Spotlight on Charlotte

I moved to Charlotte in 2007. The job market boomed. People moved there from around the country, energizing the city. The influx of new residents meant that local builders kept busy.

Fast-forward to 2009, and the city told a different story. The recession hit Charlotte hard, and the nation's second-largest banking city suffered massive layoffs. Home owners replaced "For Sale" signs with foreclosure notices. My husband got laid off from his job at a local residential builder. Within a year, the builder closed down altogether. When the builders shut down, so did framers, roofers, and landscapers. We found ourselves in a new normal, among droves of men and women - unemployed and uninsured.

The recession diversified the face of the uninsured in Charlotte. From 2007 to 2009 the percentage of uninsured people in North Carolina grew more than in any other state. The unemployment rate in Charlotte has hovered about a point higher than the nation's average since 2009. But charity healthcare groups in Charlotte have worked together to meet the increased demand for quality healthcare to the uninsured and underinsured, with each clinic striving to keep those in need from falling through the cracks.

I began my visit to these clinics with Shelter Health Services, located on the outskirts of downtown. The small facility houses two exam rooms and two consultation rooms to service homeless women and children staying at the Salvation Army Center of Hope women's shelter. Executive director Michael Sowyak says that in the past few years he has seen lawyers and accountants come through their doors, professionals transitioning to the receiving end of charity.

When women arrive at Shelter Health Services for medical care, they look worn. A young woman walks into the exam room, her waist bulging with child, and nurse Michelle Carr asks about her history: not just her medical history, her personal history. With a southern drawl, the woman shares that her children are all in the care of different people. This will be her fourth child.

"The most important thing is for the nurse to be a present, nonjudgmental presence in their life," Carr told me earlier. "We are not homeless, so we listen to what is important to them." With confident tones, Carr asks questions and jumps on teachable moments, but in the end she knows the client is responsible for her choices.

In North Charlotte, Bethesda Health Center is nestled into a warehouse building. Double glass doors open into a small waiting room where women are chatting in hushed Spanish across the room. Copies of the newspaper Que Pasa Mi Gente lie on empty seats. Camino del Rey Baptist Church formed the clinic, which relies on a strong partnership network. Even with its pool of volunteers, executive director Wendy Mateo-Pascual often finds herself stepping in to fill gaps. On the day I visit, she is behind the reception window.

"There are hard days, long days," she says. "But our mission is to show God's love to the people here through the services we provide." The clinic focuses on long-term wellness through basic health services, exercise classes, and the help of a local food pantry.

Charlotte Community Health Clinic (CCHC), closer to South Charlotte, upends stereotypes about charity healthcare with its spacious waiting room and colorful décor. It is a one-stop medical facility, offering the volunteer services of many medical specialists. It leases its building from Presbyterian Healthcare for $1 a year and receives funding from Novant Healthcare, the Duke Endowment, and the United Way, among others.

Similar to most charity clinics, CCHC accepts county residents who live at or below 200 percent of the federal poverty level and are uninsured, although it sometimes accepts people a little above the official numbers. It recently added a children's clinic in response to rising health needs: The most common are obesity, depression, and anxiety issues, especially among children who are undocumented, uprooted from their homes, and worried as they watch their families struggle to survive.

Professionally dressed volunteers in the administrative area offer warm smiles. Among them is Mary Guevara, a six-year volunteer interpreter now in school to become a physician assistant. Although CCHC is not a faith-based organization, many staffers spoke of God leading them into charity healthcare.

In uptown Charlotte, Care Ring offers low-cost healthcare to the uninsured and underinsured who are above 200 percent of the federal poverty level, charging modest set fees. It also oversees Physician's Reach Out, a community program connecting uninsured residents with doctors throughout the county. Doctors volunteer their time and see patients in their own offices.

The federally funded C.W. Williams Community Health Center serves the most diverse clientele-uninsured, Medicaid/Medicare clients, underinsured, insured, homeless, and undocumented immigrants. CEO Beverly A. Irby says, "We see everybody who comes through our doors. If you are undocumented, there is no fear that you can't come here. We make it easy and comfortable." Irby since 2007 has probably seen a 30% increase in applications for the sliding scale program, as people in the working middle class have become new additions to the uninsured. Her center joins others in focusing on prevention, disease management, and education, and in creating a circle of care with local hospitals.