Trinity Free Clinic

2015 Annual Report

Our Mission

The mission of Trinity Free Clinic is to provide

quality free medical, health and dental

support to the uninsured, underinsured, and

low income residents of Hamilton County

with dignity, through a professional and

dedicated volunteer staff.

Our Impact

In 2015 we saw 2270 unique patients during 5968 visits.

Since 2000 we have treated over 20,000 patients during

32,000 visits. Our average patient comes from a family of

4 and earns $25,429 a year.

ALICE Report

2014-2015

ALICE (Asset Limited, Income Constrained, and Employed): Households with income above the Federal Poverty Level but below the basic cost of living.

“The ALICE threshold is the average level of household income required to afford the basics such as housing, child care, food, health care, and transportation as defined by the Household Survival Budget for each county in Indiana.” (Indiana Association of United Way, 2014).

Household Survival Budget for the average Indiana family of four is $59,212.

Household Stability Budget (one that enables not just survival but self‐sufficiency) is $83,260.

Source: Connect 211 and United Way report, March 2015, http://www.connect2help211.org/wpcontent/uploads/2012/10/April2014-March2015C2HHamilton.pdf

Source: Connect 211 and United Way report, March 2015, http://www.connect2help211.org/wpcontent/uploads/2012/10/April2014-March2015C2HHamilton.pdf

21,769 (21%)Hamilton County Households

are below the

Household Survival Budget

ALICE Report

2014-2015

Hamilton County

Annual Survival budget:

$59,215

Hourly Wage:

$30/hr

Patient Place of Residence

and Income

Patients by Zip Code

2015 Trinity Free Clinic Patients by ZipCode

ZIP CODES CITY

Number of UNIQUE Patients

Number of

Patient Visist

Provided % of TTL RANK

46060 Noblesville 726 1,910 32% 1

46032 Carmel 568 1,492 25% 2

46074 Westfield 522 1,373 23% 3

46037 Fishers 250 656 11% 4

46069 Sheridan 91 239 4% 5

46034 Cicero 45 119 2% 6

46031 Atlanta 23 60 1% 9

46030 Arcadia 23 60 1% 8

46202 Indianapolis 23 60 1% 7

46077 Zionsville 0 0 0% 10

TOTAL 2270 5968

HIP 2.0 (Healthy Indiana Plan)

Income Guidelines

HIP 2.0 - Family of 4Annual Income Annual Payment % of income

$20,000 $396.00 2%

$25,000 $504.00 2%

$30,000 $600.00 2%

$35,000 Not Eligible

We’ve partnered with MDWise and IU North Navigators to enroll our patients. In 2014, 40 patients

were enrolled, many more were given required information.

HIP 2.0 Difficulties

• Complexity of available state medical insurance programs makes it difficult to register and remain in the appropriate program.

• Lack of providers in Hamilton County that accept HIP patients.

• Many patients do not qualify.

% Poverty

Level Income Credit

Medical

Insurance

Out of

Pocket for

Medical

Dental

Insurance

Out of

Pocket

Dental

Annual % of

Income

with no

claims

Annual %

of income

with claims

140 $33,500 $8,935 $1,159 $4,500 468$ 700$ 5% 20%

147 $35,000 $8,754 $1,340 $4,500 528$ 700$ 5% 20%

168 $40,000 $8,157 $1,937 $4,500 528$ 700$ 6% 19%

189 $45,000 $7,477 $2,617 $4,500 528$ 700$ 7% 19%

210 $50,000 $6,754 $3,340 $10,400 528$ 700$ 8% 30%

231 $55,000 $6,014 $4,080 $10,400 528$ 700$ 8% 29%

252 $60,000 $5,206 $4,888 $13,200 528$ 700$ 9% 32%

273 $65,000 $4,401 $5,693 $13,200 984$ 700$ 10% 32%

294 $70,000 $3,535 $6,559 $13,200 984$ 700$ 11% 31%

335 $80,000 $2,446 $7,648 $13,200 984$ 700$ 11% 28%

Marketplace Rates for Medical Insurance

Family of 4

Marketplace Costs

Hamilton County

Survival budget

$59,215

Hamilton County

Stability budget

$83,260

Marketplace rates are

often too costly for

working families

Marketplace Difficulties

• Many patients don’t qualify.

