BLADENSBURG – On a Wednesday morning in October, a large three-room van rolls into the Bladensburg Elementary School parking lot.
Laura Koo, a nurse practitioner, welcomes her first two patients of the day — Rosa Melara, 38, and Richard Fodouop, 59 — aboard the Governor’s Wellmobile. Neither has health insurance, nor anywhere else to go.
And they’re the lucky ones.
For 15 years, the Governor’s Wellmobile program, run through the University of Maryland, Baltimore’s School of Nursing, has been providing free health care services — such as routine check-ups, blood work and filled prescriptions — to the uninsured. But as the state trims more than $4 billion from its budget over the next few years to balance it during the economic downtown, funding for programs like the Wellmobile are being slashed, said Shaun Adamec, deputy press secretary for Gov. Martin O’Malley.
Thousands of visits will be cut from the Wellmobile’s schedule this year, said Susan Antol, director of the program. “We’ve had to sacrifice patient care in areas of the state where we felt we had clients,” she said.
The budget for the Wellmobile was halved in mid-August, reducing it from $570,500 to $285,250, according to a consolidated budget report by the Maryland Higher Education Commission.
The service used to operate with four truck units and made nearly 4,800 nurse practitioner visits last year — or about 40 to 50 patient visits a day. The visits normally include routine physicals and other non-emergency health services. The service also performed 3,000 screenings at health fairs and community events, including blood work and school physicals.
Now, the Wellmobile can only see about eight to 10 patients a day on its one operating unit, Antol said. She also had to cut eight positions, both full and part time, including nurse practitioners and drivers.
The Wellmobile, which used to travel as far as the Eastern Shore and Western Maryland, has reduced coverage routes and now mainly serves Central Maryland.
“You can’t mess with people’s health care like that,” Antol said.
Meanwhile, the number of Maryland residents without health insurance has climbed from 619,000 in 2001 to 669,000 in 2008, an increase of more than 8 percent, according to healthreform.gov, a site managed by the U.S. Department of Health and Human Services.
The Wellmobile is important, Adamec said, but added that O’Malley’s administration has had to make a number of cuts to balance the budget. “It includes some really difficult decisions that we otherwise would not have made.”
But the cuts’ effect on the free service has been drastic, employees say.
“There were previously four full-time nurse practitioners, or the equivalent of four full-time nurse practitioners,” said Koo, who has been with the Wellmobile five years. “At this point, we’re down to the equivalent of a .6 nurse practitioner.”
The jobs of the few employees left working for the Wellmobile — which include the driver and the office clerk/interpreter, Grace Flores — have become more taxing, Koo said.
Flores takes care of secretarial duties; she also helps patients with their forms, takes blood pressure and temperatures and talks with them while they wait for the nurse to call them in.
“I’m on the Wellmobile every day it goes out,” which is three days a week, Flores said.
She speaks French with Fodouop as she prepares him for his appointment. After he goes in to see the nurse, she then switches to Spanish, to tell Melara she is going to take her temperature.
While they wait, there is a knock on the door and an older woman with a cane comes into the waiting room. She asks Flores about the Wellmobile and tells her she was glad to hear about it, because she has no health care and she needs prescriptions. Flores said she can set up an appointment for her.
“A lot of people who come on the Wellmobile come here after five or six or seven years of not seeing a doctor,” Flores said.
But now, with the cuts, “We’ve had to try to help patients even more aggressively to find their own … primary care provider,” Koo said.
It’s part of her job now, referring the patients her program can no longer see to doctors who will inevitably charge for their services.
Unfortunately, many patients are not able to pay “a huge amount,” Koo said.
Fodouop, originally from Cameroon, was fortunate to get an appointment with the Wellmobile after hearing about it from his niece. He was also fortunate that Flores speaks fluent French, as he still struggles with English after moving to the U.S. in 2003.
Fodouop, a restaurant butler in Washington, does not use the insurance the company offers, he said.
“The health insurance is so expensive I could not afford it,” he said. Fluctuations in his daily earnings make it difficult to keep up with a steady insurance bill.
“I don’t have anywhere to go. They help me,” he said. “I have high blood pressure. I cannot go to see my doctor. I don’t have enough money.”
As they make do with what they have left, Antol said her only option now is to revise the way the Wellmobile functions.
“You can’t do it with less money, you just do something different,” she said. “But if the governor wants to call it the Governor’s Wellmobile, he’s got to come up with some money, shouldn’t he?”
There’s no money to do more, Adamec said.
“We’ve long since passed the point of trimming the fat,” he said.
“There’s no more fat to be trimmed. It’s all flesh, so to speak.”