Even without directly operating a clinic itself, the St. Nicholas Family Clinic Foundation is still helping the working uninsured in western Kentucky, its mission for the past 20 years.

Budgetary pressure, as well as heath insurance reform by way of the Affordable Care Act, created a situation where it was no longer feasible for the local charity to operate its longstanding St. Nicholas Family Free Clinic. However, Executive Director Rayla Bridges says that the organization is still working to provide assistance to its target patient group, uninsured adults working 15 hours or more per week who fall within 200 percent of the Federal Poverty Level.

"We still do the same thing as we always have, we just do it a bit differently now," said Bridges. "We simply deliver primary care and medicine to our patients indirectly, rather than directly."

The clinic at 1901 Kentucky Ave., the former location of the St. Nicholas clinic, has been operated by KentuckyCare, a non-government, private professional clinic operator, since September 2013. Through an alliance between the Foundation and KentuckyCare, St. Nicholas patients receive benefits that the charity was unable to provide when it operated the clinic independently.

"Things like expanded hours, increased diagnostic testing, and many other things we would have liked to been able to offer before," Bridges said.

Whereas the St. Nicholas clinic had only been open two nights a week, the new clinic is open Monday through Friday from 8 a.m. to 5 p.m.

Bridges also praised the doctors and nurses at the KentuckyCare clinic as providing the same kind of dedicated, compassionate care that St. Nicholas patients had come to expect.

Along with other members of the St. Nicholas board of directors, Bridges wants to emphasize that while the organization might be less visible than it was, it is still a beneficial member of the community.

"We're still here, and we still need community support," said Bridges. She expressed that the organization was still in need of administrative volunteers and fundraising support.

With lower operations costs and fewer patients as a result of Medicaid expansion, the St. Nicholas' board of directors has been considering multiple avenues to expand its ability to help patients. Programs that the foundation has been exploring include providing assistance to the under-insured, as well as providing dental insurance and assistance in paying for eye care and hearing aids.

While St. Nicholas' board of directors is taking a very active approach in exploring expanding services, board chairman Robert Goff explains that the cloud of uncertainty cast over the health care sector by a volatile political climate creates difficulties in anticipating what needs small organizations like St. Nicholas will be called upon to fulfill.

"There's reluctance to jump into these new programs until we know where the future lies with our core patient group," explained Goff.

Jessica Toren, also a board member at St. Nicholas, said that when it comes to what the future holds for health care reform, providers like St. Nicholas have no greater certainty than any other observer.

"We are all just waiting to see what happens," Toren said.

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