The following is an excerpt from our February issue:

By Michael Roy Hollihan

Some numbers are stark. One in eight Memphians live at or below the poverty level. An estimated thirty percent of all Memphis children live in poverty. But some numbers are slippery. So it is with the working poor. As many as one in four Memphians belong to the vague category of the working poor. These are individuals who have jobs but have been unable to rise above the poverty line. They live paycheck to paycheck and are one automobile problem or medical emergency away from complete disaster. On the ladder of economic success, they are one rung above ground.

Most Memphians know the working poor are out there – they’ve seen pictures in the papers or stories on the news. But for the middle-class and wealthy in Memphis, it’s a problem of others. Not me, someone else. Not here, somewhere else.

Large swathes of the city are filled with the working poor: North Memphis, Downtown, Midtown, and southwest Memphis. Drive the major traffic arteries and you see hints of them. Get onto streets like McLemore, South Third, Chelsea, Summer Avenue, Danny Thomas, Raines, and Neely, become immersed in the neighborhoods, and the impression is inescapable – we are failing ourselves. Whole neighborhoods, whole subdivisions of substandard or worn-out housing, ruined streets and alienated, lost people. We may be a top twenty metropolis, but we are a top three economic disaster for our residents.

One of the most pressing areas of concern is the issue of health care. Rarely do the working poor have the luxury of indulging an illness. Being home sick means lost wages or even a lost job. Either way, it is an economic catastrophe. Persistent illness or disease, or lifestyle-associated diseases like obesity and hypertension can reduce productivity or even limit job opportunities. Meager gains melt away. Chronic problems prevent forward progress.

While some jobs, especially corporate or government routinely offer health benefits, employment at small businesses or service/distribution sectors often means no health coverage. Although insurance companies offer rock-bottom basic packages for as low as $60 per month, even this can be too much. And that assumes that potential customers are even aware of these offerings. Most working poor simply do not get exposure to health care insurance options unless it intersects their lives.

TennCare is not the solution many may think. It was designed for the most desperately poor and the uninsurable. If you have some options in terms of insurance, no matter how expensive or inadequate, then TennCare can’t help. Add to that state-mandated cuts which took 170,000 off the rolls and the road looks bleak. The competition for available government funds is fiercer than ever. The private sector assumes that government is taking care of things and just doesn’t worry any more.

Nor is the Regional Medical Center an answer. In 2003, one-third of its patients were the uninsured. Charity care and so-called “bad debt” care (people who received treatment but never paid the bill) amounted to $50 million in 2001. These costs are transferred to the other patients, resulting in higher treatment costs that begin to cut off the poorest of the middle class as well.

The Med, as it is popularly known, may have a twenty-four hour emergency room, but emergency treatment is not a sustainable way to maintain community health. People will often allow an illness or injury to fester waiting for severity to justify a trip to the Med. A problem that could have been solved quick and cheap in the early stages (a routine visit to the doctor) will instead be treated with high-dollar emergency-level care. Others will unthinkingly use the emergency room as a doctor’s office, unmindful of the waste of high-level medical services. A doctor treating a festering sore or a cold-turning-into-pneumonia is a doctor not able to treat a heart attack.

It is the idea of early and preventive care, catching the problems small, when intervention is modest but effective. It is preventative changes to lifestyle that can obviate disease or chronic conditions that plague the working poor. The affordable and economical ninety-nine cent value meals fit into time-stressed schedules, but the cost of obesity-related disease. Telling someone to give up a greasy, meat-heavy diet when their entire family has been eating it for decades is to fight cultural inertia.

Into this storm-tossed sea stepped a man and his calling, Dr. Scott Morris. As a young man, he didn’t so much juggle twin careers of doctor and minister as seamlessly blend them into a practical and groundbreaking whole. Beginning in his native Atlanta, the young Morris began to experiment with various ways of using his medical skills to amplify his calling to minister to the poor, borrowing and discarding a great many ideas. His guiding principle, then as now, has always been clear. “The church has always been intimately involved in health care, especially the poor. One-third of the Bible is on healing the sick.”

Ready to get to work, in 1986 he moved to Memphis, “the poorest major city in America.” He arrived not knowing anyone, relying on “God’s providence.” He found a position with St. John’s United Methodist Church as an assistant pastor but his eye turned to the Randolph House across the street, at the corner of Peabody and Bellevue. Once an upper-class home, it had slid down into disrepute and settled as a boarding house when Morris considered it. So was the Church Health Center born.

That first day, he saw only a dozen patients, but today the Center sees 36,000 patients regularly and has nearly 50,000 patients of record. It’s just a fraction of the estimated 150,000 uninsured in the Memphis area.

That doesn’t matter to Dr. Morris. He is softly energized and determined. “The great countries are measured by how they treat the most deserving. We don’t measure up.”

“Poverty is fundamentally a spiritual disease. It will beat you down so fast. It tears at your spiritual fabric.” He calls living in poverty “a struggle day in and day out.” It is this focus on spirit and the individual that make the Church Health Center unique. Everything is driven by the volunteers ministering to those in need.

Doctors, physicians, nurses, optometrists, dentists and other specialists – well over 500 professionals and countless more just-plain volunteers – all donating their time and sometimes their supplies. Many will see Church patients in their own offices, though many also come to the Walk-In Clinic. While some medications are purchased through block grants, many come via samples collected from doctors and from pharmaceutical representatives. More still come from people who have extras left over from over-filled prescriptions. Surprisingly, widows and widowers will even bring in the medications of their deceased spouses, not allowing grief to overwhelm charity. None of this is free to patients and clients, but the Center uses a sliding-scale payment method that adjusts expected payment to the person’s financial situation. The poorer you are, the less you pay; but everyone pays at least something and it’s always modest.

