Five Questions With: Marie Ghazal

CEO of the Rhode Island Free Clinic talks about partnership with CVS Caremark Corp. that will see the pharmacy serving the clinic’s patients. More

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Five Questions With: Marie Ghazal

"Our mission remains to serve the uninsured in Rhode Island, adults 18 and older. If they are able to pay, they don’t come here. "
Posted 9/24/12

Marie Ghazal, the CEO of the Rhode Island Free Clinic, calls the work of her nonprofit agency “the safety net for the safety net.” In 2011, the clinic saw about 2,000 patients who were adults and lacked health insurance, and that number is projected to increase in 2012.

There are currently about 104,000 Rhode Island adults, ages 19-65, who are uninsured, according to Ghazal, and even with the launch of the R.I. Health Benefits Exchange in 2014, the projected numbers are that there will be still be 40,000 to 50,000 uninsured adults.

The Free Clinic, founded in 1999 by Stephanie Chafee with a mission to serve the uninsured poor, is about to take a major step forward to improve its delivery of health care services. Through a new partnership with CVS Caremark Corp., announced on Sept.21, CVS will now serve as the pharmacy for the free clinic, dispensing medicine to the clinic’s patients.

As a result, the Free Clinic can devote more of its limited resources to better serving its patients.

Providence Business News caught up with Ghazal in the busy hive of the clinic’s daily activities at its facility on Broad Street in Providence.

PBN: How does the new partnership with CVS Caremark enable you to serve your patients better?

GHAZAL: We are excited about our major partnership with CVS Caremark, the leading pharmacy company in the country. Through this partnership, our patients will be able to get their medication at CVS pharmacies. Up until now, we have been operating our own pharmacy. We were doing it all with volunteers, volunteer pharmacists, volunteer techs, and donations for money to buy medicine.

We reached the point in the past year where we had grown so much, we had reached the maximum that we could do at this facility, given our limited resources. Now, our patients get a card from CVS once they become a patient at the clinic. With the CVS partnership, it will allows us to focus more on the mission of primary care, and to leverage our limited resources.

The new partnership will ensure that our patients are getting the medicine they need, when they need it. We’re not open 24 hours a day, we’re not open every day from 8 a.m. to 10 at night. Now, a patient can go to CVS, they can pick up their medicine when it’s convenient for them. Even better than that, a family member can pick it up for them, so they don’t have to miss work.

The bottom line is that patients are taking their medications. CVS will be able to go a lot with improving adherence.

PBN: How many patients do you serve at the Rhode Island Free Clinic?

GHAZAL: We currently have about 2,000 patients, with more than 10,000 visits last year. The number has increased significantly in 2011.

Right now, we still have a very high unemployment rate in Rhode Island. There is a strong correlation between a high employment rate and people not having health insurance. Our patients are often working, but their employer doesn’t provide insurance, or they can’t afford health insurance. There are a lot of skilled workers in our state – take hairdressers and nail salon [technicians] and construction workers. They can be working at minimal, low-paying jobs and cannot afford health insurance.

We receive no reimbursements. We don’t collect insurance. Our mission remains to serve the uninsured in Rhode Island, adults 18 and older. If they are able to pay, they don’t come here.

PBN: Why do most patients come to clinic? Is it to be seen for emergency care? For chronic care?

GHAZAL: It’s primary care. Once you become a patient of the Free Clinic, this is your medical home. You see the doctor or nurse practitioner; your care is managed.

If people have put off health care [because they can’t afford it], they tend to have more chronic problems – we see a lot of diabetes, a lot of cardiac issues, high blood pressure.

PBN: How is the Free Clinic staffed?

GHAZAL: We have a small, core staff, but we depend on our volunteers. We have more than 700 volunteers, including many doctors, nurse practitioners and physicians assistants, through the physicians network statewide. We rely on philanthropies and volunteers to support our efforts at the clinic – and corporate partners and academic partners.

We currently have six VISTA workers.

PBN: There is now an ongoing political debate about the responsibility of the community and the government to provide services to those who have fallen through the safety net. How do you see your work at the Free Clinic in that context?

GHAZAL: Everyone deserves health care. Within the context of the delivery of health care in Rhode Island, our patients are the people who have fallen through the cracks, who cant’ get health insurance. These are people who don’t fit into the system. Many are very hard working.

Once you’re our patient, we manage your care. We get your lab work done, your blood work, if you need physical therapy, if you need medicine. Without health insurance, there’s a cost to everything you need to keep you healthy.

We’re not making money here. If the total care can be managed, if we can change your behavior and make you well, it reduces the costs for everyone.

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