Report to the July 1, 2018 to June 30, 2019 2019 OUR MISSION Arlington Free Clinic provides free, high-quality healthcare to low-income, uninsured Arlington County adults through the generosity of donors and volunteers. Our Patients Our Services Our patients are people you see every day in COMPREHENSIVE EDUCATION & OUTREACH our community—cashiers, dishwashers, security HEALTHCARE guards, and childcare providers. Although most of Nutrition Primary, Preventive, our patients work, their jobs do not include access Osteoporosis to health insurance. and Specialty Care for Adults Diabetes All live in Arlington County and have incomes at Gynecology or below 200% of the Federal Poverty Level (for Breast Health a family of four, this is $50,200). Most are parents Care For Chronic Physical Activity with children who live at home. There are two Diseases Including ways to become a member of AFC and access our Diabetes, Hypertension, comprehensive healthcare services: Cancer, and Obesity MENTAL & BEHAVIORAL HEALTH 1. Each month, we accept approximately Optometry 25 new patients through a lottery process. Psychiatric Assessment & Pharmacy Medication Management 2. Eligible individuals referred by Virginia Cancer Screenings Individual Therapy Hospital Center, Arlington County Department of Human Services, and other safety-net Diagnostic & Laboratory Support Groups organizations are directly accepted. These Services Social Services include our sickest patients, such as those Physical Therapy with cancer, uncontrolled diabetes, and renal Case Management failure. Dental Services Many patients have one or more chronic diseases, such as diabetes or heart disease, and need access to a range of services including medical treatment, medications, and ongoing care management. About 250 AFC patients have been transitioned out of our care and onto their own health insurance plans since the Affordable Care Act’s (ACA) Health Insurance Marketplace was launched in 2014. The Marketplace, coupled with Medicaid Expansion in Virginia—allow AFC to take in more new patients who continue to lack access to care. Arlington Free Clinic 2921 11th Street South Arlington, VA 22204 703-979-1425 arlingtonfreeclinic.org PATIENT STORY Susana Dr. Thomas Rakowski, a nephrologist who Susana: From 12 Medications practices at VHC, cared for Susana while she was in the hospital. A longtime Arlington Free Clinic to Healthy & Strong volunteer, Dr. Rakowski continued seeing her when she was discharged into our care. In 2005, Susana was 24 years old and busy Susana has had medical ups and downs over the balancing life as a single mom with a retail job and years. When she was first diagnosed, she was a professional softball career—she played catcher prescribed 12 different types of medication and and pitcher for a regional team in El Salvador. Life was too weak to work. Her friend helped her buy was moving along well enough, but she constantly food and pay rent. Two years later, she developed worried about her daughter’s future. That’s when a pulmonary embolism, a life-threatening her best friend—who moved with her family to complication of lupus. the US when she and Susana were 12 years old— offered to sponsor Susana’s immigration. Today, Susana is only on one medication! She comes to AFC every month so we can monitor Susana and her daughter were settling in as and manage her pulmonary embolism, and the first snow of the season fell on Arlington. sees Dr. Rakowski annually so he can keep an She quickly found work caring for children and eye on her lupus. Susana is feeling strong and cleaning homes, but then out of nowhere, just healthy—so much so that in addition to her fulltime three months after arriving, Susana became construction job, she picked up part-time work very sick. She ended up in the Emergency washing dishes at a restaurant in Arlington to help Department at Virginia Hospital Center (VHC) her daughter pay for classes at Northern Virginia where she learned she had lupus and associated Community College. kidney failure. 2019 Report to the Community 1 MEDICAL DIRECTOR REPORT Joan Bowes Ritter, MD While the focus of MtH is on behavior change, Moving with Patients Toward not weight loss, we did find that patients who participated were three times more likely to lose Better Health weight than those who enrolled but weren’t able to participate. MANY ARLINGTON FREE CLINIC PATIENTS struggle MtH also ties in well with a new Fatty Liver Disease with obesity, heart disease, diabetes, and (FLD) care management program at AFC. FLD is a high blood pressure—chronic conditions often chronic condition caused by too much fat stored connected to lifestyle. For the past several years, in the liver cells and is increasingly common AFC has been working to develop an exercise and