Seven-year-old Cody Lantz fidgeted as he sat on the fragile paper of the patient examination table. The second grader was waiting for the doctor to check his progress with attention deficit disorder.
His mother, Mindy Sessions sat in the chair next to him - knowing she was lucky to have her son seen by a local pediatrician.
For years, Sessions had no health insurance, but had three children who needed the standards shots and checkups.
The children's clinic at the Wood County Health Department welcomed her despite her inability to pay, "even when we didn't have any kind of insurance for them," the Bowling Green mother said.
"We can't afford to pay a doctor," she explained.
In addition to the regular childhood illnesses, Cody also suffers from asthma.
"We'd have been lost," without the clinic, Sessions said.
Though she now has Medicaid coverage, the family went four years with no insurance.
"The most we ever had to pay was 10 percent of the bill," she said of the clinic's sliding fee scale.
With more families lacking adequate health insurance, or insurance all together, the health department's clinic provides care for children who otherwise might go unseen by medical professionals, according to Ann Smith, director of nursing at the health department.
"We aren't here to replace physicians. We are a safety net," she explained.
Even families with health insurance are sometimes finding the co-pays more than they can afford. So for all these families, the children's clinic provides care on a sliding fee scale. But Smith is concerned that some children, whose parents aren't aware of the clinic, are going without any professional medical care.
"We want to make sure people know we are here, and know what we have to offer," she said. "We are concerned that people who fall in the cracks don't know where to go."
National studies show that when times are tough economically, families are often forced to cut back on health care, Smith said. The same appears to be occurring now, with the number of pediatrician visits down this year, she added.
"Those kids we're afraid we're not reaching," Smith said. "Those are the kids who end up in the emergency room with a bad cold or flu."
To respond to unmet needs, the health clinic offers comprehensive medical care, including well child visits, sick child visits, referrals to specialists and follow up care.
"It's a full service clinic," Smith said.
Meanwhile, the health department has seen demands for adult care increasing greatly.
"Our adult clinics have gone off the charts," Smith said. "They are putting off their own health care until they are desperate. They shouldn't have to wait till they are desperate."
Many of the adults being served are new patients, such as the man who recently came in only after going for a month without insulin for his diabetes.
"I think we are seeing a new face to poverty," she said.
Uninsured adults are also charged according to a sliding fee scale.
"Nobody is ever turned away due to inability to pay," Smith said.
Some adults have to fight the stigma of seeking help at the health clinic.
"Once they get here, they see it's no different than a doctor's office. But it's hard to take that first step," Smith said.
Bowling Green pediatrician Dr. Michael Lemon, who serves as medical director at the health department, has seen the value of the children's clinic during his nearly 20 years of working there.
"It's the safety net for the county. It gives care to kids who otherwise would not get care," he said.
Through the clinic, serious conditions have been identified in young patients, such as attention deficit, neurological problems, infections and surgical problems.
"I really do think we serve a vital role in the community," Lemon said. "That is terribly important."
Cody Lantz, 7, waits with his mother, Mindy Sessions, to be examined by Dr. Lemon. 9/24/09 (Photo: J.D. Pooley/Sentinel-Tribune)