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Community Health Centers Offer Lifeline To Uninsured And Underinsured Kansans

Bryan Thompson
Heartland Health Monitor

Health centers that serve Kansans who lack insurance or struggle to pay for primary health care are seeing no lack of demand for their services.

Rebecca Lewis was once among those Kansans. In 2011, the McPherson woman found herself working three part-time jobs and trying to complete a college degree. As a single mom with three young boys — then ages 8, 5 and 2 — it was hard to make ends meet.

“My earned income was under $10,000,” she says. “I was experiencing extreme survival mode. Every single day is a fight. So, plugging in everywhere I knew how and running my tail off every day. And it was always about the rent, and the lights, and transportation.”

Although her sons had health coverage through the Kansas Medicaid program, she found it challenging to find a doctor who would accept them as patients. She could have taken them to community health centers in Hutchinson or Salina, but those were 30 miles away. So Lewis did what a lot of people in her situation do.

“There were times that I would wait until later in the evening and take them to the emergency room when I knew that they needed antibiotics, because it was a better short-term choice for me and my children if I didn’t have to miss work or miss school and go out of town,” Lewis says.

Relying on the emergency room for health care is expensive and meant that her boys only saw a doctor when it was absolutely necessary. They missed a lot of the routine preventive care kids are supposed to get.

Lewis and others who couldn’t afford health care wondered why McPherson didn’t have its own clinic to serve uninsured and underinsured patients. Then a local committee studying ways to address poverty came up with a solution: partner with an existing federally funded health center to open a satellite clinic in McPherson.

Wichita-based GraceMed has agreed to do just that. As soon as a location in McPherson can be finalized, the committee plans to conduct a fund drive to raise the money to pay for the building and equipment.

“We will take over, in terms of providing the medical provider and the support staff to deliver that care,” says David Sanford, chief executive officer of GraceMed, a ministry of the United Methodist Church that operates 10 clinics serving 35,000 patients in the Wichita area.

“It’s just a great opportunity to bring clinical services to a community without repeating all of the administrative costs that would go into establishing an independent entity,” he says.

Sanford expects the clinic in McPherson to be sustainable for the long haul. That’s based on the assumption that 60 percent of the patients there will have some form of insurance, whether it’s private coverage, Medicare or Medicaid. Sanford says that target would be easier to meet if Kansas would expand Medicaid eligibility http://www.khi.org/news/article/hospitals-leader-to-brownback-medicaid-expansion-would-help-us-innovate .

“Without Medicaid expansion, the state is making it even more difficult for people to access quality care," he says. “They’re basically forcing them to get into the bad habit of going to the ER for non-emergency care. They’re forcing people to wait too long to come and be seen by a physician just because they don’t have the resource to do so.”

And people literally are dying because of it, according to Krista Postai, who runs the Community Health Center of Southeast Kansas. The Pittsburg-based organization operates 10 health centers that serve 40,000 patients in four counties in southeast Kansas — an area with some of the state’s least-healthy residents http://www.khi.org/news/article/southeast-kansas-counties-still-rank-low-for-health .

“Down in southeast Kansas, depending on what county you live in, you’re likely to die five or 10 years earlier than other Kansans,” Postai says. “The No. 1 reason for that is access to care, and that’s why every night when I go to bed I pray that Medicaid will expand someday.”

The Community Health Center of Southeast Kansas is among six Kansas health centers that will receive $4 million in federal funding to open new facilities http://bphc.hrsa.gov/programopportunities/fundingopportunities/NAP/0815awards/ks.html . Postai’s organization will use $475,000 to open a new health center in Parsons, replacing an all-volunteer clinic that had been open one afternoon a week.

The health centers are able to provide basic care for uninsured patients, Postai says. However, if uninsured patients need specialty care — like cancer treatment or a heart bypass — they may be out of luck.

“If they had Medicaid, I could refer them in to specialists,” Postai says. “But right now we are finding it almost impossible to find providers who will take patients who have no coverage.”

Currently, 45 percent of the patients at Postai’s clinics have no insurance. She estimates that figure would drop to 10 percent if Kansas expanded Medicaid.

There’s no end in sight to the demand, she says, as patient volume at the clinics has been growing around 18 percent each year.

Bryan Thompson is a reporter for KHI News Service in Topeka, a partner in the Heartland Health Monitor team.

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