In November, when Buffalo insurance broker Patrick Reilly announced the formation of a free medical clinic with Altoona doctor Zane Gates at Indiana Regional Medical Center, there were symptoms of frustration.
"We have been running around for three years telling everyone this model works, but [have gotten] no government support just yet," Reilly said, explaining why the partners decided to take their arguments directly to hospitals like Indiana.
That lack of government support for the Gates-Reilly idea may be ending.
In his 2013 budget proposal Tuesday, Gov. Tom Corbett included $5 million for free clinics - with perhaps half of that amount destined to help hospitals statewide duplicate the Gates-Reilly model.
"It's getting closer," said Gates, who founded his first clinic in Altoona in 1998 in a van he took around to community centers to treat people who earned too much to qualify for Medicaid but not enough to buy insurance.
"Money has loosened up."
According to the "budget in brief" provided by the state, the governor wants to allocate "$4 million to establish the Community-Based Health Care Subsidy program as a new and additional way for the commonwealth to fund community-based health care clinics."
According to the same document, the governor wants to allocate $1 million to increase loan repayment awards for doctors and other practitioners willing to practice in rural Pennsylvania.
"In the world of politics, I usually wait until the ink is dried on the checks to make sure who gets what," Reilly said.
That doesn't say explicitly that any of the money would go to help found Gates-Reilly style clinics.
But the hope is that current Senate Bill 5 - if it becomes law - would govern distribution of those funds, according to Gates, Reilly and State Sen. John Eichelberger.
The bill calls for 50 percent of what was previously to be $1 million to go to hospitals to set up clinics on the Gates-Reilly model, according to Gates and Eichelberger.
It calls for 25 percent to go to "federally qualified" clinics that provide a medical home for Medicaid recipients, especially in rural areas.
And it calls for 25 percent would go to "pure free clinics" set up in facilities like churches, with volunteer practitioners, according to Gates.
That Gates-Reilly model comprises a paid staff and volunteer doctors to care for the working poor, with the partner hospital providing free imaging and tests. Patients who can afford it would be required to buy inexpensive hospital-only insurance.
This setup helps partner hospitals by keeping uninsured patients from seeking costly emergency treatment for routine matters.
Eichelberger, a longtime Gates supporter, thinks the governor is "thinking on those lines."
"All the key players understand that is the model we need to grow," the senator said.
Other clinic models - including clinics open for medical service only one or two days a week - would get some funding because it's "difficult to shut them off entirely," Eichelberger said.
They do good work, but a clinic open only on Tuesdays isn't sufficient to serve any group of patients, because "if you get sick on a Wednesday, that's a problem," Eichelberger said. "Then you end up in the ER and that defeats the purpose."
Eventually those "happenstance" clinics may be able to transition into the more substantial Gates-Reilly model, which provides patients with full-time access to a primary physician and a link with a hospital, Eichelberger said.
"Ours is a full-time medical practice," Reilly said.
Hospital CEOs have shown "a lot of interest" in the Gates-Reilly model, but may be waiting for the kind of government assistance proposed in the governor's budget before committing, Reilly suggested.
It takes as little as $200,000 for a hospital to start one up, so if the state allocates $2 million to the idea, it could spawn 10 new clinics, Reilly said.
"That would take care of a tremendous amount of these [uninsured patients] immediately," he said.
"From my perspective, it's encouraging," he said.
Mirror Staff Writer William Kibler is at 949-7038.