LAFC In The News

Notable Heroes in Health Care: Crystal Cepican

Dec 14, 2021

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Last updated on December 17th, 2021 at 12:22 pm

Crystal Cepican, a bilingual RN case manager at the Lake Area Free Clinic, is known to patients for her compassion and to the medical community for being an advocate of her patients, colleague say.

LAFC serves low-income residents of Waukesha County. During the COVID-19 pandemic, when patients weren’t being seen in person, Cepican used virtual visits to make sure no one slipped through the cracks.

“She worked long hours on patient files that were literally stacked over her head. She made sure patients’ needs were met, even delivering medication to their homes,” said Megan Welsh, clinic marketing and development director.

Just one example, Welsh said, is a man who came to the clinic needing surgery. Cepican took him to the ER and helped him apply for financial hardship for the visit. She also connected him to the Hispanic Health Resource Center for assistance to pay for surgery. After the surgery, LAFC provided his medication and care, and Cepican helped him obtain insurance to transition out and have greater access to the specialist care he needed.

“He’s now working and providing for his family,” Welsh said. “He’s positioned to be able to receive a transplant if needed.”

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Natalie's Everyday Heroes: Dr. Geiss with The Lake Area Free Clinic

Click to view Natalie's Everyday Heroes:  Dr. Geiss with the Lake Area Free Clinic

By: Natalie Shepherd

58 WDJT - Milwaukee
August 28, 2019

MILWAUKEE (CBS 58) -- Access to health care is a top concern for many people. And for those who don’t have insurance, it can be expensive and difficult to get the care they need. The Lake Area Free Clinic in Oconomowoc is helping to fill that gap. Dr. Peter Geiss, the clinic’s Medical Director, is leading the way.

Dr. Geiss is retired, but it can be hard to tell. He spends several evenings a week seeing patients by appointment and fitting in those who just walk in.

“I mean, you're energized. You continue to be intellectually stimulated, and at the end of the day, you can do some good. I just don't know anything better than that,” Dr. Geiss said.

The Lake Area Free Clinic mainly serves Waukesha County’s working poor, and they do it all for free. That means mean patients don’t have to pay for doctor visits, diagnostic tests, or medication. The clinic mainly serves Waukesha County’s working poor.

“These are people who are working hard,” he said. “They have great families, but they just fall through the cracks.”

Dr. Geiss said 70% of the clinic’s patients work, but don’t have insurance provided by their employer. Patients must also fall below 250% of the federal poverty rate. Geiss said that works out to be about $30,000 for a single person and $48,000 for a family.

“In Waukesha County, we estimate there are at least 18,000 people who fit into the category of low income, no insurance and needing health care,” explained Dr. Geiss.

And at the clinic, they’ve seen it all. Many patients have avoided going to the doctor because they don’t want bills they can’t afford to pay. So some patients come in with serious conditions that have gone untreated, including cancer, diabetes and heart issues.

“Unfortunately because of lack of access, a lot of the people we see are quite ill when they get here,” Geiss said.

The clinic is staffed by volunteers. More than 320 doctors and nurses provide care to thousands of people each year. The clinic recently opened a dental clinic, too.

“It truly is the community's clinic,” said Mary Reich, the clinic’s executive director.

She’s been with the clinic since it opened in 2001, first as a volunteer, and later as an administrator.

“I get to work where I would choose to volunteer,” she said.

When she started in 2001, the clinic served just 100 patients. This year, they will have more than 3,500 visits. Dr. Geiss and the staff make sure they get the care they need. Reich calls Geiss a mentor.

“He always does the right thing. He will advocate fiercely for the patients and the clinic,” Reich said.

Reich and Geiss said the clinic is a community effort. They partner with businesses and organizations in Waukesha County to keep it running.

“Let's face it, I've been lucky, and most of the people who work here have been lucky in their lives,” Geiss said. “To be able to, after you've retired, to work with people who are definitely in need, sometimes I think I get more out of it than they do.”

The Lake Area Free Clinic also fundraises $900,000 to keep the clinic funded.

We’d love to hear from you. If you have someone you’d like to nominate for “Natalie’s Everyday Heroes,” just send a message to Tell us about someone who’s doing good work in your community.

