THE UNINSURED R.I. Free Clinic helps to fill the gap BY STEVEN STYCOS

When Frederick Altieri of Warwick needed five stints to improve blood flow to his heart, Blue Cross & Blue Shield of Rhode Island paid for the surgery. But the operation left Altieri, 61, unable to work and forced him to leave his job as a machine operator at Astro-Med Inc. With no job, Altieri and his wife lost their health insurance, and he then developed breathing problems.

According to the state Department of Health, about one of every 11 Rhode Islanders share the Altieris’ predicament and have no health insurance. But the Warwick couple was among the fortunate few to find a solution. When Altieri’s wife told her doctor, Martin Kerzer, she could no longer afford to pay him, Kerzer suggested that she and her husband see him at the Rhode Island Free Clinic, next to St. Joseph Hospital on Broad Street in Providence.

The clinic impressed Altieri, who was used to seeing private doctors thanks to his health insurance. "Top shelf," he comments. "The nicest people you ever want to deal with." He adds, "They made me feel unashamed. I wasn’t embarrassed." Clinic doctors diagnosed his asthma and arthritis, and found two fractured disks in his back. Altieri says he has no idea what he would have done had he not found the clinic.

The brainchild of Rhode Island Hospital emergency room doctor Bruce Becker and AIDS research nurse Stephanie Chafee, the Rhode Island Free Clinic opened in June 1999. It currently provides free health-care to 1250 people from its basement offices.

Unfortunately, the clinic cannot serve all who need care and turns away about 10 new would-be patients every day, according to Laura Nelson, a VISTA volunteer who works as the clinic’s fundraising and public relations coordinator. Eighty percent of the clinic’s patients have jobs, Nelson estimates, but no health insurance. Most are between 45 and 65 years old.

Nationally, 43.6 million people, or 15.2 percent of Americans, have no health insurance, according to a September 2003 US Census Bureau report. Fewer people in Rhode Island lacked health insurance (8.3 percent) during the 2000 to 2002 survey period than any state except for Minnesota. But the Census Bureau report also revealed that the percentage of uninsured is growing more rapidly in Rhode Island than in any other New England state.

The clinic — one of an estimated 1000 free clinics in the US — works to improve the situation, one patient at a time. Once a month, it accepts 10 to 15 new patients on a first come, first served basis, and people line up in the morning in hopes of winning an evening appointment. In May, the clinic also started offering pre-employment physicals to help unemployed people get jobs, and hopefully, health insurance.

With the exception of executive director Lisa Smolski, a full-time nurse and two VISTA volunteers, the clinic’s staff is unpaid. One hundred and twenty doctors, nurse practitioners, Brown University medical students, translators, secretaries and other staffers donate an evening or two a month to provide free health-care. The clinic also provides free drugs from a well-supplied closet of drug samples and has free care arrangements with specialists, laboratories and x-ray facilities. Although not affiliated with an institution, the clinic has a $340,000 annual budget, including the two full-time salaries paid by the nonprofit hospital chain Lifespan.

The clinic, Nelson says, is always looking for more volunteers — both medical professionals and others willing to staff the office (interested volunteers can call 401-274-6347). "Turning away all these people is just unbelievable," says Smolski, "It’s horrendous."