Standing in the packed waiting room, three pajama-clad children playing at her feet, Thousand Oaks resident Donna Luft stared incredulously at the young mother cuddling an infant on a nearby chair.
"You mean it's $5 for an immunization? You pay $5 and you can see a doctor?" Luft asked in disbelief.
At the tiny Conejo Free Clinic, the answer to both questions is an emphatic "of course."
For the past two decades, free clinics in Thousand Oaks and Simi Valley have provided inexpensive services to residents who fall in an awkward middle ground--not poor enough to qualify for Medi-Cal, not wealthy enough to purchase private health insurance.
Volunteer physicians stop by after work to help out single moms suffering from burning migraines, unemployed men struggling with depression, red-faced babies bawling through infected gums.
Volunteer attorneys hold regular bankruptcy and divorce classes to counsel residents worried about failing businesses or messy marriages.
And volunteer nurses offer podiatry care for senior citizens, clipping the toenails of those too frail or arthritic to bend down.
"I paid $121 for my son to get his shots before school started," said Luft, a day-care provider who came to the clinic for a tuberculosis test and was astounded to discover the range of services. "I'll never do that again."
As Luft found out during her tuberculosis test one recent evening, patients need not fill out claim forms or present insurance. Instead, they simply pay a donation if they can--$5 per visit at the Conejo Free Clinic in Thousand Oaks and $10 at the Free Clinic of Simi Valley.
That donation covers everything from checkups to gynecological exams to blood tests. Often, the doctors throw in enough free medicine to last several months.
Such service seems almost miraculous to patients like Steve Smith, a self-employed Thousand Oaks construction worker raising two children on his own.
Hit hard by the slumping economy, Smith dropped his own health insurance years ago, though he still tries to scrape up enough money to cover his children, at a cost of $196 a month.
"I haven't been to the doctor in 30 years," Smith said as he sat on a plastic seat in the Conejo Free Clinic waiting room.
But a suspiciously lumpy gland scared him so much that he headed to the free clinic for a checkup last week. "This is great when you're down on your luck," he said. "I can't imagine what you would do without a place like this. Where would you go?"
Founded in the early 1970s, the free clinics in Thousand Oaks and Simi Valley until recently offered the only low-priced medical care in eastern Ventura County.
"We started when there was an economic downturn, a major epidemic of sexually transmitted diseases, and many people returning from Vietnam," said Sharron Baird, who helped establish the Conejo Free Clinic nearly 18 years ago.
"We figured we would fill a need and that would be it. Well, we're still here--and now look, we're in a recession, we have a health care crisis again," Baird said.
Free clinics in Ventura and Oxnard folded years ago, in part because the county began boosting its services to Medi-Cal patients and indigent residents on the western side of the Conejo Grade.
But the Thousand Oaks and Simi Valley free clinics continued to thrive, drumming up enough volunteers and equipment donations to serve thousands of patients a year on annual budgets of less than $75,000.
Although the free clinics are located in two of the county's wealthiest communities, they never stand idle. Waiting lists for appointments can be weeks long.
"Our phones are just choked with calls," said Diane Pettifor, a part-time receptionist at the Conejo Free Clinic. "The need will always be there because the working poor will always be there."
To help meet some of that need, the county government this month opened a public clinic in Simi Valley to serve Medi-Cal patients, and a similar center is under construction in Thousand Oaks.
Both county facilities will offer more comprehensive services than the free clinics.
Dr. Chris Landon, who will direct the county's Thousand Oaks clinic, said he aims to provide a "bilingual, bicultural facility" that will supplement the Conejo Free Clinic. Because his clinic will focus on Medi-Cal patients, Landon said he expects to serve "a different segment of the population."
Directors of the free clinics agreed. Despite the new competition from county facilities, they said, the free clinics will always attract patients.
"We're as much a mainstream provider as anyone else, and we have our own niche," said Fred Bauermeister, director of the Free Clinic of Simi Valley.
Recounting the case of one young man who refused to go to the county medical center despite severe injuries from a car accident, Bauermeister said many patients seem to prefer the atmosphere at free clinics.
"We're very personal, very small, and you're not sitting in some huge waiting room," he said.
But free clinic care does have drawbacks.