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Oconomowoc Enterprise
July 25, 2019
Oconomowoc Enterprise July 25, 2019
Lake Area Free Clinic saw the need for better access to dental care -- and did something about it. The immediate response to the clinic makes clear the limited access to dental care for many people.
Guy Boulton, Milwaukee Journal Sentinel Published 6:00 a.m. CT July 15, 2019 | Updated 10:53 a.m. CT July 15, 2019
Oconomowoc clinic provides free dental care to thousands of patients.
Dentist Pablo Fernandez uses a headlamp and magnifiers attached to his glasses as he does a dental filling for a patient at the Lake Area Free Clinic in Oconomowoc.
The response when Lake Area Free Clinic opened a dental clinic shows the limited access to dental care for people without dental insurance or covered by BadgerCare Plus or other Medicaid programs. The clinic also shows the work that some nonprofit organizations have done to help lessen the problem.
Lake Area Free Clinic in Oconomowoc was founded in 2001 to provide medical care to people without health insurance. It opened a dental clinic in late 2017 — and almost immediately was seeing more patients seeking dental care than medical care.
“Many of them haven’t had access to dental services in years,” said Mary Reich, executive director of Lake Area Free Clinic. The clinic had 7,686 patient visits last year, and 4,190 of them were for dental care. It expects to have 7,000 patient visits for dental care this year.
Pablo Fernandez (left), a dentist, and Kristina Hoffman, a dental assistant, fill a cavity for a patient at the Lake Area Free Clinic in Oconomowoc. (Photo: Michael Sears / Milwaukee Journal Sentinel)
The response probably wasn’t a surprise. In 2017, more than 700 adults received care for emergent dental conditions, such as severe pain from an infection, at the emergency departments of ProHealth Care’s hospitals in Waukesha and Oconomowoc and at Aurora Health Care’s hospital in Summit.
Lake Area Free Clinic provides dental care only to adults. That’s because Waukesha County Community Dental Clinic, founded in 2008, focuses on providing care to children at its clinics in Waukesha and Menomonee Falls. Its clinic in Menomonee Falls opened last year with a gift from Froedtert Health.
Desperate need for care
Lake Area Free Clinic’s board decided to build the dental clinic after a survey of dentists in Waukesha County who accepted patients covered by BadgerCare Plus and other Medicaid programs found only one who was taking new patients. “We were getting desperate calls from people,” said Megan Welsh, director of marketing and development for the clinic.
Dentists in private practice don’t accept or limit the number of patients who are covered by Medicaid programs because the reimbursement rates don’t cover the cost of providing care. According to the Wisconsin Dental Association, the programs pay:
$34.61 for children and $42.41 for adults for a basic exam and cleaning.
$34.58 for children and $32.57 for adults to fill a cavity.
Those rates are one-third to one-half — or less — of what commercial insurance will pay, with the exception of the reimbursement rate for a basic exam and cleaning for children.
Dental care accounts for about 1% of the state budget for health programs.  Gov. Tony Evers proposed a roughly 20% increase in what the state spends on dental care for children and adults — the first significant increase in spending on dental care in more than 15 years — but the proposal was rejected by the Legislature.
Lake Area Free Clinic stays away from politics. But Reich acknowledged that the clinic would have benefited from the governor’s proposal to increase reimbursement rates 50% for nonprofit clinics if half of their patients were covered by Medicaid programs.
The clinic bills the state or the managed care organizations that contract to manage the care of people covered by BadgerCare Plus. Co-pays and contributions make up the shortfall.
Tina Nissen, a dental hygienist, gives a patient a dental cleaning at the Lake Area Free Clinic in Oconomowoc. (Photo: Michael Sears / Milwaukee Journal Sentinel)
ProHealth Care and Aurora Health Care also support the clinic, accepting referrals for patients who need specialty care and providing lab and imaging services.
Lake Area Free Clinic’s dental clinic accounts for roughly $810,000 of its $1.3 million budget. The clinic employs one dentist full time and two dentists part-time. It also employs one hygienist full time and one part-time. They are supported by five dentists and four hygienists who volunteer their time. Three other volunteers help with administrative tasks. In all, Lake Area Free Clinic has roughly 260 volunteers — physicians, nurse practitioners, physician assistants, nurses, interpreters and others.
Built by volunteers
The new dental clinic — an addition to the medical clinic — was even built by volunteers, some of them in their 70s and many of them who also worked on a new building for the medical clinic in 2009. “The joke was they got the band together,” Welsh said.
The clinic initially provided basic dental care but soon expanded its services to include more complex procedures, such as root canals, partial dentures and crowns. Patients are billed at cost for the additional services — $450 for a partial denture and $550 for a crown — and can make payments. Those services can be life-changing for some people, such as a homeless woman who wanted front teeth for a son’s wedding or a man who was seeking a job but missing his front teeth. “It was the last piece in his turning his life around,” said Reich, the executive director. Uninsured patients are charged a flat fee, ranging from $25 to $35, based on their income for basic dental care. The clinic has a fund for people who don’t have the money for the co-payment and doesn’t turn anyone away, Welsh said.
Lake Area Free Clinic also has established a relationship with Waukesha County Technical College. The clinic typically has three dental hygiene or dental assistant students and an instructor working at the clinic on weekdays during the school year. It also has affiliations with the University of Wisconsin-Milwaukee, Carroll University, Alverno College, Concordia University, Medical College of Wisconsin, Marquette University, Cardinal Stritch University and others schools. Lake Area Free Clinic was booking dental appointments three to four months out before adding a full-time dentist. That’s now down to about six weeks out, with about 250 people waiting to get dental care. “There still remains a significant waiting list,” Reich said. But all of those people — and more than 1,000 people before them — would have had a much harder time getting dental care were it not for the Lake Area Free Clinic.
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