• Too costly for many working families above poverty level.

• Only open during certain enrollment periods.

Patients by Country of Origin

“Other” Countries of Origin

2015 Trinity Free Clinic Patients by "Other" Countries

Afghanistan Ecuador Kazakhstan Papua New Guinea

Algeria El Salvador Kenya Paraguay

Armenia England Korea Peru

Australia Eritrea Kuwait Philippines

Bangladesh Estonia Kyrgyzstan Poland

Belarus Fiji Latvia Russia

Belize Germany Lebanon Saudi Arabia

Bolivia Ghana Liberia South Korea

Brazil Greece Libya Spain

Bulgaria Guatemala Malawi Sudan

Cambodia Haiti Malaysia Syria

Cameroon Honduras Moldova Thailand

Canada Indonesia Mongolia Ukraine

Colombia Iran Nepal United Arab Emirates

Congo Iraq Nicaragua Uruguay

Costa Rica Israel Nigeria Vietnam

Cuba Japan Pakistan Zambia

Dominican Republic Jordan Panama Zimbabwe

Who do we care for?

Patients with Medicare – Medicare does not cover dental health unless the patient pays for a separate plan. We provide dental care for the elderly and disabled who cannot afford dental plans.

Patients eligible for HIP – We provide care for HIP eligible patients until they enroll in the program and to those who cannot find a provider in Hamilton County who will accept HIP patients.

Patients with insurance through the Marketplace – We serve those who cannot afford their out-of-pocket insurance costs.

Patients who do not purchase insurance through the Marketplace due to cost.

Patients between jobs and currently without insurance.

Patients who are not U.S. citizens, such as refugees – Many of our patients are refugees and immigrants who do not qualify for any government assistance, and who are not yet established enough to afford medical insurance.

