Just weeks after adding a fourth day of medication-assisted treatment, Riverside Free Clinic is warning that expiring grants could force it to cut services within the next year.
Riverside Free Clinic is warning it could be forced to scale back services within the next year unless it secures new funding, medical director Dr. Isolde Ferris said, even as the no-cost clinic’s patient volume continues to climb. Vance said the clinic’s reliance on a patchwork of grants, several of which expire within the next 18 months, has left its budget more precarious than its recent expansion into a fourth day of medication-assisted treatment might suggest.
“We just added a fourth day of treatment because the demand was undeniable,” Vance said. “What people don’t always see is that the same week we announced that expansion, I was also looking at a spreadsheet showing two of our largest grants running out before this time next year.”
Growth without a growing base
The clinic’s overall patient volume has grown by roughly 40 percent over the past three years, driven in part by referrals from Bellwater General’s emergency department and a broader increase in uninsured residents seeking primary care in Lowertown and Cedar Hollow. Vance said the clinic’s annual operating budget has grown to keep pace, from roughly $2.1 million three years ago to $3.4 million today, but that growth has come almost entirely through temporary grants rather than any recurring public appropriation.
“Every dollar we’ve added has an expiration date attached to it,” Vance said. “That’s a sustainable way to fund a pilot program. It is not a sustainable way to fund a clinic that ten thousand people now depend on for their primary care.”
Every dollar we’ve added has an expiration date attached to it. That’s a sustainable way to fund a pilot program. It is not a sustainable way to fund a clinic that ten thousand people now depend on for their primary care.
Dr. Isolde Ferris, Medical Director, Riverside Free Clinic
Two grants expiring within 18 months
Vance said the clinic’s largest single funding source, a state grant supporting general operations, expires in 14 months, while the separate one-year grant funding the clinic’s newly added fourth day of medication-assisted treatment expires even sooner. She said the clinic has applied to renew both but has received no indication either will be approved before the current funding lapses.
“If both of those don’t renew, I’m not talking about trimming around the edges,” Vance said. “I’m talking about cutting clinical hours, and possibly cutting back the fourth treatment day we just spent months building capacity to add.”
A county commissioner responds
Commissioner Deborah Ashworth, chair of the Wentworth County Board of Commissioners, said she has heard Vance’s warning and noted that the board is currently weighing how to allocate the county’s share of opioid litigation settlement funds, a separate pool of money commissioners could direct toward clinics like Riverside. “I don’t think Dr. Vance is exaggerating the stakes,” Ashworth said. “The settlement money gives us an opportunity to put at least some of this on more stable footing, if the board chooses to prioritize it that way.”
Vance said she has submitted a funding request to be considered as part of the settlement allocation process but cautioned that the clinic cannot plan around money that has not yet been approved. “I appreciate that the settlement funds exist,” she said. “I also can’t tell my staff to hold their breath for a county vote that hasn’t happened yet while a grant we’re currently relying on is expiring in real time.”
What a scale-back would mean
Vance said a worst-case reduction in services would likely mean returning to three days of medication-assisted treatment instead of four, along with reduced hours for general primary care appointments, changes she said would disproportionately affect patients who lack reliable transportation to alternative providers outside the neighborhood. “A lot of our patients walk here,” she said. “If we cut hours, we’re not just inconveniencing people. For some of them, we’re removing their only realistic access point to care.”
Donna Wysocki, executive director of Wayfinder Recovery Services, said a reduction at Riverside would ripple into her own organization’s intake process, since the two providers coordinate closely on referrals for patients needing both medical and residential treatment services. “We built a referral relationship with Riverside because it was reliable,” Wysocki said. “If that reliability disappears because of funding, it doesn’t just hurt their patients. It hurts the whole system we’ve built around them.”
Vance said the clinic plans to continue publicizing its funding situation in the coming months, both to press elected officials and to give donors a clear picture of the stakes. “I’d rather sound alarmist now and be wrong than stay quiet and have to explain to two hundred patients next year why their treatment day disappeared,” she said.