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An increased need for free or low-cost medical care in Montgomery County is putting a squeeze on local health providers, but Mercy Clinic in Gaithersburg now has room to grow.

A 1,800-square-foot addition, completed in November, provides more space for patient screening, a large conference room for lifestyle education and diabetes programs and administrative offices.

Rooms in the original clinic that had been repurposed for patient services can revert to being work stations for nurses, educators and physicians. A clinic kitchen again is available for the 54 volunteer doctors and other staff at Mercy, which served 2,230 patients free of charge during more than 10,500 visits in 2009.

"We were very crowded before. Now we can hang up our coats," said Dr. Jim Ronan, the clinic's founding medical director, as he gestured to the 50-plus crisp, white doctors' coats hanging along a wall in the new physicians study area.

The expansion eased the work day for doctors and nurses, but also was needed to accommodate a growing number of uninsured patients, a trend seen in clinics across the county.

The $153,000 project was funded by grants from the Cafritz Foundation, Kaiser Permanente Health, the Montgomery County Council, Saint Mark Presbyterian Church and Standard Properties.

Mercy is one of 11 clinics with 24 locations included in Montgomery Cares, a network of community-based clinics which provide primary health care services at low or no cost to low-income residents who lack health insurance.

Some of the clinics have paid staff; others, like Mercy, are run solely by volunteers.

When Montgomery Cares was created in 2005, the county had an estimated 80,000 uninsured residents. That population now is between 100,000 and 120,000, estimates Jean Hochron, senior administrator of Montgomery Cares, in the county's Health and Human Services department.

"For the last several years, there has been a constant increase in the demand," Hochron said. "The need is enormous in the county. We just wish were able to meet all the need."

The goal of the program when it was created was to reach 40,000 uninsured county residents by 2010.

For the 2011 fiscal year, the county funded the Montgomery Cares program at $9.2 million, which would allow for 28,000 patients and 70,000 patient visits from July 1, 2010, through June 30.

Six months into the fiscal year, patient visits are far outpacing the annual budget.

Luz De Alba, a 40-year-old office cleaner from Germantown, has been coming to Mercy Clinic for about a year. She was treated for an infection that gave her stomach cramps, De Alba said through a translator. She learned about the clinic from her sister, also a patient, and then referred her brother to Mercy after he experienced a health problem.

"I have been so blessed. I wouldn't be able to go to any doctors because it would be too expensive," De Alba said. "This is a place where people can get the help they need."

Almost 18,000 patients had been served in the Montgomery Cares program through Dec. 1, in a total of 36,000 visits, Hochron said. Mercy Clinic saw 1,561 patients in 3,210 visits in the first six months of the fiscal year.

"We will expend the dollars we have in our budget to support as many visits as possible," she said. "But we are working on a budget, so we can't go beyond that."

Hochron said she hoped private industry could support the needs the county can't meet.

All the clinics in the network are privately run and privately funded, but the county reimburses $62 for each visit where a patient is treated by a doctor.

About 50 percent of the clinic's $953,924 budget in 2009 came from the county. Most of Mercy's private funding is donated by local churches and grants from other nonprofit foundations.

The clinic also receives funding from a golf fundraiser, investments and voluntary patient contributions.

Established in 2000, Mercy is one of the larger health clinics in Montgomery County. Its mission is to improve and expand primary medical and specialty care, health education and pharmaceutical support for low-income, uninsured residents of the county.

dgaines@gazette.net