Sample Monthly Schedule

2015 Visits by Clinic

2015 TFC Medical and Dental Visits

DENTAL 2024

PREVENTIVE DENTAL - TOOLS FOR SCHOOL 377

ACUTE 1419

ACUTE/PEDS 117

ASTHMA 62

EYE EXAMS 449

EYEGLASSES FITTINGS 210

PODIATRY 93

HYPERTENSION 141

IMMUNIZATION 217

PEDIATRIC 484

PHYSICAL THERAPY 103

WOMENS 272

TOTAL 5968

Patients by Zip Code

2015 Trinity Free Clinic Patients by Zip Code

RANK ZIP CODES CITY % of TTL

Number of UNIQUE Patients

Number of Patient Visits

Provided Total CostTotal Value

Provided

1 46060 Noblesville 32% 726 1,910 $191,353 $398,864

2 46032 Carmel 25% 568 1,492 $149,494 $311,613

3 46074 Westfield 23% 522 1,373 $137,535 $286,684

4 46037 Fishers 11% 250 656 $65,778 $137,110

5 46069 Sheridan 4% 91 239 $23,919 $49,858

6 46034 Cicero 2% 45 119 $11,960 $24,929

7 46031 Atlanta 1% 23 60 $5,980 $12,465

8 46030 Arcadia 1% 23 60 $5,980 $12,465

9 46202 Indianapolis 1% 23 60 $5,980 $12,465

TOTALS 2270 5968 $597,978 $1,246,450

Patients by Township

2015 Trinity Free Clinic Patients by Township

Township Unique Patients Visits Percentage

Noblesville 704 1,850 31%

Clay 545 1,432 24%

Washington 499 1,313 22%

Fall Creek 182 477 8%

Adams 91 239 4%

Delaware 91 239 4%

Jackson 68 179 3%

White River 0 0 0%

Wayne 23 60 1%

Non-Hamilton 23 60 1%

TOTAL 2270 5,968 100%

Cost by Clinic

Dental Clinic Acute Clinic Women's Hypertension Physical Therapy

36.20% 25.38% 4.86% 2.52% 1.84%

$232,148.72 $140,510.72 $34,933.70 $13,941.23 $10,199.16

Pediatric ClinicImmunization

Eye Clinic Podiatry Clinic Asthma Clinic Senior Citizens

14.63% 11.79% 1.66% 1.11% 14.05%

$80,999.13 $69,874.80 $9,208.95 $6,161.48 $82,082.72

Total TFC

Cost:

$597,977.89

Volunteer Program

We currently have 515 active volunteers, including doctors, nurses, nurse practitioners, dentists, pharmacists, and many others without a medical background.

Emergency Fund

Amanda, a 10 year of girl, came to our clinic with a broken arm. Her parents could not afford the $400 cash up front fee required by the Orthopedic Surgeon. As a result, Amanda’s arm healed crooked. Not knowing what else to do, Amanda’s mother brought her to our clinic. This situation made it clear to us that we need an Emergency Fund. We found an Orthopedic Surgeon who agreed to repair Amanda’s arm at a lower cost and we paid for his upfront fee.

Our patients are uninsured or underinsured and low income. For our patients, medical emergencies are truly tragedies. By having an Emergency Fund, we can be prepared to help our brothers and sisters in need.

Linda and Steve

Schneider

Sponsored by

Hope Abounds Project

Need for Mental Health Resources:

-Identified in every need assessment in the county as one of the top needs

-Studies show that roughly 1 in 5 adults suffer from at least mild depression

-Many of our own patients suffer from depression

Hope Abounds ONLY for Mild and Moderate depression

Phase I - Pilot

Patient screening to identify magnitude of the problem

Formalized behavioral training with educational package

Weekly patient touches to encourage and measure improvement

Phase II

Form Peer to Peer support groups

Create a Safety Net of therapists

Assign therapists for those patients not improving

Phase III

Hire a manager for the Hope Abounds program

Sources of Funding

Our 2014 Key Supporters

Hamilton City BOH

Richard Fairbanks Foundation

Ruth Lilly Grant

Clay Township Trustee

Estridge Family Foundation

Clinic Details

Acute Medical Clinic

1,419 visits in 2015

Services provided: • Treatment of various illnesses• Physicals• Labs• Medications

Needs:- Volunteer Doctors, Nurse Practitioners, and Nurses- Interpreters (Spanish, Arabic, Russian, Chinese, and others)- Clinical Assistants, Medical Managers, Clerks - Pharmacists and Pharmacy Techs- Social Services

Eye Clinic

449 Eye Exams in 2015

210 pairs of glasses provided

Services Provided:

• Referrals for cataracts, glaucoma,

and other eye conditions

• Eye exams

• Glasses

Needs:- Opticians, Optometrists, Ophthalmologists- Eye Clinic Managers (We’ll train you!)

Pediatric Clinic

Needs:- Volunteer Pediatricians, Pediatric Nurses

601 visits in 2015

Services provided:

• Physicals

• Treatments for minor

illnesses

Pediatric Immunization Clinic

● We are a Vaccine For Children Clinic. Vaccines are provided for children from birth through age 18 from the state at no cost.

● All vaccines for entry to school are provided.

● We provided 719 vaccines to 217 children in 2015.

Needs:- Immunization nurses

Women’s Health

272 Patient visits in 2015

152 Paps completed96 Mammograms

50 Pregnancy TestsServices include:● Clinical breast exams● Referrals for mammograms● Pap smears● Pregnancy testing● General infection care● Ultrasounds

Needs:- OB/GYN Doctors and Nurse Practitioners- Nurses- Women’s Clinic Managers

Physical Therapy

103 patient visits in 2015

Services Provided:

Physical Therapy to help our

patients regain health in order

to return to their employment.

