From Living in LoCo correspondent Val Cavalheri:

When Sonia, a 41-year-old single mother of two, first walked into the Loudoun Free Clinic this past September, she knew something was wrong, but the last thing she expected to hear was that she had Stage 4 breast cancer. With no insurance despite her full-time job, Sonia wondered what would happen to her children if she could no longer take care of them.

However, the staff at this busy but unassuming clinic in Leesburg doesn't allow that type of pessimism. Instead, they got on the phone and went to work, arranging for her to be seen by specialists at the University of Virginia (UVA is one of two hospitals in Virginia that will see indigent patients free of charge, if they qualify financially). They also made sure someone would take care of the children, although staff members were prepared to take them into their own homes, if necessary. Sonia has since undergone a radical mastectomy and reconstruction, and her chances of seeing her children graduate from college are much improved.

Jennifer Montgomery, the clinic's executive director (Photos by Val Cavalheri)

The Loudoun Free Clinic sees about 600 uninsured adults who, like Sonia, have no health insurance and whose incomes are 200 percent of the federal poverty level or below (equal to $41,300 a year for a family of four). In existence since 1998 and located in a building at the Cornwall Street Campus in downtown Leesburg, the clinic was formerly used as a hospital. In fact, Jennifer Montgomery, the clinic’s executive director, was born here -- "right upstairs," she said -- 33 years ago.

“My job is essentially about fundraising and we are only limited by how much funding there is. The financial support comes from church and company contributions and the clinic’s yearly fundraising gala," Montgomery said. In addition to support from the town and county, "the state provides $25,000 and the rest is from private donations. Inova Loudoun Hospital makes a huge contribution. Not just in funding, but they also loan us this building and their medical group helps us to get doctors and nurses.” She continued: “We have a great return for the money we raise. For every $1 the clinic spends, we deliver $5.40 in health care.”

The clinic pays three full-time employees and one part-time nurse. All medical staff -- doctors, nurse practitioners, nurses, etc. -- are volunteers, seeing patients in the clinic in the evening after they are done working at their own practice. Among other illnesses, for example, they will treat diabetics or hypertensive individuals who require both monitoring and prescriptions to keep their health under control. These patients will return to the clinic for both. If they can afford it, they will pay a small fee for their prescriptions, and if not, they will receive it for free.

Due to a recent collaboration with Northern Virginia Community College, the clinic is now being used as part of its community nursing program training. The presence of nurses allows the clinic to not only see more patients, but to schedule daytime appointments. “It’s a win/win for everyone,” said Sheila Mathis, assistant professor of nursing at NVCC. “We can show our student nurses a bigger picture than what they can see in a hospital setting.”

Sheila Mathis with two student nurses

Amanda Brooks, a nurse practitioner and assistant professor at NVCC, agrees: “Our students are exposed to people who have left the hospital after a stroke, for instance, and are back in their community. When our student nurses question them about why they are not taking life-saving medicine, they are told that it’s not because they don’t want to, but because they have to feed their family, instead.”

“We try very hard to make sure that this doesn’t happen,” Montgomery said. Brooks added: “Our volunteers spend many hours on the phone convincing our patients to pick up and use all their medicine. This clinic does a great job of making people feel accepted."

Acceptance and compassion seem to be an important aspect of the clinic and those who make it work. Take, for instance, Jeannie Testa. Testa, who volunteered to help with the diabetic clinic one day a few months ago, is now a regular, coming in four days a week and passing out advice and hugs to scared and needy families. “There is just so much to do, I can’t seem to tear myself away. It all goes back to the first time you know that you’ve made a difference,” she said.

“At the end of the day it’s about the patient,” Montgomery added. “Loudoun is so affluent, that sometimes people don’t realize that there are so many people working hard who can’t afford health insurance. And that number keeps going up every day.”

As an example, Montgomery mentioned a conversation in which she overheard someone comment that 'there are no homeless in Loudoun.' "I didn’t even know how to respond," Montgomery said, pulling out a chart of a current patient at the clinic. "He's making $28,000 annually and trying to support a family of six." What can he afford? Where does he go for heath care?”

Volunteer Jeannie Testa

This patient is not unusual. The Virginia Health Care Foundation Web site profiles the 1 million Virginians who are uninsured as either working full time (70 percent) or part time (12 percent), and (despite the controversy) almost 83 percent are U.S. citizens. Additionally 60 percent of low-income uninsured adults had an unmet need for care last year because of the financial difficulties of paying for health care.

Loudoun Free Clinic might just get the boost it needs with December’s announcement from Gov. Tim Kaine proposing to expand access to health care for the uninsured. “We must also look for new, innovative ways to provide access to health insurance, sharing responsibility with our private sector partners and our citizens," Kaine said.

But until that happens, Montgomery continues to push for assistance from everyone who comes in contact with her. “We need office supplies, brown lunch bags (which the clinic uses to hold the prescriptions), people willing to cook for the volunteers, people to make phone calls, and always, we need interpreters, nurses and doctors. Next time you’re at Costco maybe you can pick up some snacks … or a new EKG machine,” she said, laughing.

She’s not kidding.