Just over 20 years ago, Summit County doctor Jim Oberheide wrote a letter. Addressed to the medical community, the letter put forth in words what Oberheide and others, including Marilyn Repscher of Public Health, had been feeling for some time about the state of health care affordability in the county — that it was too expensive for a significant group of people.

“We started seeing an increasing need for taking care of uninsured and underinsured people,” Oberheide said of the late 1980s. “We felt that a lot of people were falling through the cracks and it would be a good idea to see what we could do to set up a clinic to see people (who) couldn’t afford to go to private offices.”

This idea — based on need seen throughout the community — became the seed for what would soon become the Summit Community Care Clinic.

“I think we as a group can be effective in some way, however small, in improving the care available to some of the less fortunate people in Summit County,” Oberheide’s letter stated.

A developing service

The clinic first opened its doors in 1993. Managed by Summit County Public Health, it began as a one-night-a-week walk-in clinic running entirely on volunteer effort, from Public Health and local physicians.

At that time, the mission of the clinic was to provide those with little to no insurance access to basic health care.

“That was the original mission, to improve access to health care for the working poor and not really to take over the job of primary care, per se, but to just help people out with acute illness,” said Deb Crook, a longtime Public Health nurse and recently retired director of Health and Human Services, who was involved with the clinic in its early years.

Those working at the clinic quickly found plenty of people eager and ready to use the offered services. Though it started as a place to treat occasional illness like cold or flu, soon they realized that more was needed.

“So then as time moved on, it was clear that people needed access also to primary care, (and) that’s where we expanded to, not just acute care incidences but into more primary care, so that people could have a medical home who did not have access to health care based on underinsured status,” said Crook.

Over the years, the care clinic has expanded both its staff and its services. Through donations and grant money, it brought on paid staff, from physicians and nurses to coordinators and front-desk staff. In 2006, it gained nonprofit status, separating from Public Health. Today, the majority of those working at the clinic are salaried, although plenty of volunteers throughout the Summit medical community continue to offer their time and services when they can.

Sarah Vaine has worked as executive director of the clinic for nearly five years. She is proud of the fact that, 20 years later, the clinic has continued to move forward in its mission to provide vital services to an underserved population.

“The focus now is really on holistic, integrated, exceptional health care,” she said, explaining that with each visit, the clinic assesses not only current wellness but overall needs of the patient.

“What we see, because we do ask a lot of questions and have a holistic approach, is that people’s lives are complicated,” Vaine said. “So we’re not just talking with them about their health, we’re talking with them about whether they’re able to pay their rent, whether they can afford to buy nutritional food for their families, (whether) they have access to quality childcare … You learn more about their overall needs.”

Having this information not only allows the clinic to take care of any current issues, but potentially avoid further problems in the future, or guide patients to other Summit County organizations, such as the Family & Intercultural Resource Center, to find assistance.

One example of its forward thinking is that the clinic now keeps electronic health records of its patients, consolidating medical, dental and behavioral health into one electronic file rather than multiple electronic and paper files. As yet, this is not a common practice, making the Summit Community Care Clinic one of only a few in the state and possibly the nation to do so, Vaine said, adding “that’s very exciting for us.”

20th anniversary and not the last

“I think it’s interesting to see where we’ve come from and the advances and strides we’ve made over the past 20 years,” Oberheide said, “and I think it’s encouraging that we’re still viable and vital. Even though the future’s very uncertain regarding health care over the next several years, I think it’s clear that we’re going to be a part of it.”

Pat Kopystianskyi is both a board member and patient of the clinic — a requirement for at least 50 percent of board members. She said she greatly enjoys her work on the board and interacting with the various people who work and volunteer for the clinic.

“As soon as I met these people and I saw how seriously they took everything, I realized that they really are producing a quality product here for people who are uninsured,” she said. “These people just care about their patients. They’re invested in their lives.”

Kopystianskyi, a longtime nurse who worked at a large safety net hospital in New York, said that the atmosphere at the Summit County clinic is unique.

“Once you get into the doctor’s office, you really feel like you’re a special person and they want you be happy and healthy,” she said. Later she added, “that’s (another) really important thing that I feel here is the community support for this clinic. Even people who don’t use the services, have never used the services, will never need to use the services, they truly seem to understand the need for the services that are offered here and they support us.”

While clinic staff and services have expanded over the years, so has the need for accessible health care in Summit County. The percentage of children living in poverty in Summit County has increased this year, said Vaine, referencing the Kids Count in Colorado, an annual publication of the Children’s Campaign, providing state and county level data on child well-being factors including child health, education and economic status.

The main barrier to health care access is, without a doubt, cost, according to Oberheide, especially in a location like Summit County with high cost of living.

“It’s the cost, it’s just unaffordable,” he said. “I mean, (if) people (are) making $1,000 a month and health care premiums are $500 a month, people are going to look at their rent and their food before they’re going to look at buying health insurance, so it’s not good.”

And while the community care clinic can help provide basic care to those with little or no insurance, when it comes to specialized care for more serious illness, most of those people are still out of luck.

“There are people every week who come into our clinic who need surgery, who need treatment for a specific disease, (who) don’t have access to care because they don’t have insurance,” Vaine said. Although the clinic does have volunteer specialists, they only come periodically and their brief amount of care is often not enough for the very ill.

“Even though we’re able to see these people in the clinic, when it comes to trying to get certain laboratory tests or x-rays, procedures and specialty care, it’s very difficult to do this because we’re not able to,” Oberheide said. “We don’t have an x-ray machine here, we don’t have specialty care in the clinic on a regular basis. We have volunteers, but when it comes to getting a procedure or an operation that needs to be done in the hospital, it’s a real roadblock.”

Continuing to care

Despite the challenges, both staff and volunteers at the clinic are positive about the future, as well as the value of the clinic’s everyday impact.

“You start out with a vision of what it could be and you know it’s not going to be the same as where you started, but you just keep plugging along, working toward that vision of access to health care for everybody and you know after 20 years here it is,” Crook said, “and it’s a major piece of our community and it shows a lot about our community’s caring for the basics, … and I think it shows us to be a very healthy community because of that.”