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Arthritis Donor Legacy and At-Risk Patient Care

For Nerida Zapata, 55, it’s hard to remember the terrifying moments she experienced before she became a patient at a free arthritis clinic in South Florida.

Eight years ago, Zapata, who suffers from rheumatoid arthritis, could barely walk. Her feet were swollen, she was completely exhausted and she was losing weight. Instead of visiting the beach when she had time to relax, she could only stay at home.

However, in 2014, a friend took notice of her situation and took her to the main office of a nearby clinic. He was financially supported by the Arthritis Foundation through funds bequeathed by a local woman who had passed away more than 20 years ago.

At the West Palm Beach facility, Zapata applied to become a patient at the clinic. When she was accepted, she remembers her doctors telling her, “Don’t worry, we’ll take care of everything.”

“And that’s what happened,” Zapata said. medpage today. “He put me on medication and within a month I was a different person.”

Before receiving care through the clinic, Zapata could not afford adequate medical care. His medication alone costs $5,000 a month.

Zapata is one of hundreds of uninsured and underinsured patients the clinic has helped throughout his life.

It has done so through the last will and testament of former St. Lucie County resident Mary Greissler. In 1994, Greissler specified that his estate would be left to the Florida Middle East Branch of the Arthritis Foundation, provided that part of the funds were used for the purchase or construction of a permanent branch and the remainder was used to expand the local programs and services “to reach and help more people in this area with the crippling disease of arthritis.”

Now, that legacy is being challenged.

In September of last year, the Florida Attorney General’s Office filed a lawsuit against the Arthritis Foundation over its proposed sale of a building built in 1997 with funds from the Greissler estate. And the litigation, which has included a recent mediation between the foundation and the attorney general’s office, is still ongoing.

The AG’s office wrote in its complaint that it was first reported that the Arthritis Foundation may have been considering the sale of the property at 400 Hibiscus Street in West Palm Beach in 2002. At that time, the AG’s office sent a letter to the AG’s office. national. of the Arthritis Foundation, warning that a sale or diversion of the property “would not only diminish the level of medical care for the Palm Beach community, but would directly contradict the stated terms of the legacy.”

The building was not sold at the time. However, in 2015, the Florida Chapter of the Arthritis Foundation was merged into the national office.

In 2020, the national office informed people and organizations providing arthritis-related charity care at 400 Hibiscus Street that it would no longer fund their activities and ordered them to vacate the facility by Jan. 1, 2021, according to the complaint.

“As a result, these service providers had to find new sources of financial support and secure new locations to continue their much-needed work on behalf of people suffering from arthritis,” the AG’s office wrote in its complaint.

As a result, doctors who had volunteered their time and effort for the clinic for many years turned to another source of support, CreakyJoints, which is part of the New York-based nonprofit Global Healthy Living Foundation. CreakyJoints announced in March of last year that it would replace the Arthritis Foundation in supporting the clinic after the latter organization ended its commitment to fund clinic operations.

In July, the AG’s office received correspondence from the national office of the Arthritis Foundation that was again considering selling the property at 400 Hibiscus Street, according to the complaint. He said he was doing so because arthritis patients were not currently being served there, and the national office “‘funds activities that benefit arthritis patients in other ways.'”

However, the AG’s office argued in its lawsuit that the national office’s decision to sell the property is contrary to and in violation of Greissler’s will, as well as the terms and purposes of the charitable trust created pursuant to the provisions of the will. .

“Because the national office no longer needs a permanent branch and intends to sell the property, Florida statutes and the cy pres [as near as possible] the doctrine allows the court to amend the terms of the will to require that the property continue to be used to provide services to people with arthritis; transfer the property to another non-profit organization willing and able to act as trustee with title to the property consistent with the charitable purposes specified in the will…and prohibit any future sale of the property without a court order permitting such sale and restricts sales proceeds from being held in trust for the benefit of arthritis sufferers within the branch counties,” the AG’s office wrote in its lawsuit.

It added that the national office is not allowed “to sell the property and use the proceeds of the sale for any purpose it chooses, such as officer salaries and bonuses, or to provide services outside the seven-county area.”

Shawn Baca, MD, a rheumatologist and former president of the Palm Beach County Medical Society, is one of more than a dozen physicians who have continued to volunteer their time to care for patients at the clinic.

The clinic aims to fill in the gaps when it comes to access to health care, Baca said. medpage today. It has hired a strong coordinator who is trusted by doctors and patients for face-to-face services and a variety of administrative skills, Baca said. The clinic also needs significant laboratory work to be carried out and medications to be obtained for patients at a discounted rate through requests sent to pharmaceutical companies.

Even if the building is sold, if the proceeds remain local, they could be used to maintain and expand care for both adults and children, he added. She would also fulfill the wishes of the donor.

When people donate money, he said, they deserve to know where that money is going and how it is being spent.

Michael Schweitz, MD, another doctor who has long volunteered at the clinic, agreed.

“Our position is that these patients need to be taken care of,” Schweitz said. “We need funds to be able to do that.”

If the Arthritis Foundation is going to sell the building, it must provide an endowment with that money that will fund the clinic, indefinitely, he said.

“They have this building now worth a fortune in the middle of downtown West Palm Beach,” Schweitz said. “We don’t know exactly how much it’s worth, or what price they might sell it for; it’s in the many millions. It wouldn’t take a huge percentage of that sale to create an endowment for us to maintain and grow and expand the clinic.”

For its part, the Arthritis Foundation has argued that Greissler’s will does not create a trust and does not prohibit the sale of the property, according to legal documents filed in the case. The foundation has also stated that the sale of the building would not lower the level of medical care in the local community.

The foundation declined to comment on pending litigation and details of any mediation in an email to medpage today. However, he simply said that his mission is “to find a cure for the leading cause of disability in the United States.”

The Florida Attorney General’s Office also refused. Today’s MedPage comment request.

As for Zapata, she said she wants people to understand the extreme pain that can affect people, like her, with rheumatoid arthritis. She compared it to having needles stuck in her joints.

“It hurts every day,” he said.

It’s easy to take simple things like getting out of bed or taking a shower for granted.

“It can be very difficult, believe me,” Zapata said. “You can be exhausted after you shower if you don’t have the right medication, the right care.”

She said that she and other patients are extremely grateful for the many years the Arthritis Foundation has provided them with the care they need to participate in daily activities. But she added that patients at the clinic were heartbroken to learn of the foundation’s decision to vacate and sell the building at 400 Hibiscus Street, especially as it happened early in the pandemic.

“That shocked me tremendously, I couldn’t believe it,” Zapata said.

“I think Mary Greissler’s last will and testament should be respected,” Zapata said. “Those were her wishes, and her wishes must be respected. The building belongs to the patients, to the clinic.”

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    Jennifer Henderson joined MedPage Today as a business and investigative writer in January 2021. She has covered the New York City healthcare industry, life sciences, and the business of law, among other areas.

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