Most importantly, Dr. Morris says, “It’s not called ‘Church’ for nothing. This is a healing ministry.” He sees the Church Health Center as a way for churches, temples, and synagogues to respond to God’s call, to be faithful to God’s word and to give their congregations a chance to express their service to God. They are steadfastly non-sectarian and non-denominational, though. “We take all comers.”

Good doctor that he is, Dr. Morris also can’t resist a sharp observation. “The least healthy meal is at church. Is fried chicken on Wednesday night the best way to draw people? Take off that first layer of grease.”

The Church Health Center and Dr. Morris are resolute in their focus on health care. His sole criticism of government is to express some shocked surprise at TennCare’s disenrollment of 170,000 people last year, which he points out is the largest single cut of people from a government health program in history. “Health care is not a right, since it can be taken away.” He also notes that even the most ambitious of the universal health care plans of the 1990s would have still left as many as 50,000 Memphis and Shelby County residents without coverage. It’s implicit acknowledgment that some kind of need will always be there unaddressed but for the actions of those who are moved to meet those needs. “Government cannot do the work of the faith community, nor should we ask it to.”

Morris is also skeptical of technology and the “infatuation with technology” he sees around him. Millions spent for clearer x-rays provide a “diminishing return” on its costs; exponential rises in the price of newer machines and tools nets only an incremental increase in actual treatment benefits.

This is not to say that he doesn’t see responsibility elsewhere. “We desperately need change in attitudes to health care.” First and foremost is, as noted before, a shift away from relying on emergency treatment and ignoring our bodies to a healthier, preventive attitude to living. The Church Health Center has a Hope and Healing Center on Union Avenue that works on this. It offers a gym, an indoor walking track, a meditation chapel, nutrition and health classes, dance and movement classes and much more. The emphasis is on developing and maintaining a healthy diet, and fighting the passivity and immobility that is too common today.

But a groundbreaking faith-based community supported health care system wasn’t enough. Even though the Church Health Center is drawing national attention, bringing both religious and medical professionals from around the country to Memphis to study the Center’s success, they have taken yet another innovative step. Beginning seven years ago, the Church Health Center began to offer its own affordability alternative: the MEMPHIS Plan. It was so radical an idea, so outside of daily preconceptions that it turned out to be illegal! A special act of the Tennessee General Assembly was required to allow it.

The brainchild of Teresa Bolton, it provides for the working poor and the self-employed highly affordable ongoing health care that includes hospitalization. Any business with interested employees can sign up to provide basic but wide-ranging services for them. MEMPHIS Plan, now managed by Associate Director Gannon Weaver after Bolton returned to the private sector, is not insurance. All the doctors, nurses, offices, etc. are providing their services for free of charge. There are certain income and employment requirements as well, but for only $45 per month per employee and $25 per dependent (to a family maximum of $120) every enrolled employee will be seen in a doctor’s office rather than at the Church Health Center clinics. The Center’s only demand is that employers pay a minimum of $10 of the monthly fee. The co-pay is an astonishing five dollars.

As Weaver says, echoing Dr. Morris on the wider mission of the Church Health Center, “It’s not about a handout. It’s a helping hand.” That hand up has netted about 1200 businesses and 3700 participants, proof of their small-business orientation. Members range from the self-employed to companies with more than a hundred employees.

“Our goal,” Weaver says, “is to grow the MEMPHIS Plan, to have as many on it as we can.” To that end, he works with a staff of three full-time marketing representatives, using a mix of cold-calling and employee referral. They also make sure to inform new patients at the walk-in clinics as well.

Weaver is excited by their success. “There’s nothing like this in the country. No manual. We’re writing it every day. It’s an ever-evolving process. And we’re constantly looking for things we can provide — services –” in addition to the current plan.” But he also wonders why they aren’t having more success. “Why they aren’t beating our doors down?”

So far, they’ve enrolled dry cleaners, restaurants, churches and day cares. One such participant is The Cupboard, the famous meat-and-three restaurant on Union Avenue. Owner Charles Cavallo says, “We think it’s the best thing we offer, besides a paycheck.” There are ten Cupboard employees and several dependents enrolled. The Cupboard pays all monthly fees for employees. “It’s like a perk, a drawing card.” Cavallo says emphatically, “I think it does have an effect on morale and retention. Everyone loves it.”

The benefits to the employees are obvious, but the benefits to the companies are important. An employee who doesn’t have to worry about their health is one who can focus on their job; morale is boosted. Parents of children don’t have to make agonizing decisions about staying home from work to attend to their sick kids for days on end. Sick time is reduced as people can make timely visits to their doctor. All of this raises employee retention rates, improving productivity and reducing training costs for replacement hires.

All for modest, very affordable rates that also support an important ministry. The return benefits to the Center are also noticeable. Cavallo was quick to mention that he and The Cupboard are involved with the Center and promote its works with customers.

The Church Health Center and the MEMPHIS Plan are a classic solution to a community problem – identify or recognize a need, then mobilize the community to address it. Those who have the pertinent skills do the main work. Those who can organize and support, work alongside. And those who care but cannot otherwise help directly provide financial or material support.

In this case, one man, Dr. Scott Morris, stood up and stepped out. Every day, thousands are touched by his handiwork. He did not set out to tackle the whole problem of poverty, only one small piece of it. But as a consequence of his actions, he’s relieving at least some of the grinding fear and despair every day. As the Church Health Center and the MEMPHIS Plan are models for the rest of the country, so Dr. Morris is, in his quiet and unassuming way, a model for Memphians.