyers and trained volunteers who can help enroll patients,” clinic board member Caroline T. Riley said. “Once they have coverage, they can access many health care services, including medicine and specialists’ visits.”The clinic in January converted from paper to electronic health records, which should help with Medicaid requirements.“By sharing a unified patient record, our dentists, doctors and mental health counselors can coordinate much more effectively,” said Dr. Margaret Rowe, a clinical pharmacist who led the conversion effort.“We are concerned that many of our patients will not be able to find a primary care home that will accept their new coverage,” said Dr. Amy Trace, the clinic’s volunteer medical director. “Since we are already using electronic health records, we are in good position to keep them in house.”Relying heavily on volunteers and donations, the free clinic operates on an annual budget of $1.4 million.