Christ Clinic, a nonprofit medical clinic at 914 W. Carlisle, says its patient load has risen sharply since it moved into a larger building in the fall of 2008.

Danielle Riggs, a nurse practitioner who's the clinical director of Christ Clinic, says there's more need than ever now for the treatment of people who don't have medical insurance.

"This is a growth industry," Riggs says. She says the clinic currently sees about 400 patients a month, a 60 percent to 70 percent increase compared with the number of patients it handled at its former location, and it has 4,000 active patients altogether. Riggs expects to increase the patient load further this spring when a nurse joins the staff.

Christ Clinic offers low-cost medical care primarily to people who don't have medical insurance. The staff includes Riggs, psychiatric nurse practitioner Cynthia Rounds, several office staff members, and a development coordinator, in addition to 10 volunteer physicians and a psychologist who each donate time. Also, a number of specialists around town donate time and services to patients through Project Access, to which Riggs refers patients when they have needs that can't be handled at the general-care Christ Clinic.

Riggs says the system of care works well, with the volunteer doctors solving diagnostic dilemmas, and Riggs following up with lab work, referrals, and additional care as needed.

"My position is to anchor and maintain the continuity of care," she says.

The clinic was started in 1991 by four doctors, Scott Edminster, Jeff O'Conner, Frank Otto, and Bruce Bauma, who wanted to address a lack of access to basic health care for the poor, Riggs says. They launched the clinic in a small rented space in the basement of a west central neighborhood church. Edminster, O'Connor, and Otto continue to volunteer at the clinic regularly and serve on its board of directors, and Bauma, a surgeon, donates surgical services to the nonprofit, Riggs says.

"He's the guy on my fast dial" if someone needs an appendectomy or has another surgical emergency, she says.

Greater need for services

Not only is Christ Clinic seeing more patients now, but many of its patients are in more desperate situations, Riggs says. Most of the clinic's patients pay about 25 percent of the cost of an office visit, based on a sliding-scale fee system. More frequently, however, Riggs says she's compelled by the dire circumstances of the patients to not charge even $5 for some visits.

Riggs says many people who are newly out of work or have lost their homes feel more desperate because they aren't used to being destitute.

"We'd have to build four clinics" to address the need, she says.

Christ Clinic relies on the aid of other health-care organizations and donations to help it fulfill its mission. It gets most of its funding from donations and grants, and Spokane-area hospitals donate money or services to Christ Clinic because that helps people to manage their health rather than waiting until a problem results in a visit to an emergency room, at great expense, because they haven't had regular care.

"An emergency room visit can bankrupt someone who's working at minimum wage," Riggs says.

Local medical laboratories offer processing of samples on the same sliding fee scale that Christ Clinic uses to bill its patients, and Group Health Cooperative provides at-cost medications that must be dispensed at the clinic, she says.

Though the economy floundered even as the clinic was working on its building project, the community has supported the clinic, Riggs says. So far, nearly 100 percent of the $2.1 million in pledges it received during the capital campaign it mounted to build the facility have been delivered as promised, Riggs says.

Providing services to a low-income population is not without its challenges. No-shows are an issue, since nearly every appointment time is booked, but the clinic works to be as flexible as possible for its patients, who often have chaotic lives.

"I saw a guy the other day who, in the month that I didn't see him, lost 25 pounds," not a healthy thing for him, she says. In some cases, building trust with patients is as important as the care itself, she says.

"One of the things I love about having a psychiatric nurse here is that the severely mentally ill usually don't get their medical health needs taken care of" because they are seen in a mental health setting. Riggs eventually would like to bring a case manager on staff.

Room to grow

The new facility cost about $2.3 million, and the nonprofit now is in a second phase of fundraising to seek an additional $800,000 for higher operating costs as it grows into its new space. The clinic's space includes six exam rooms, a room for procedures such as biopsies and setting casts to treat fractures, and two offices for psychiatric visits, as well as administrative space and several flex rooms that can be used as offices or exam rooms.

It's the small amenities that the clinic did without for so long that Riggs notices the most, she says.

"We have a mop room," she says, and a bathroom by the back door for staff that's also equipped with a shower. The clinic also has complete electronic medical records capability through Inland Northwest Health Services.

The clinic has been taking its time settling into its new space, and hasn't started recruiting additional providers yet, but Riggs says the goal is to have about 40 volunteer physicians, which she says would be equivalent to one full-time doctor.

The clinic's operating budget this year will be around $450,000, up from $180,000 in its former space. Though it's a challenge to deal with the additional expenses of owning its own building—Christ Clinic rented its former space for $800 a month and paid no utilities—Riggs says it's well worth being able to see more patients and to offer them services in a professional clinic space. "Our bottom line isn't the dollar," Riggs says.