Community Health Free Clinic cofounder, CEO retires after 25 years of delivering health care to patients in need

CEDAR RAPIDS — Some leaders are good at running the numbers. Others are people persons focused on the humans affected by each decision they make.

Darlene Schmidt, cofounder and CEO of the largest free health clinic in Iowa and most of its neighboring states, has managed to do both for the last 25 years — plus so much more.

Any day at the office of Community Health Free Clinic makes this apparent. It’s hard to chat with Schmidt for more than a few minutes without an interruption of some kind or another.

In her last few days as CEO, the visionary of the organization that has been a health care lifeline for 164,000 people was dealing with the things most CEOs don’t think about: fixing the furnace, securing urgent eye care for one patient and making sure another who traveled a long distance got the care they need.

For her, it’s all in a day’s work. In fact, she hardly considers it to be work, in the traditional sense.

“I feel guilty for taking a check, because this is a dream,” she said. “When people say you don’t work a day in your life when you love something, this is the perfect example.”

But now, at 78, she’s ready to hand the reigns to the next generation as the need for heath care and barriers to receiving it continue to grow.

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The start of a vision

Starting in 1966, Schmidt’s vision was built by the people she saw as a nurse in Cedar Rapids doctors’ offices over 25 years. Under three doctors, she saw a different segment of the population: wealthier patients, Medicaid patients and the working class that often fell through the cracks of insurance.

Her work with Dr. Bill Finn came as the city’s former meatpacking plants like Wilson & Co. started to close, leaving workers without health insurance.

“At the time, I think an office call might have been $3 or $5. But patients were beside themselves because they now had no health insurance,” Schmidt said.

Those who could get a diagnosis and prescription from Dr. Finn immediately faced another problem — getting it filled.

Back then, prescription samples from pharmaceutical companies filled her doctor’s office’s cupboards, and consequently, the ad hoc needs of some patients. But what they didn’t solve was something more systemic in the health care system.

“That was how I already knew there was a problem,” she said.

In the earlier years of her career, emergency rooms kept call lists of doctors to assign to patients without a primary care provider. She said doctors of that era took seriously their oath to serve the entire population — whether they could afford it or not.

But as time went on, she said the health care industry became “big business” as a payment-first mentality permeated critical junctures for health care, barring access to those without funds.

Working class families with one parent out of work were left in a quandary: not poor enough to qualify for Medicaid, but not rich enough to afford health care.

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A foundation in empathy

Numbers were important to Schmidt. But just as important was the empathy that drove her day-to-day leadership.

In her medical practice, that started by prepping Dr. Finn with reminders of who his patients were — not what their diagnosis was.

“Her daughter died six months ago — did you remember that?”

“This is the grandma to the baby you delivered three days ago.”

And, between appointments, she built a network of friends by attending wakes. She was there for the good times and the bad.

As the leader of CHFC, her empathy manifested in the solutions she found for patients that often went beyond the scope of a doctor’s office.

When a young boy’s jaw was wired shut and required a liquid diet, a hospital referred his inconsolable mother to CHFC.

The mother didn’t have any money for a blender, so Schmidt paid for one over the phone and left it for pickup at the store.

When the only thing between a patient and her new prosthetic leg was a $500 deductible, Schmidt tried to negotiate it over the phone. When the provider wouldn’t budge, she paid the $500.

When patients slept on cots at the clinic’s makeshift shelter after the flood of 2008, she called a local furniture store to get recliners for those who had difficulty laying flat.

And, until the COVID-19 pandemic hit in 2020, she drove patients who needed an emergency room transfer in her personal car.

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A different approach

Raised strictly Catholic, Schmidt used to hurry past a local Lutheran church during her walks as a girl, afraid of the churches she didn’t know. Today, she works with people of all faiths.

In 1995, Schmidt became clinic director of Cedar Rapids Free Medical Clinic, the religiously-affiliated nonprofit that operates as His Hands Free Clinic today. In 2001, Schmidt and others split amicably to form Community Health Free Clinic.

Demonstrating her faith to people of all faiths was more important than talking about religion.

“I just felt like there’s a church on every single corner,” she said. “I will do my best to show you I’m a Christian without talking about that. I just want to give you relief from your ear ache.”

