Tompkins Weekly 05/13/2013

By Abbe Lyons

Have you made decisions on whether to get married or stay married based on access to health insurance? Have you applied for, stayed in or left a job or career path because of how it would affect your health insurance? Have you ever come close to losing a job with health insurance benefits? Even if the answer is no, have you ever known anyone else in any of these situations? If you needed urgent care for an injury or accident that wasn’t covered by health insurance, could you afford to pay for it? Was our system of health insurance ever sustainable?  It’s questions like these that led to the founding of the Ithaca Health Alliance and its signature program, the Ithaca Health Fund.

Begun in 1998, using a unique cooperative funding model, the Health Fund provided financial assistance for specific categories of health care to any member who met income guidelines. Many community members, healthcare providers, businesses and organizations understood that healthcare disparities affect the physical, mental and financial health of our community. They provided discounts and donated memberships so that health care in Tompkins County began to be a little more accessible for everyone, especially those who could not afford the $100 annual membership. Becoming a tax-exempt organization seemed like a natural step, but government requirements led to growing pains that required some restructuring. Now the Alliance is re-launching the Ithaca Health Fund with a newly adapted model continuing our mission to facilitate access to health care for all, with a focus on the needs of the uninsured.

The Health Fund, which began assisting with the costs of broken bones and ambulance rides, grew to offer 22 grant categories, discounts on preventive care and holistic care, and a free loan program. Yet there were still so many needs that could not be met solely through the Health Fund, and the membership made clear in community meetings the importance of becoming more than just one program, voting to incorporate as the Ithaca Health Alliance. In 2000, free educational programming began, and in 2006, the Ithaca Free Clinic opened to offer direct services to people without health insurance. Research prior to opening the Clinic indicated that IFC could expect to begin with 250 visits per year and grow over five years to 500 visits per year. However in the very first year, there were 861 visits, and in 2012, almost 2900! The board began the process of applying to become a 501(c)3 tax-exempt charitable organization, not knowing that this would lead to a tough choice between the existing membership model and the long-term sustainability of the Alliance in general and the Free Clinic in particular, as the IRS set this as a condition for approval of our application. As with all important decisions, this one was put to the membership for a vote. In 2011, the membership voted overwhelmingly to disband in order to receive 501(c)3 status, exempting the organization from paying taxes and allowing us to apply for foundation grants and give donors a tax deduction.

What makes the new Health Fund different, and what is the same? Like the old Health Fund, grants are available area residents who meet income guidelines (low-to-moderate income). Generally, a person whose income level would have qualified them for grants under the old Health Fund should still qualify for grants under the new Health Fund. Unlike the old Health Fund, the new Health Fund does not require membership in order to be eligible for Health Fund grants. Like the old Health Fund, there are specific categories of care, and the funding for these grants comes largely from community members. We’ve had to start smaller with the re-launch, offering six grant categories for medical and dental emergencies: broken bones, emergency stitches, dental extractions, root canals, Chinese herbal medicine and post-exposure rabies inoculations. We have a new application form and trained volunteers who can help with other financial advocacy for people without insurance.

The foundational values of community input, integrated health care with both conventional and holistic providers, community-based funding and volunteer efforts continue to guide the Health Alliance today. One of the my favorite aspects of the Ithaca Health Alliance is the way Allies are not limited to only one role. Many of our staff and board members first became connected as Alliance members, Clinic patients, volunteers or donors. The Health Alliance is all of us, together, working towards sustainable health for all in our community, giving, receiving and taking care of ourselves and one another. Learn more about the many ways you can be an Ally at www.ithacahealth.org.

As a longtime Alliance member, Abbe Lyons voted to elect board members, open the Free Clinic and finally, to disband the membership. She now serves as Executive Director of the Ithaca Health Alliance.