Questions for interview with Dr.

Karl Hakmiller on radio show

1. Tell me a little bit about yourself and your professional background

I am a registered nurse and have been in the medical field for over 25 years
primarily practicing in the hospital setting. I have experience in private practice
and also clinical research. I am a member of the healthcare Emergency Response
Coalition of Southwest Alabama, Baldwin County Medical Reserve Corps and the
Association of Fundraisers Professionals.

Born in Selma and went to nursing school at the University of Central Florida
college of nursing.

2. When and how did you get involved with AFC?

I began as a volunteer nurse for AFC in 2009. I found when I left the clinic I had a
good feeling, like I used my gifts and talents for the reason I was born with them.
I applied for the position of Clinic Coordinator in 2010 and became Executive
Director in 2011.

3. Tell me some history on AFC

First Free Clinic in Alabama
Started in Bay Minette in 1998
We are in our 17th year since
Dr. Bill Goetter was one of our founding physicians and still serves as president of
our organization.
Partnered with the Baldwin County Health Department for Mutual Benefit – they
provided space and we provided free care to the community
Expansion project began in 2007 to offer services throughout the county and
shortly thereafter the Robertsdale clinic opened. Then in 2011 we opened our Gulf
Shores clinic.

Alabama’s Volunteer Service Act protects health care providers from liability - civil
suit unless they commit acts of willful or wanton misconduct.

4. What qualifies a person to receive care from AFC?

Previous Diagnosis of:
Hypertension (high blood pressure), Diabetes, hypercholesterolemia (elevated
cholesterol) or COPD (Chronic Obstructive Pulmonary Disease)
Adults - 18 or older
Baldwin County resident
No private medical insurance, Medicaid, or Medicare Parts A or B
Must provide:
a. Proof of income
b. Medicaid denial letter

5. What was the “scope” or emphasis of care at AFC’s inception?

It has always been focused on the medical management of hypertension,
hypercholesterolemia and diabetes.
Medication Assistance through generic prescriptions, mail order prescription
programs, and pharmaceutical company patient assistance programs, Laboratory
testing & diagnostic imaging, Patient Wellness & Health Education
6. Has the scope expanded? If so, why?
* COPD – the main reason for this disease focus is because it is the 3rd leading
cause of death and no cure. We are decreasing hospital visits and admissions by
helping to manage this disease and lower the amount of acute exacerbations.
*Dental Care - Maintaining Oral Health is a crucial component in the treatment of
our patients. Dental care helps combat the side effects of the disease and
medications.
*Wound Care, Treatment & Management – Diabetes is the leading cause of
nontraumatic lower extremity amputations in the United States, and approximately
14 to 24 percent of patients with diabetes who develop a foot ulcer have an
amputation.

7. AFC has made a significant community and patient investment in the

area of education and training for its patients through years… what
type of classes, resources, workshops, and seminars are you
planning for 2015?
We will continue to have our monthly diabetes education classes, nutrition and
gardening, smoking cessation and healthy living classes (diet and exercise)
We also have volunteer pharmacist that consult with our patients during clinic.
I believe it’s important to grow a greater level of community involvement through
health fairs and food ministries so we plan to do more of that through churches and
companies.
*We just received a shipment of flu vaccine and will be giving our flu shots to some
local factory workers.
We are looking forward to implementing a seminar series, so to speak – Last year
we had Dr. Jud Menefee, a local endocrinologist and monthly volunteer physician
for our diabetic clinics, give a PowerPoint presentation and algorithm on the newest
treatments for diabetes to our community of physicians and nurses. I would like to
see us have quarterly seminars from different specialized fields – like yourself, Dr.
Hakmiller – with cardiology. It keeps the physicians up to date and gives our
patients continuity of care.

8. I understand AFC now offers Dental and Wound Care services for its
patients?
Yes, we have a physician (Dr. Bill Garretson) providing wound care for our
patients and any Baldwin County resident without insurance in our
Robertsdale location every other Tuesday.
We have a volunteer dentist (Dr. Tara Wheeler) that provides our patients with
dental services in her private practice in Loxley when her office is closed to the
public.
 9. I understand that you are seeking partners to implement
Vison/Eyecare for your patients?
Yes, as you know Dr. Hakmiller, patients with diabetes are at risk of disorders or
problems with vision and the longer someone has had diabetes, the more likely
they are to have a form of retinopathy, glaucoma and cataracts. So we have laid
the foundation and implementing eye care is definitely in the future for AFC.

People with diabetes are 40% more likely to suffer from glaucoma than people
without diabetes. The longer someone has had diabetes, the more
common glaucoma is. Risk also increases with age.

Many people without diabetes get cataracts, but people with diabetes are 60%
more likely to develop this eye condition. People with diabetes also tend to get
cataracts at a younger age and have them progress faster

10. How many strategic partners are on board today?

We are fortunate to be able to draw from the research, experiences, best
management practices, and services of over 25 Physicians, 4 diagnostic and lab
centers, 3 hospitals, and over 50 pharmaceutical companies.

