"I knew my teeth needed to be fixed but I had no money," says Michelle Daulton, 18, who has been living at the shelter for about four months and hadn't seen a dentist since she was 13. Now she's had three chipped teeth repaired. "It was absolute and pure relief, I mean that," she said.
From the Colorado homeless shelter to rural Pennsylvania clinics that can accept new patients, health centers that serve the poor are among the first places the federal stimulus package is being spent.
The stimulus law sets aside $2.5 billion for free and low-cost health clinics, and a big chunk of it - about $500 million - is already being spent. The White House has promised another burst of money this summer.
"This has really been a boost for us," said Bob DeFelice, CEO of First Choice Community Health Care. "It's allowed a level of stability in some very difficult times." DeFelice's group runs nine community health clinics around Albuquerque, N.M., and used a $703,000 grant to hire two physicians and four support staffers.
Health clinic executives say the money will allow them to keep their doors open as the rolls of uninsured patients grow. An estimated 64 million people use rural health clinics, a number that is expected to rise as people lose their jobs and health insurance.
"We're seeing more and more people," said Edward Michael, president of the Rural Health Corp. in Wilkes-Barre, Pa. The six-clinic group in northeastern Pennsylvania had no room for new patients until it received a $311,000 grant in April. Now, Michael says, his clinics can expand from seeing 18,000 patients last year to 19,000 this year.
"You know, we weren't there back in the Depression, so we never experienced being back in the '30s standing in line for food, standing in line for a doctor," Michael said. "This money is really going to prevent a lot of long-term hardship."
The health clinic grants are one-time boosts, not long term health care fixes. The stimulus won't make up for a lack of doctors in poor and rural areas, a shortage the Association of American Medical Colleges says is growing and could reach 159,000 doctors by 2025.
"I look at the stimulus bill as one step to health care reform," said Maggie Elehwany, vice president for government affairs and policy at the Washington-based National Rural Health Association. "It isn't everything."
While Congress considers a health care overhaul, clinic workers hope just to keep up with basic needs such as vaccinations and exams.
"I can't imagine not having the stimulus money right now because we wouldn't be able to do any of this," said Nicole Noll, who drives the mobile health clinic to the teen homeless shelter and rural elementary schools.
The van was provided by Ronald McDonald House Charities. But stimulus money pays for Noll, the doctors and the dentists.
Far more than a brighter smile can be at stake in dentistry. In Maryland, a 12-year-old boy whose Medicaid coverage had lapsed, Deamonte Driver, died in 2007 after bacteria from the abscess of an aching tooth spread to his brain. An $80 tooth extraction might have saved his life.
"I'm so glad they did this," Michelle Daulton said. "My parents were cheap. They never took me to the dentist. And when you don't have any money, your teeth, you just leave 'em alone. Not anymore."