Needs:- Physical Therapists

Podiatry Clinic

93 patient visits in 2015

Services provided:

● Treatment of foot fungus

● Ingrown toenails

● Diabetic foot care

● Orthotics.

Needs:- Podiatrists - Podiatry Clinic Managers

Asthma Clinic

62 patient visits in 2015

Services Provided:

● Pulmonary function testing

● Diagnosis and treatment of asthma

● Enrollment of patients in drug

company patient assistance programs.

Needs:- Asthma Specialists- Respiratory Therapists- Asthma Clinic Managers

Hypertension Clinic

141 patient visits in 2015

Services Provided:

● Treatment by a cardiologist until patients are scheduled with a permanent provider.

● Prescription medicines required to control blood

pressure.

Needs:- Asthma Specialists- Respiratory Therapists- Asthma Clinic Managers

Dental Clinic

2,024 Dental visits and 4,486Procedures in 2015

Services Provided:● Extractions● Fillings● Dental hygiene ● Oral surgery ● Limited root canals● Fluoride varnish for children

Needs:- Volunteer Dentists, Dental Assistants, Dental Hygienists - Donations for dental supplies

Sponsored by:

Tools for School

Our clinic, in collaboration with the Merciful Help Center, participated in the 2015 Tools for Schools campaign. 377 children received fluoride varnish treatments to prevent

cavities and even to restore health to teeth with early decay.

Pharmacy Facts

3,042 prescriptions filled in 2015

265 Flu Shots givenServices Provided:

• Prescription and over the counter medicines (no narcotics).

• Our annual cost for medicine is nearly $25,000.

• Butler University School of Pharmacy interns serve our patients along with volunteer pharmacists and technicians.

Needs:• Donations for medicines and lab costs• Pharmacists• Pharmacy techs – We’ll train you!

Lab Facts

• Our most common labs include: Pap Smears, Complete Metabolic Panel, Basic Metabolic Panel, Thyroid Panel, Lipid Panel, Hepatic Function Panel, CBC with Differential, Hmg A1c, Urinalysis with Micro,Urine Culture.

Sponsored by

Linda and Steve

Schneider

715 labs drawn in 2015

Social Services

The Social Service program provides patients a connection to other community programs such as food pantries, legal services, financial help, holiday assistance and the County Trustees.

A Victim’s Advocate is present during Women’s Clinics to assist patients who live in unsafe home environments.

Needs:- Licensed Social Service workers

- Social Service volunteers, we will train you!

Car Seat Program

In partnership with the Carmel Police Department, and by grants from St. Vincent Health and Franciscan Alliance, car seats are provided the first Saturday of every month. 151 Car Seats were installed in 2015.

Reach Out and Read Program

• Each child that enters our clinic receives a free new book.

• Adults can choose from a variety of books in the waiting area to take home with them.

• During our Saturday Acute Care Clinics, a Volunteer Reader reads to the children while they wait to be seen.

Needs:- Volunteer Readers- Book donations

2015 Patients by Age

2015 Trinity Free Clinic Patients by Age

Under 18 (Includes Tools for Schools) 753 19.85%

Over 18 1517 80.15%

Age 62 and Under 2040 89.87%

Age 62 and Over 230 10.13%

Aged 55+ 319 14.05%

Aged under 55 1951 85.95%

Total UNIQUE Patients 2270

2015 Patients by Gender

2015 Trinity Free Clinic Patients by Gender

Male 938 41.30%

Female 1332 58.70%

Total UNIQUE Patients 2270

Overall Patient Evaluation Responses

• Appointment: 4.1/5 average score• Staff: 4.9/5 average score• Communications: 4.8/5 average score• Provider Visit: 4.7/5 average score• Facility: 4.4/5 average score• Overall Satisfaction: 4.7/5 average score

Patient Survey

Thank you!

The Trinity Free Clinic

Address: 1045 West 146th St.,

Suite B, Carmel, IN 46032

Phone: (317) 669-6920

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