Ryan Handoko is a Brown University undergraduate student who also is one of the founders of CHEER clinic, a clinic within Clinica Esperanza/Hope Clinic.
Clinica Esperana was founded in 2007 by a group of medical volunteers to provide “culturally sensitive and linguistically appropriate” health care for uninsured patients and those who cannot afford health care.
The CHEER clinic is a walk-in clinic founded to serve the state’s uninsured population with non-urgent healthcare needs and is supported by volunteer medical students from Brown University and the University of Rhode Island and other healthcare providers.
PBN: How has the clinic most changed since it was founded in 2007?
HANDOKO: The clinic started in a church basement. We had an exam table with a privacy screen in the boiler room and we ran flu clinics in the common room. We had as many patients as charts would fit into a roller suitcase. The economy was in a nose dive. Our patients were people who had lost their health insurance when their factory gates were chained shut. From there we moved to AIDS Care Ocean State. All the while, we worked to raise funds to build our own clinic. By May 2010 we were building and by December 2010, we had a new clinic open for business. Between June 2008 and now, our patient base has increased by more than 900 patients – to 1,000 by the end of this month - and our volunteer base has increased 10 fold.
PBN: What do people most often come to the clinic for?
HANDOKO: People most often come into the clinic for immunizations and glucose checks. We also have had a fair number of cases of skin rashes and back pain.
PBN: When residents are required to purchase health insurance, will you still be able to help those who don’t purchase it?
HANDOKO: Our clinic can probably handle up to 3,000 patients. We are currently at almost 1,000. We expect there to be hundreds of patients who will still need free health care. The R.I. Department of Health estimates that there will still be 55,000 uninsured patients including all people who have incomes above $15,500 per year and would not be eligible for Medicaid but might not have funds to purchase on the health exchanges even with subsidies. And of course we will serve people just arriving in Rhode Island who do not have health insurance including many refugees and immigrants and those who are temporarily without insurance because they moved their job. The CHEER walk-in clinic will be of even greater use for this reason. It serves as a means to provide information about insurance options in Rhode Island. We plan to apply for funding to hire a full time “explainer” who will work on connecting walk-ins to the new insurance exchange.
PBN: Many of the volunteers at the clinic are medical students. How valuable is this experience to preparing for a medical career?
HANDOKO: As a student aspiring to become a physician, this experience is incredibly fulfilling, inspirational, and invaluable. I love the work that I do at the clinic, where I can help in combating the health inequities associated with lack of access to health insurance. Volunteering at this clinic has given me guidance in learning the ins and outs of medicine and patient interaction, but it has also fostered a deep concern for providing health care to those who especially need it. My work here has inspired me to continue serving the uninsured as a prospective physician.
PBN: What evidence suggests the clinic’s system is working to serve the needs of the uninsured and underinsured?
HANDOKO: By establishing a free walk-in clinic, we hope that patients can come to us for non-urgent health needs instead of going to the emergency room, where the wait is longer and the cost is greater. According to our assessment of the past six months of running the CHEER clinic, we have found that about 45 percent of our walk-in patients would have gone to the emergency room had they not come to our clinic. With a count of 161 patients, this equates to about $60,000 saved in health care expenditures due to emergency room diversion, based on an estimate of $792 per ER visit.