As more and more people lose their jobs, they're also losing their health insurance. When they get sick, free or income based clinics come to their rescue.
Falls Community Health in Sioux Falls is federally funded. And they don't turn anyone away, no matter their ability to pay. That also means they keep a close eye on their budget.
Several years ago Sylvia Thorstenson was living on a shoestring budget. She started her own business and her out-of-pocket health insurance cost was astronomical.
"When I started having trouble with my blood pressure and some other things, I started coming down here," Thorstenson said.
She came to Falls Community Health because she could pay, based on what she made.
"When you have to go to the doctor for recheck every week or every two weeks, that takes an awful lot more out of your income too," she said.
"We offer a sliding fee discount and that's where the federal assistance comes in. We receive federal dollars to be able to offset the cost of healthcare by providing that sliding fee discount," Assistant Public Health Director Jill Franken said.
Franken says the facility brings in nearly $2 million each year. That includes federal dollars and grant money. But she says the need for funding is greater than ever before.
"The number of our uninsured is about a 20 percent increase. The number of people that are higher level of poverty is increasing by about that same amount," Franken said.
Franken says they've especially noticed an increase in the need for mental health services.
"It's very unfortunate because families are feeling desperate. They're very concerned about the immediate future," Franken said.
They're also seeing a lot of new faces.
"The cost does go up but the unfortunate thing is we really can't increase beyond what we've got in our budget to handle it," Franken said.
That means patients may not be seen as soon as they'd like. The health facility is applying for more grants to meet the increasing demand.
"There's just so much we can do, but we're trying to expand where we can," Franken said.
The health facility is getting more help from the government. Over the next few years, Falls Community Health will receive more than $900,000 dollars in stimulus money.