Since 1968, the Minneapolis-based Neighborhood Involvement Program (NIP) has provided a range of free or low-cost health care and other support services to thousands of uninsured clients in the Twin Cities.
This summer, stymied by the prospect of a prohibitively expensive transition to electronic medical records and insurance coding required to accept reimbursement under new federal regulations, NIP’s board of directors made the difficult decision to shut down the program’s medical clinic. The clinic, which was largely staffed by volunteers, had never accepted insurance coverage. Clients were treated for free, or billed on a sliding-fee scale.
Implementation of the Affordable Care Act meant that a large number of NIP’s clients now have access to health insurance. Staff felt that this was a good time to make the transition from free care at NIP to insurance-based treatment at mainstream clinics.
The closure of the medical clinic — a centerpiece of NIP’s menu of service offerings — brought out a mix of emotions for employees, volunteers and board members, said NIP CEO Patsy Bartley.
“In one respect we claim victory that our services aren’t needed as much as they were,” she said, “but we also mourn that we won’t be able to be here to take care of people who still need our help.”
Key programs survive
In the wake of the medical clinic’s shutdown, NIP is working to keep other key services open, including dental, senior and youth services — and the mental health clinic.
Bartley explained that NIP’s mental health clinic was able to weather the ACA storm better than the medical program because it began accepting private insurance several years ago. “The reason we made the decision to accept insurance was so our clients could stay with their therapists here even if they got private health insurance,” she said. “With mental health, patients develop these long-term relationships with their therapists, and they are important. It is a different kind of relationship than you usually develop with a physician. You don’t want people having them to switch in the middle of their therapy.”
NIP therapists see 800-900 patients each year, Bartley said. The program also runs a rape-crisis phone line that takes more than 2,000 calls a year. Two staff legal advocates help some 300 sexual-abuse survivors navigate the court system.
Bartley said that even with the medical clinic closed, NIP — which was founded in the mid-1960s by a coalition of six Uptown-area congregations to address growing social problems — continues to struggle financially. The board of directors is investigating ways to keep the program operating.
“All I can tell you is we’re trying,” she said. “We want to see these services continue to be provided to the community, to our clients. We are currently talking to potential partners in the health-care community — providers with compatible and complementary values — to see what kind of relationships we can build.”
May sell headquarters building
Another option involves moving out of the brick building at 2431 Hennepin Ave. where NIP has been headquartered since 1986. “We own our building,” Bartley said. “We are looking at whether or not we should sell it as a way to raise funds. No stone will be left unturned. It is a financially challenging time.” The building is now listed for sale.
Supporters of NIP hope that the program, which has weathered state shutdowns and recessions, will be able to find a place for itself in a new health-care landscape.
“These changes are stressful for everybody affiliated,” Bartley said. “Nobody here is unaffected. We are all passionate. We care about what we do. That’s why we’re here. It has been tough for staff, volunteers, clients, funders, partners, vendors and our board of directors. None of these are easy challenges. It’s grief and loss for everybody.”