A native of Anamosa, Schmidt grew up thinking she would become a Sister of Mercy. She instead became an Associate of Mercy with Sisters of Mercy of the Americas in 2008 and completed her lifelong covenant in 2022.

Critically, CHFC’s pivot away from a religious mission statement allowed it to access more grants and grow into one of the largest free clinics in the Upper Midwest.

Since 2002, the clinic has served over 164,000 patients with 447,000 volunteer hours donated. Today, it operates with 130 active volunteers, 17 volunteer medical providers and 22 part-time staffers that account for less than 6 full-time employee equivalents.

The CEO has been the organization’s only full-time employee.

Through new partnerships, it has grown to cover eye services and dental services, in addition to other medical specialties. Last fiscal year alone, it provided over $7.2 million in prescription medications — all of it at a cost of $0 to patients and funded entirely by private donations without government funding.

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Fixing a broken system

Schmidt’s vision at retirement was as immediately clear as it was on Day One.

“To see as many people walk through the door — no restrictions,” she said. “Listen to their stories. See what we can do.”

Since its inception, the types of walk-in patients filling the waiting room of the first come, first served clinic have changed.

In its early years, patients were often people who were “down on their luck” — the unemployed, refugees or someone who was homeless.

Today, many of their clients are employed but underinsured, or have a medical condition that requires unaffordable prescription drugs, like Eliquis blood thinner or insulin. They’ve become more diverse, too, now speaking to health care providers through interpreters in Spanish, French or Arabic.

“They come to us in business suits,” said Amy Johnson, the director of donor and community relations who started volunteering at CHFC 24 years ago.

“What breaks my heart is I see people at the clinic all the time who are doing the right things. They’re pulling themselves up by the bootstraps, they’re employed, they’re working two, three jobs,” she said. “And they can’t get the health care they need. That, to me, says the system is unbelievably broken.”

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Schmidt’s leadership style

Schmidt’s leadership is described unanimously as “visionary” among those who have worked the most with Schmidt over the last 25 years.

“Darlene has been the heart and soul of this clinic,” said Dr. Dave Muller, board chair of CHFC. “It’s a better place because of her dedication.”

For Johnson, 63, the weight of that leadership is especially inspirational for women. In the era when Schmidt entered the workforce, women’s professional choices were often limited to becoming a teacher, nurse or secretary.

“Darlene became a nurse, but she leveraged that to serve so many people, and she leveraged it to create this amazing organization,” Johnson said. “She has single-handedly saved countless lives.”

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New leadership

After the Affordable Care Act passed in 2010, CHFC’s swelling case load received much needed relief as some patients became eligible for more affordable insurance plans, allowing them to visit traditional clinics.

But with impending cuts to Medicaid by the Big Beautiful Bill and insurance premiums set to triple for many on the Affordable Care Act Marketplace, the need for the free clinic’s services are expected to grow in the coming years.

Michele Davis, former director of quality and risk management for Eastern Iowa Health Center, hopes to face those challenges with some new improvements. Like Schmidt, she’s a former nurse who fell in love with healthcare through family practice care.

“Working with patients one-on-one early in my career, I got to know them, I got to hear their stories, and realized a lot of our community did not grow up the way I grew up,” she said. “I did not worry that my mom couldn’t get me my medicine.”

Unlike a Federally Qualified Health Center, the clinic is not held to all the same regulatory hurdles and tedious guidelines that can be cumbersome.

With volunteerism on the decline among younger generations, the 40-year-old hopes to find new ways to engage volunteers, care for loyal employees and bolster the clinic’s future against challenges.

Efficiency remains top of mind with hopes to see more patients, be less wasteful and offer new services in-house that make coverage more seamless.

“I think about it like when the doctor used to visit your house,” Davis said. “The whole approach they have is there is a patient in front of you — let’s get them the help they need. It’s what doctors, (physician assistants) and nurse practitioners go to school to do.”

Embracing that simplicity, she said, could be key to breaking through a broken healthcare system.

Comments: Features reporter Elijah Decious can be reached at (319) 398-8340 or elijah.decious@thegazette.com.