Clinic that has served sanford’s indigent patients for 30-plus years faces bleak future as funding drops and political pressure continues to grow

When the Helping Hand Clinic first opened its doors to assist low-income, medically uninsured patients back in 1993, its mission was simple. It didn’t matter what your income level was. It didn’t matter where you came from. You were going to get quality medical care. 

“We’re all children of God and we’re all made in the image of God, and we’re here to treat everyone with respect,” says Dr. Marty Pate, the clinic’s founder. “If someone’s in need, and there’s something we can do to help them, that’s what we’re called to do.”

That mission and that stance could be what leads to the unraveling of the 32-year-old nonprofit organization, as clinics across the nation that refuse to turn away undocumented patients are seeing drastic cuts in federal funding and grants. On July 10, the U.S. Department of Health and Human Services announced a “significant policy shift” that it said would “ensure that taxpayer-funded program benefits intended for the American people are not diverted to subsidize illegal aliens.”

Before the news, Helping Hand was already facing a dire financial crisis thanks to a significant drop in grants and local donations. The clinic was forced to cut four of its six full-time staff members in July, and the future is, to put it mildly, uncertain. 

Despite the bleak outlook, the organization’s board of directors voted unanimously recently to continue to treat all patients who walk through the doors of the clinic located on Carthage Street near downtown Sanford (across from the former site of the Prince Motel). Voting any differently would have gone against the whole idea and mission that formed the Helping Hand in the first place. 

“To suddenly shift from our original charter for whatever reason — be it politically, socially or whatever,” says Pate, “would have been a betrayal of our deeply held belief that all people deserve to be treated with dignity.”

DO SOMETHING ABOUT IT

Sanford was nearly half the size it is today back in 1990. Still, there was great concern over the rising number of people who couldn’t afford basic medical care. 

“It wasn’t just a Sanford problem; it was all over the state,” says Pate. “And we were seeing a lot of patients — particularly in our emergency rooms, but also in our clinic — who were uninsured and couldn’t afford those visits. So their situation would grow to where they’d get some sort of illness or develop a [chronic condition], and they would ignore it or try to deal with it the best they could at home until it was intolerable.”

Pate recalls talking to his friend, Fr. Craig Lister at St. Thomas Episcopal Church, at the time and voicing his concerns over the lack of resources for indigent patients. 

“He basically said, ‘Shut up and do something about it,’” Pate recalls. “So the church back then had an adjacent building [now a parking lot] where the Bread Basket was founded, and he said we could start a clinic in the building and see where it goes from there.”

Helping Hand Clinic began in a small room with a pharmacy shelf roughly the size of a small bookshelf or closet. The clinic was open two nights a week and run by Pate and a group of volunteer physicians. In no time, the patient list grew and Helping Hand became too big for its space. Local orthopedist Dr. David Ciliberto offered space in his building (ironically, the same building the clinic upgraded to in 2024) for Pate and his staff and, to “make it legitimate,” charged a whopping $1 a year rent.

About four years later, Helping Hand outgrew that space as well and found a home in the basement of the Mann Center, which would be their home for the next 28 years. Pate — who calls the clinic a community effort and credits its longevity to “many, many others who deserve much more credit for its success” — says one of those early contributors was Marilyn Green, a retired pharmacist who had “great connections and some very amazing fundraising skills.” Pate says Green expanded the clinic to make it less about treating walk-in patients and more about treating them and establishing long-term care plans for them. 

“Suddenly, we had our own patient population that was using the clinic as their primary source of care,” Pate says. “The thing that was most amazing about it — and an example of how this community was willing to pitch in and help — was having all of these doctors and health care professionals who bonded together to make this work.”

Soon, Central Carolina Hospital became involved and began providing free access to a “wealth of services” such as radiology, laboratory services and more, totaling tens of thousands of dollars in free care. Local dentists began to donate their time and expertise, and Helping Hand’s patient list grew to hundreds of regular visitors and well over 1,000 total unique patients each year.

“Sure, the years have been feast or famine, but in those years where we did have to cut back somewhat on our services or scrounge around, we always managed to come through one way or another,” Pate says. 

Green and the clinic became savvy at finding funding through federal, state and local grants, and millions of dollars in pharmaceutical supplies and medications were donated to keep the clinic well stocked.

“It’s always been a community wide effort,” Pate adds. “If there’s anything that I will extol about Sanford and Lee County, it’s that I’ve been humbled in many ways by how people are so generous with their time and with their money. It’s never been an issue, certainly in terms of volunteers. I suppose there are other [clinics] that are like this throughout the state and nation, but to me, I can’t think of a more generous community than this one. It’s really been remarkable.”

