When Deana Youngblood got back from a short vacation in South Carolina earlier this year, she knew something was wrong. “I got very sick,” she said. “I was having a difficult time breathing, coughing up horrible stuff.”

Youngblood, a store manager who currently works 13-hour shifts starting at 4:30 a.m., had no insurance. And she was getting worse by the day. Youngblood left a message for Wheeling Health Right, a local free clinic. “That was Tuesday,” she said. “On Wednesday, they said Wheeling Hospital is waiting for you for x-rays. No paperwork. I don’t have health insurance because I can’t afford it. Health Right said, ‘If the hospital sends you a bill, you bring it to us.’”

“Next thing I knew, I had a Z-Pak [antibiotics],” she said.

Wheeling Health Right is the only free clinic in the Northern Panhandle of West Virginia, serving uninsured and underinsured residents across several counties from Brooke to Tyler, an area shaped by decades of industrial decline and a significant drop in population. According to the latest census data from 2020, 124,670 people live in the Northern Panhandle, a decline of nearly 6 percent compared to 2010.

In 2024, the clinic logged about 29,000 patient visits across medical, dental, and pharmacy appointments. The clinic also partners with organizations, including the West Virginia University Eye Institute, to provide heavily discounted care.

“I can honestly tell you I get better care there than I have with any primary care physician,” Youngblood said. “I’m not saying that just to say it, I mean it. They take the time to get to know you personally, they’re so compassionate.”

She said the clinic’s responsiveness has been consistent, even during holidays. “It was a holiday, a Friday, and the clinic was closed. I got out of work late, and couldn’t make it in time to get my prescription. I left a message, and Don, the pharmacist, called me back and asked, ‘Do you need your meds today? I’ll meet you down there.’ They’re just all good people.”

She also survived a stroke five years ago, and now takes several daily medications, including one that costs about $700 a month without assistance.

Beyond acute illnesses, Youngblood depends on inhalers to manage COPD, chronic lung disease. “That inhaler is a lifesaver,” she said. “Without Health Right and that inhaler, I’d probably die.”

Clinic Key in Fragile Local System

Like Youngblood, many of Wheeling Health Right’s patients fall into coverage gaps, as they earn too much to qualify for certain safety net programs, yet are unable to afford private insurance premiums or high deductibles. Hospital closures across the area have made access even more limited, pushing more people toward the few ERs still operating.

“The need for care in our region is huge,” said Anne Ricci, executive director of Wheeling Health Right.

During a recent phone interview with Direct Relief, clinic leaders say that geography and transportation barriers routinely keep patients from attending appointments, especially when breathing problems worsen. Even for those with some insurance coverage, high deductibles, inconsistent pharmacy benefits, and Medicare Part D gaps mean essential medications are often unaffordable.

For the past year, the clinic has been able to draw on a multi-year donation of albuterol inhalers supplied by Teva Pharmaceuticals U.S. via Direct Relief, creating a reliable and consistent supply of the medications.

The inhalers have become one of the most heavily used resources in the pharmacy, said Don Rebich, a pharmacist at the clinic, and the person who Youngblood recalled came to meet her after the clinic was closed during a holiday. Since January, Wheeling Health Right has received albuterol inhalers and dispensed them to patients at no cost.

“Retail prices [for inhalers] can reach $100 or more, so many patients with chronic respiratory problems simply go without treatment,” said Rebich.

“And that shouldn’t be an option,” Ricci added, before her colleague, Linda Shelek, a nurse practitioner and clinic coordinator, chimed in, “and then they end up in the emergency room.”

Some patients have pharmacy coverage that may exclude certain medications altogether. The donated supply allows same-day dispensing and helps stabilize breathing before patients deteriorate.

The need for inhalers often intensifies during emergencies. Ricci shared that, after a recent flood, one patient with chronic lung disease lost his only rescue inhaler while clearing mold-damaged debris from his home.

He was able to get a same-day refill from the clinic’s pharmacy and return safely to cleanup work. In Triadelphia, where flooding disrupted access to medications across multiple neighborhoods, the clinic has been providing no-cost albuterol refills throughout the ongoing recovery effort.

Other patients face chronic challenges that don’t require a disaster to impede their lives. One woman living at the YWCA struggled to climb three flights of stairs with untreated asthma until she enrolled in the program and received a no-cost inhaler, allowing her to manage daily tasks and keep medical appointments.

To address increasing healthcare access challenges, Ricci said the clinic is working to expand partnerships and mobile services while continuing to apply for grants from state and local organizations. Maintaining access to donated medications, Ricci said, remains essential for their patients, including Youngblood.

“What would be my workaround without Health Right?” Youngblood said. “I honestly don’t know.”