11. How many Volunteer Physicians, nurses, etc… are necessary to

operate AFC currently?
We obviously must have a physician at every clinic, 2 nurses (1 for triage & 1 to
follow the physician) and 1 clerk. We also have lay volunteers calling patients to
remind them of appointments and to get their labs done prior to appointment.
Alabama Free Clinic offers a friendly and hassle-free environment in which to
practice, collaborate with colleagues, and make a difference in your community.
Our many volunteers come for the same reason - to provide high quality care in a
practical manner to appreciative patients. Volunteer providers are invited to
practice as often as they feel comfortable.

12. What kind impact has Healthcare Reform had on AFC?

Since the implementation of healthcare reform AFC has become even more
important to the chronically ill and poor in our area. Although, our staff has worked
and continues to work to get as many of our patients enrolled in ACA - ObamaCare
~ our number of new patients increase each week. The number of new patients
exceeds the number of those who qualified and could afford Obama Care.

13. What are the 3 things you love about AFC?

1) It gives someone that has fallen on hard times a hand up not a hand out.
2) Our approach is both efficient and cost effective because it integrates
volunteer medical professionals with charitable donations from individuals
and organizations.
3) Teamwork is making the dream work and the health care crisis is being made
a little less devastating – one patient at a time.
 14. Briefly tell me a few of memorable success stories regarding AFC
patients, strategic partners, and volunteers.
We have a female patient with cataracts and only able to see minimally in one eye
– she was able to have surgery and now has the ability to see with great vision

Woman in wheel chair able to get her diabetes in control and she is now walking
independently and able to enjoy activities of daily living

Young lady pregnant with diabetes and Medicaid only provided care for her
pregnancy not her diabetes. Diabetes gets harder to treat during pregnancy and
she had no means to have treatment. We took care of her and mom and baby are
fine now.

Female that has been a patient for almost 4 years. She is type 1 diabetic requiring
insulin since the age of 4. She is a single mother and currently works full time. She
stated, “If I did not have Alabama Free Clinic, I could not afford to see an
endocrinologist and I could not afford my insulin and honestly, I believe I would be
dead”

Patient has been 115 days without a cigarette due to patient’s desire to quit, One of
our Physicians prescribed chantix through compassionate assistance program for
free medication. Patient reports breathing better and has been riding her bicycle 5-
6 miles weekly.

15. What are the greatest needs of AFC today?

We have needs
• More and diversified services for our patients – Expansion like Vision
• Strategic partners - expanding to gynecological and dermatology
(living here at the beach-skin checks are important!)
• Finances
• Informing those in need – reaching out to the community
• Educating those who serve- need educators
• We need the most cost effective way to put our best foot forward to
help those in need.

Clerks, Medical Assistants, Nurses, Doctors, Pharmacist, Teachers, Counselors,

Social Workers, Case Managers and MONEY!
We could not offer excellent health care to our patients were it not for our
wonderful lay volunteers who generously give of their time and talents,
serving as administrative support staff, front office assistants, patient
registration clerks, interpreters, and more.

We are humbled by the number of individuals who want to volunteer.

It is our desire that all who wish to serve the people of Baldwin County
through Alabama Free Clinic can be a part of this great service to those
within our community.
 16. How is AFC funded?
We are a tax exempt 501c3 non-profit organization. We receive no government
funding and 100% dependent on private charitable giving…We have an annual Wine
Tasting and Food Pairing fundraiser at the Fairhope Yacht Club and this year it is
scheduled October 13th….for information look on our facebook page or email
info@alabmafreeclinic.org

17. How would you define a strategic healthcare partner, financial

partner, volunteer?
They are community-minded individuals caring for Baldwin County residents who
struggle to maintain their health while experiencing financial hardship and they are
the heart and soul of our clinic.

18. If you had only 60 seconds to tell a total stranger, potential patient,
partner, or volunteer what would you say?

It is estimated that close to 40,000 Adults in Baldwin County cannot afford health
insurance, medical treatment and their necessary medications. It only takes
compassion towards others, gratitude for blessings, caring for the sick ~ a sense of
community…these serve as the foundation for the mission and mandate of Alabama
Free Clinic. By addressing these chronic diseases or illnesses, the “Ripple Effect” of
benefit continues throughout the community.

– Healthy People
– Healthy Families
– Healthy Community
As this “Ripple Effect” continues, our community becomes:
– Physically Healthier
– Socially Healthier
– Relationally Healthier
– Emotionally Healthier
– Spiritually Healthier
– Economically Healthier

To Become a Patient:

 Call the clinic office at (251) 937-8096

 Complete a phone screening
 Provide requested documents
***Patients are seen by appointment only; no walk-ins are accepted.
If you are interested in learning more about volunteer opportunities,
please call the clinic office at (251) 937-8096. To register your interest
in volunteering, click here to download the volunteer application, fill it
out and mail to: Alabama Free Clinic, P.O. Box 1284, Bay Minette, AL
36507. Or, you may fax it to (251) 937-3879.

***look us up on facebook!