Several months ago, Elizabeth Tapia was struggling to climb out of a pit of depression, fearing she would sink so low that suicide would leave her children without a mother.
While depression has been a problem she's battled for years, Tapia has repeatedly been denied help because she lacks health insurance. Then, she found assistance in the most unlikely of places, in a nondescript clinic housed amid chalkboards, crayons, playgrounds and laughter: her children's own school.
Tapia is one of more than 1,100 people so far this year who have sought help at Intermountain Health Care's Rose Park Elementary Family Health Center, which provides a hodge-podge of care to anyone who walks in the door, regardless of ability to pay.
The clinic is one of three school-based clinics in Salt Lake City that are funded by the IHC Foundation, providing charity care to uninsured and low-income people. In 2003, more than 15,000 patients were served.
In addition to those clinics, the foundation also financially contributes to nine other clinics across the state that served more than 175,000 patients in 2003.
"I wasn't able to get care anywhere else because you have to be able to pay up-front if you don't have insurance. No one is willing to help you. It's really frustrating."
As an example, while the mother of three did receive care for a sprained ankle in a hospital emergency room, doctors there told here she could not come back for her follow-up visit. She was turned away by another clinic, so she wound up at Rose Park.
"I've been there four or five times," she said.
The clinic, still humble in its appearance, began its modest operations four years ago and was strictly operated by volunteer staff who donated two nights a week to treat neighborhood residents.
It has since grown to include paid IHC employees who staff the clinic four times a week, including after hours until 8 p.m. on Tuesdays and Thursdays.
Additionally, "specialty" clinics are held once a month, offering breast cancer screenings and health care related to cardiology, dermatology, audiology and mental health.
Terry Foust, director of IHC's Community and School Clinics, said patronage at the clinic started out slow as members of the community — especially illegals — feared seeking medical help would land them in other trouble.
"I think we have had to earn the respect of the community over time," he said. "It hasn't come overnight."
Gradually, word of mouth has taught residents the clinic is there to deliver medical help and that it has no agenda beyond that.
"How scary is it?" questioned Wendy Whitney, a family nurse practitioner who splits her time between the clinic and the Veterans Administration Hospital. "They are afraid, but they still need health care."
Whitney recently treated a 37-year-old man who came in on a walker because of a leg amputation suffered in an earlier accident. Another clinic had treated him and referred him to a specialist for orthopedic surgery.
"He's not going to go there; it's too expensive," Whitney said.
He sought help at the clinic because of an infection in his stitches that was so painful it was keeping him up at night.
"He can't work, but he has a family to take care of, and he can't help them," she said.
In addition to taking care of his immediate problem, Whitney and others at the clinic tapped into a network and found the man a prosthetic limb to help get back to a productive life.
Aside from drawing residents into the facility for a wide assortment of problems, the clinic attracts medical professionals yearning for diversity. Wendy Nichols decided to put her Spanish-speaking skills to use by transferring from the pediatrics unit at McKay-Dee Hospital in Ogden to the clinic. Although she splits her time between the clinic and Cottonwood Hospital, Nichols said being able to treat patients on a repeat basis for a variety of problems is rewarding.
"You see the whole spectrum of things and you see patients on more of a follow-up basis," she said. "They remember me and I remember them."
One clinic's finances
Payment distribution at IHC Rose Park Elementary clinic
Charity care: 57 percent
CHIP: 0 percent
Medicare: 0 percent
Medicaid: 6 percent
Private insurance: 13 percent
Sliding fee: 24 percent