"We decided in the very early days we aren't a free clinic, that health care is valuable and everyone can pay something for it," said Don Yost, whose title at Maple City Health Care Center is storyteller.
It has been a question of how much that something is since the clinic started, Yost said.
The clinic has a standard charge for services. It offers discounts based on what families can pay.
Some clients receive up to a 90 percent discount but still are unable to pay the 10 percent they owe.
"What we're finding with the current economic situation is there are some people who can't pay that," Yost said. "Then the question comes, what is affordable? What can people pay?"
At the core, Yost said, the center is a community health organization, and employees see the program as an investment in the community.
"We are seeing people who have bad debts with us, and that was disturbing because as we were thinking about it more and more, that reflected the breakdown of our compact with our patients," Maple City Medical Director James Gingrich said.
"Either the care isn't affordable or they aren't doing their part," he said.
More Than Money only applies to selected, low-income patients. Patients who can't afford to pay the 10 percent they owe instead can use community service to pay off their balance. For every hour of community service a patient works, he or she earns $10 toward his or her balance with Maple City. The money they earn can be used toward previous bills, lab work, office visits or medication.
"This is a collaborative adventure of our community. ... This is an effort to invest in our community and our patients," Gingrich said.
Gingrich said no external funding has been given for the program, and the clinic is not cutting costs in other areas to make the program possible. Instead, time and resources will be saved by not having to collect money from people who aren't paying their bills, he said.
In the program's first few weeks, Maple City has identified up to 20 people who qualify for the program, Yost said. Volunteer opportunities include construction at LaCasa, construction and working at the Re-Store for Habitat for Humanity of Elkhart County, serving food at The Window and filing at the Center for Health and Healing.
Patients who participate in the center's six-week Healthy Living class receive $60 off their bill if they go to each class.
Kate Irelan of LaCasa Inc. in Goshen is looking forward for volunteers on home renovation and construction projects, including painting, stripping woodwork and putting in windows.
"Sometimes people need help, but it's hard to ask and accept it," Irelan said. "This gives people a chance to get the help they need and also help them help the community when they get the volunteer work."
McCourt has been a patient at Maple City for about 18 years, and has worked at the office there.
In September 2007, she left her job as an office manager of a church to try a new career as a patient educator. Her income was not stable, so she took a part-time job a few months later with Wal-Mart to make up for it.
In August 2008, during a routine lung check, a doctor discovered tumors in her lungs. Since she had a history of thyroid cancer, they thought the cancer had returned, this time to her lungs. She underwent tests and had to miss work, and eventually had to stop working. She has not worked since Sept. 26.
"I had finally got a diagnosis that I could live with, but no job," she said. "Depression was starting to get to me."
She was at Maple City a month ago for a thyroid check and a nurse practitioner mentioned the idea of More Than Money. McCourt asked to be a part of it. She didn't have a high bill with the clinic, but she could contact community organizations and gauge their interest.
"I am doing this to give me purpose, to give and to contribute to something I feel really good about and believe in," McCourt said.
"When we are going through hard times, we get down because we are looking at our own circumstances and we lose hope. But when we change our focus away from ourselves to others, it immediately begins to improve our spirit.
"What I get from doing this project is something I would never get from a paycheck," McCourt said.