The 56-year-old farm employee from Marshall works about 40 hours a week but doesn’t get insurance through his job.
James Thornley and about 6,200 fellow Fauquier residents — or 9 percent of county population — go without health insurance coverage, according to the U.S. Census Bureau.
Mr. Thornley wonders what would happen to him without the Fauquier Free Clinic.
He suffered a heart attack a decade ago. When he got a new job at a farm in Northern Fauquier five years later, he lost his insurance and struggled to buy critical prescriptions.
“Everybody can’t afford insurance,” said Mr. Thornley, who raises three grandchildren with his wife. “If it wasn’t for (the free clinic), I don’t know where I would be . . . probably dead.”
For 25 years, the Fauquier Free Clinic has provided free medical, dental and, more recently, mental health services to low-income residents of Fauquier and Rappahannock counties.
Last year the free clinic served more than 2,100 patients.
“Obviously, we’ve touched a nerve, and we are still meeting a need,” clinic Executive Director Rob Marino said.
What started as a small, after-hours clinic at the Fauquier Health Department building in 1993 has turned into a sophisticated organization caring for “the whole patient.”
More than 250 volunteers work alongside clinicians, nurses, dentists and administrators to run the non-profit clinic.
While working as a health department volunteer, family practice physician and emergency room doctor in Fauquier 25 years ago, L. Trice Gravatte IV saw a tremendous need.
“It was sad that people were not getting care because of expense barriers, and I knew the free clinic method could get people healthcare,” Dr. Gravatte said in a recent interview.
So he came up with a solution and started the Fauquier Free Clinic with several other local doctors and dentists.
Setting up at the Fauquier Health Department on Thursday nights, volunteer physicians treated walk-in patients.
Mr. Marino recalls his first night working at the free clinic after he became executive director in 2000.
“We could only see 40 patients, max,” Mr. Marino said. “I had to go out to the people standing in line, and I had to count to 40 . . . . Anyone behind that, we couldn’t see them. It was awful. We wouldn’t open again for a week.”
In 2006, the free clinic moved to a dedicated building that Fauquier Hospital owns on West Shirley Avenue and began to see patients two days a week by appointment.
“We definitely had tight budgets,” Mr. Marino said. “But, I would never say that in my experience we had a year when we didn’t come out OK. The community has come through for us . . . . When we raise the alarm and say we’re in trouble, they always seem to come through.”
After raising $1.5 million, the free clinic in April 2015 moved into a modern office building at 35 Rock Point Lane in Warrenton with updated technology and equipment.
The move allowed the clinic to expand, with the main floor devoted to medical and mental health services, and the second floor housing dentistry.
“It’s fantastic for us,” Mr. Marino said. “Patients walk in and feel like they’re going to get good healthcare, because it looks like the place where they will and, of course, they will.
“It’s good for morale. The key is the dental, mental health care and primary care are here all together, and our doctors can talk to our dentists, counselors and psychiatrists. They can actually be a team.”
Sophia Bumbrey of Midland has relied upon the free clinic’s services on and off for about three years.
“They treat you with respect,” Ms. Bumbrey said of the staff. “They are professional. Everyone is phenomenal.”
Her family cannot afford insurance through her husband’s truck driving job, which would cost about $1,200 a month for a family plan, she said.
“When you’re sick, the last thing you need is to worry about not being able to afford it,” said Ms. Bumbrey, a 51-year-old homemaker.
She has used the dentist, physician and mental health aspects of the clinic.
“I love that they are under one roof. They are healing the whole person, regrouping you and sending you (back) out there,” she said.
Most patients who receive care at the free clinic work part-time jobs and have an average annual household income of $11,771.
Today, about 20 local doctors volunteer once every eight weeks and sometimes more often. Another 40 doctors have agreements with the clinic to see uninsured patients in their own offices, according to Mr. Marino.
In 2017, the free clinic had a budget of $1.4 million, 87 percent of which comes from foundation grants, donations and local gifts.
The Warrenton-based PATH Foundation owns the building, for which the clinic pays $1 in annual rent. The foundation also routinely gives grants to the nonprofit clinic.
“It’s one of the organizations that focuses on our four priority areas: access to health, childhood wellness, seniors and mental health,” PATH President Christy Connolly said.
“What’s especially nice is it provides a model of integrated care,” Ms. Connolly added. “There are very few places you can go to get your primary care, dental care and mental health care under one roof.”
Fauquier Health “provides diagnostic services to our patients, and they don’t charge for that, which is a huge gift,” Mr. Marino said.
“I like to think we are helping the hospital because of what we do,” he said. “I think they see it that way. This is a healthier community because of us, and the patients we see don’t really have any other place to be. If they don’t, they go to the emergency room. That’s an expensive way to get care, and often it tends to happen too late in the process.”
In 2017, Fauquier Health delivered more than $6.69 million in charity care.
The free clinic gets about $6 million worth of prescriptions donated through manufacturers’ “patient assistance programs” each year, according to Mr. Marino. It spent about $144,000 last year for drugs and medications not accessible through that program.
“At the beginning, our biggest expense was paying for prescriptions we couldn’t get any other way,” Mr. Marino said. “That’s still a big chunk of our expenses.”
Getting citizens who need help to the clinic also remains a challenge.
“We tried hard in the last few years to solve transportation problems for people, but it’s a constant nagging issue,” Mr. Marino said. “Transport to healthcare prevents people from getting healthcare.
“We have a lot of patients cancel appointments, and when they call us, they say their ride fell through.”
The clinic hopes to expand its mental health program and get patients the care they need more quickly.
“I want people not to wait for healthcare. That’s how we know if we are doing enough or not,” Mr. Marino said. “If we have to say, ‘You need a filling, but it’s not an emergency; we can give you an appointment in six weeks,’ I really don’t like that.
“This is not a Fauquier problem, it’s a nationwide problem,” he added. “You can’t do anything else if you’re sick. You can’t thrive, you can’t be good at your job, you can’t go to school and get good grades if you’re ill.”
Dr. Gravatte agreed: “The short of it is, without that clinic, people would be missing work, be in pain, and some people would die.
“They truly, through that clinic, are able to get many of the same services that people who are insured do . . . . And, it’s a way to provide dignity to those in the community who don’t have those services.”
A patient at the free clinic for about five years, Mr. Thornley knows its care has made a difference in his life.
He takes six different prescriptions for blood pressure, diabetes and his heart. He visits the clinic every six months for a checkup.
“They make sure my blood pressure and cholesterol and my diabetes is level,” Mr. Thornley said. “They’re all nice . . . . It’s like a big family.
“They’ve kept me from having another heart attack . . . so I’m thankful for them,” he said. “They need more free clinics for people like me. I couldn’t thank them enough. I don’t have the words to thank them.”