among our patients as well as the broader US nutrition program that’s suitable for our patients population. If left untreated, FLD can be quite and sensitive to their unique barriers to health. serious, occasionally leading to cirrhosis and liver failure (an effect similar to that caused by heavy It’s challenging to change habits even when alcohol consumption). Improved liver tests, lower you have sufficient resources, but our patients triglycerides, better sleep, and increased stamina must overcome a number of hurdles to institute are some of the benefits that our MtH participants lifestyle changes. They often struggle to buy have experienced. It’s easy to see how these groceries, let alone healthy ones, and work individual changes will positively impact the wider multiple, physically demanding jobs that leave community when our patients provide healthier them with little energy or motivation to exercise. meals for their families and encourage friends Last year, we partnered with about 70 patients and family to join in on exercise classes. through our Move to Health (MtH) program to help them incorporate healthy habits into Our conference room is consistently packed on their lives. Conscious of the barriers they face, Move to Health nights with people who show up the program includes tailored guidance on to improve their health despite the significant nutrition, exercise, stress management, and personal, work, and transportation barriers—it’s sleep as foundational elements of healthier incredibly inspiring. living. We’re even exploring ways to use technology so that patients can continue the Joan Bowes Ritter, MD program at home. Medical Director 2 Arlington Free Clinic Board of Directors Executive Committee Meredith E. Anderson Principal, Firekeeper Coaching Adam R. Hess, JD Chair Edgar Aranda-Yanoc, LLM Partner, Venable, LLP Executive Director, VACOLAO; Senior Lead Organizer, Legal Aid Justice Center Carly Kelly, JD Board of Directors Vice-Chair Katy Banks Associate Senior Counsel, Cigna- Clinic Volunteer; 2017 & 18 Gala Chair Healthspring Kathleen Buto Community Council John Rhee, MD, FACS Principal, Kathleen Buto Consultants, LLC Secretary David Duhamel, MD Cardiovascular & Thoracic Surgeon, VHC Joseph A. Backer, MD Timothy J. Naughton Partner, PMA Health; Director, Lung AFC Founder & Past Board Chair; President & CEO; AvalonBay Communities John Couric, CPA Cancer Center & Pulmonary Special Physician Volunteer; Radiologist, Mary Ann Nirschl Treasurer Procedures Unit, VHC Northern Virginia Radiology Consultants, CFO, Promontory Interfinancial AFC Board of Directors 1996-08; AFC Grant M. Ehat PLLC (retired) Board Chair 2000-01 Network, LLC Partner, Willard Retail Partners John F. Benton Dianne Morse Houghton Patricia Rodriguez, MD Danine Fresch Gray, DDS Deputy Undersecretary for Finance & Oncologist, Virginia Cancer Specialists Chair, Governance Committee Dentist/Owner, Clarendon Dental Arts Administration, Smithsonian (retired); Director, Library of Congress Past Board Chair Matthew D. Shank, PhD Ginger Loper President Emeritus, Marymount Jennifer Sosin Lobbyist, Loper Consulting David W. Briggs University Chair, Outreach Committee Attorney, Holland & Knight LLP (retired) Advisor, Weber Shandwick Joseph Lynch, JD Allison Shay Partner, Epstein, Becker & Green, P.C. Lawrence Cheng 20th Anniversary Gala Chair Diane H. Naughton Lawrence Cheng Photography, LLC Chair, Development David Ogilvie Matthew Shay Assistant Director, Case Management, Committee James B. Cole President & CEO, National Retail Past Acting Executive Director; 2014 VHC President & CEO, Virginia Hospital Center Federation; 20th Anniversary Gala Chair Special Gifts Chair; Clinic Volunteer Douglas H. Root N. Thomas Connally, MD Thomas Shooltz Managing Partner, Blackfin Real Estate Internist (retired) & Physician Volunteer; Partner, Ironwood Realty Partners, LLC Investors AFC Medical Director 2005-10 Mark Silverwood Keegan Stroup, CPA Stephen Fedorchak Silverwood Investments, LLC Office Managing Director, Washington Restaurateur; Liberty Tavern, Northside DC, Andersen Tax Social, Lyon Hall Andres Tobar Executive Director, Shirlington Loren Friedman, MD Employment & Education Center Joan Bowes Ritter, MD Palliative Care Specialist, Virginia Cancer Medical Director Specialists Chuck & Kristian Todd Meet Internist, Walter Reed National Military Community Volunteers; Moderator, Raymond Hoare, MD the Press Medical Center Cardiologist (retired); Physician Volunteer David Townshend Christine M. Shiker, JD Julissa Marenco Otero Counsel to the Board Senior Vice President, Global Sales, Assistant Secretary, Smithsonian Marriot International (retired) Holland & Knight Institution Kathy Townshend Nancy White Rev. Andrew T.P. Merrow President 20th Anniversary