Volunteers, patients come together at clinic.

Byline: Mark Baker The Register-Guard

Nina Perez is anything but average, yet that's exactly what she is at the Volunteers in Medicine Clinic on West 11th Avenue in Eugene.

She has one child. She rents her home. She has some college education but didn't graduate. And her monthly income is $1,200. All of which pretty much describes a typical patient at the clinic.

Perez, 39, is also a Latina, a diabetic, a patient, a volunteer at the clinic, and she was diagnosed four years ago with multiple sclerosis, which slurs her speech, slows her gait and sometimes robs her of strength to dress herself or rise from a chair.

"She's a good representation of the flavor of the clinic," said Jo Ann Cook, the development coordinator at the 3 1/2 -year-old clinic. "She has every reason to be lazy but she's not."

The free clinic relies on volunteer doctors and staff, many of them retired. They have seen an increasing demand for services, particularly from Latino patients, since state budget cuts earlier this year sliced in half eligibility for the Oregon Health Plan, down to about 50,000, with more cuts expected. After experiencing about 1,600 patient visits during its first year, the VIM clinic had seen 26,000-plus patient visits in 2004 as of Nov. 30, said Sister Monica Heeran, the clinic's executive director.

Many who have lost their OHP benefits still do not qualify for coverage at the clinic because they make too much money, although it's often not enough to meet their basic needs. Other area clinics that care for low-income clients, such as Eugene's White Bird Clinic and the recently opened RiverStone Clinic in Springfield, are also experiencing an increase in patients wanting care after losing their OHP benefits.

"Hopefully, we'll be able to find a way out of this," said Bob Dritz, White Bird's clinic coordinator. "But the cost of health care will continue to soar until we figure out a way to provide it to everyone."

Luckily, Perez qualified at the VIM clinic after she was ineligible for the OHP. The clinic accepts patients for primary care treatment who fall between 100 and 200 percent of the federal poverty level, which is $9,312 for a single person and $12,492 for a two-person household. So Perez, whose Social Security disability income brings in $24,000 a year and who lives in Springfield with her 13-year-old daughter, Candice, makes it under the 200 percent limit.

Since it opened in 2001, the clinic has added a diabetes program after discovering that many of its patients suffered from the disease.

"(Diabetes) is the most frequent diagnosis of patients in the clinic," Heeran said. "And many had not received treatment or didn't know how to manage their disease." The clinic began using a new model, group visits, about two years ago to address the problem. Diabetes affects low-income people in greater numbers because of poor nutritional choices, said Cheryl Moore, a diabetes nurse educator at the VIM clinic. Those who suffer from it often do not talk about it, she said. So they come to the clinic once a month and meet others who have the disease and learn how to manage it.

Perez discovered she had type 2 diabetes after being diagnosed at the VIM clinic. A former phlebotomist at McKenzie-Willamette Hospital, she lost her job at the Thurston Medical Clinic not long after she took a position there a couple of years ago. She soon began volunteering at the VIM clinic.

"I've always been on the side of helping people," Perez said, "so I'm not used to accepting help."

Despite her MS, she finds the strength to volunteer at the clinic two or three times a week as a translator and office assistant. She sees the clinic almost like a family, she says. She has bonded with staff and many of the retired doctors who find their work just as fulfilling as Perez does. She monitors her illnesses and receives medication from the clinic, but she no longer receives the much-needed $1,200 from the Oregon Health Plan for monthly shots to treat the chronic and debilitating MS.

The VIM clinic is trying to help her get those shots through its Patient Assistance Program, said Jennifer Johnson-Joefield, the clinic's manager. Perez noted that the shots, which relieve the agony of MS and help to stabilize it, cost the same as she receives to live on from Social Security.

"I wish there were more clinics like this," she said, "because there are people out there who need help. Especially the Latino (population). They're ashamed or embarrassed to ask for help."

Dr. Hugh Johnston, 71, who came out of retirement to lead the VIM clinic when it opened, said he's amazed at the cases that come through the door. Seizure patients with no medication to control them. Mentally ill people who have not been diagnosed. Fifty-year-olds who look like they're 65 because they have no access to thyroid medicine. A 27-year-old man with active tuberculosis, a potential public health threat, who had never been diagnosed. And a 50-something man riding his bicycle past the clinic a few weeks ago who was experiencing chest pains, walked through the door, was found to be having a heart attack, was cared for at the clinic, then rushed to the hospital and is now a patient after finding out he qualified.

"People look at this clinic like it's a charitable clinic," Johnston said. "Well, yeah, it is. We're giving care to the downtrodden. But I look at it as besides that. I look at it as ... economics. It's cheaper to take care of them here. There is no question there's a group of people who fall through the cracks. And if they don't get taken care of, society pays double down the line."

Ask him about the cuts to the Oregon Health Plan and Johnston gets an exasperated and frustrated look on his face.

The VIM clinic's board is considering expanding the parameters of those eligible for treatment, those below 100 percent of the federal poverty level. Of those who have lost their OHP privileges in the past year, about 2,500 live right here in the Eugene-Springfield area, Johnston said. How can they all find care?

"We couldn't possibly do that," he says.

MEDICAL CARE

The Volunteers in Medicine Clinic, 3321 W. 11th Ave., provides primary health care for those who earn too much to qualify for the Oregon Health Plan - but no more than 200 percent of the federal poverty level - and don't have adequate health insurance.

Hours: 9 a.m. to noon and 1:30 p.m. to 5 p.m. Mondays and Thursdays; 1:30 p.m. to 8:30 p.m. Tuesdays; 9 a.m. to noon Fridays.

Appointments: Call 685-1800

To volunteer: Contact volunteer coordinator Glenn Benson at 685-1920; or visit the clinic's Web site, www.vim-clinic.org to fill out an online application.

CAPTION(S):

Nina Perez is a volunteer translator when she's not a patient herself at the Volunteers in Medicine Clinic on West 11th Avenue in Eugene.