A DROP IN FUNDING

Gwendolyn Cooper-Lee joined Helping Hand as its new executive director in 2022, and her impact was felt immediately. Cooper-Lee was brought in to increase the number of grants and donations the organization received, and by 2024, more than 4,000 people and 400 businesses and organizations were donating to the clinic, which enabled it to increase its coverage for area residents. 

In April of 2024, Helping Hand moved from the Mann Center to its current (and former) location at 409 Carthage St. The new home has a waiting area, large pharmacy room, patient rooms and offices for staff. When the move was made, Helping Hand touted the new location as one with both more room and more visibility in the community.

In the U.S., community health clinics saw a 64 percent decline in profit margins between 2021 and 2023, and that trend has only gotten worse since then. Cooper-Lee was brought in to Helping Hand because of her experience as a fundraiser, but even she has had a hard time navigating the shifting political climate and the overall drop in funding and donations clinics everywhere are seeing.

Add to that the financial ramifications of standing on a certain side of a hot-button political issue like immigration, and the concerns about Helping Hand’s future are warranted. 

“We’ve faced a decision to either stand for what we believe in or shift so that we can continue to collect certain funds, and our board decided that we would not change,” Cooper-Lee says. “That hasn’t necessarily aligned with a lot of our donors or funders [grant-providing organizations and large corporations]. Our donations have dropped by 33 percent … and we are getting denied grants that we’d previously received. We’re not the only ones, but I’ve found it disheartening, because I really didn’t think we lived in a community that would be affected by this and that would openly support the opposite of what we’re trying to do.”

Cooper-Lee says when she first joined Helping Hand in 2022, a very small percentage of their patient population was Hispanic, documented or undocumented. The clinic received a $40,000 grant to hire a Hispanic liaison to reach out to that part of Lee County’s population and inform them of their options. In the last two years, that number has gone from 2 percent to 26 percent. The clinic does not ask about documentation status — only whether they’re insured, whether they live in Lee or Harnett counties and whether they qualify financially for free health care (within up to 400 percent of the poverty level).

Cooper-Lee says the current “dismantling of Medicaid” has Helping Hand — despite its current financial woes — predicting a large influx of new uninsured patients between now and the end of the year (up to 1,200 additional patients, by one estimation). 

“There’s nowhere else in Lee or Harnett counties for them to go, because we are almost on the border of a health care desert,” she says. “[Federally Qualified Health Centers] and health departments do not see uninsured people. So we are here, able to bring a quality continuity of care with highly trained professionals, and these patients don’t have to pay a penny, whether it’s for services, prescriptions or even health care education. There is literally nowhere else for them to go.

“So I take all of this personally. These are our patients, but they’re also residents of your city, your state and your country. Our community will suffer, and nobody seems to be able to stop it.” 

A HELPING HAND

Bill Huggins joined the board of directors of Helping Hand Inc. in 2020, and he became the board chairman a few years later. He was one of the unanimous hands that went up when the board voted to continue with its mission to treat anyone and everyone, regardless of their citizenship or legal status. 

But Huggins points to other reasons for the clinic’s current financial problems, aside from politics. For one, there’s competition. The number of organizations vying for the same grants Helping Hand is seeking has more than tripled in recent years, which means a smaller chance of receiving funds or receiving a smaller piece of the pie if approved. Even in Lee County, he says, the number of nonprofit organizations continues to grow as the population (and the needs) grow.

This isn’t going to change, he says. What Helping Hand needs more than anything right now is support from the community — larger donations from local businesses and regular, smaller donations from individuals. Basically, they need a helping hand. 

“We need more sustainable [donations],” he says. “For example, I give $80 a month. That’s a small amount, relatively, and my daughter in Washington, D.C., donates $50 a month. We have others who give like that, but that number is small. We need about 200 more people to step up and give in that area. That would come to about $10,000 extra a year. Then we can continue to build on that. That’s the job of this board — raise money. And we haven’t done as well as we need to.”

A way to start meeting that goal, Huggins says, is by spreading the word. 

“When I tell people about the clinic and explain what it does and what the need is, often people are excited to help support that,” he says. “We just aren’t getting the word out like we should. I think that will lead to more donations, more volunteers and [sustainability].”

Huggins says the community will suffer without an organization like the Helping Hand Clinic, and ultimately that will affect everyone’s pocketbooks. 

“If there’s a large segment of the population in Lee County that can’t get medical treatment, there’s a long-term cost,” he says. “That long-term cost is that people are not healthy. More people are sick. More people aren’t able to work anymore. There’s a real need, and I believe that if people need help, you help them.”

— by Billy Liggett

HOW TO HELP

To learn more about donating or volunteering with Helping Hand Clinic, visit hhcsanford.com. The front page of the site has secure donation links.