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Sept. 26, 2011
PRATT Starting Saturday, uninsured adults and children who live in and around here will have access to a hometown safety-net clinic.
They won’t have to drive 50 miles to Hutchinson or 75 miles to one of the free or reduced-cost clinics in Wichita.
The new Pratt clinic will be a fresh example of local response to the ongoing and growing problem of uninsured Kansans in all parts of the state who lack access to basic health care.
The problem is considered particularly acute in rural counties.
“Research has shown that in Pratt County, we have about 1,000 people who are uninsured and who are living at or below 150 percent of the federal poverty guidelines,” said DeWayne Bryan, director of the Pratt Health Foundation and one of the clinic’s organizers. “When you add in the surrounding counties, that number goes to 5,000.”
The total population of Pratt County is below 9,500, according to the U.S. Census Bureau.
‘Starting out slow’
In the past, Bryan said, most of the county’s low-income uninsured people have not had access to a safety-net clinic. Instead, they have either put off seeking medical care or used the emergency room at Pratt Regional Medical Center, which under federal law is obliged to help all comers regardless of their ability to pay.
One concern is that the new clinic eventually could become overwhelmed by regional demand.
“I think we’ll be OK starting out,” Bryan said. “But as word gets out and we start getting all kinds of people from outside Pratt County — we won’t turn them away, but some adjustments will have to be made. That’s why we want to start out slow.”
On its opening day, the clinic will be open from 9 a.m. to noon. Then, if all goes according to plan, the new Agape Health Clinic will be open thereafter on the first Saturday of each month.
In July, the clinic received a start-up grant for $8,126 from the Kansas Department of Health and Environment.
It will be used to hire a part-time director, Bryan said.
“These grants, really, are a sign of being a Kansan,” said Robert Stiles, director of the Primary Care Office within the KDHE Bureau of Community Health. “They’re about local communities looking to meet their needs locally.”
In Pratt, for example, the clinic will be housed at the Chandler School of Nursing and Allied Health at Pratt Community College. Local physicians are donating their time. Church groups have been raising funds.
“A lot of people are involved in this,” Bryan said, “but I have to say it was the churches that got the ball rolling.”
‘Something’s got to be done’
Of the 44 safety-net clinics in Kansas, six have started since 2008.
“I think it’s a sign of the times,” said Cathy Harding, executive director of the Kansas Association for the Medically Underserved, which represents the safety-net clinics. “As more and more communities become more and more aware of the needs that are out there, the leaders in those communities are stepping up and saying, ‘We need to do something.’”
For example, the Franklin County Health Department opened its part-time safety-net clinic last month. Its hours are 10 a.m. to 1 p.m. each Monday.
“It’s been very positive so far,” said Becky Hastings, nursing supervisor for both the department and the clinic. “I think with the economy the way it is, and with so many people not having insurance, not having a doctor and not having any place to go — the community just came together and said, ‘Something’s got to be done.’”
The clinic, she said, is collaborating with the local hospital and several physicians.
KDHE awarded a $10,000 grant to Franklin County.
Federal dollars also are playing a role in encouraging the development of new clinics.
Last week, federal officials announced that the City-Cowley County Health Department in Winfield and the Labette County Medical Center in Parsons each had been awarded $80,000 grants to help them lay groundwork for starting community health centers.
“In Labette County, 20 percent of the people are uninsured,” said Jodi Schmidt, chief executive at the Parsons hospital. “We have a high level of unemployment, which means people have lost their health insurance, and we’ve had a lot of employers decide that they can’t keep shouldering the cost of insuring their employees.”
Schmidt said plans for the clinic are in the early stages and that local officials essentially are starting with a blank slate.
“That’s what’s so exciting about this grant,” she said. “We’re not wedded to any one model, so we’ll be bringing all the right players to the table. We’ll be collaborating with all the different providers — dental, mental health, the clinics that are here now — to come up with a solution that’ll work for Labette County.”
The expectation is that the new clinic will replace one at a local church that’s now open from 3 p.m. to 6 p.m. on Thursdays.
“What’s happening, basically, is that demand is outstripping the volunteers’ ability to keep up,” Schmidt said.
In Winfield, the initiative is being driven by a 2005 citywide needs-assessment survey.
“Fifty-two percent of the respondents cited the need for increased access to health care,” said David Brazil, director of the City-Cowley County Health Department.
“The planning grant is with the health department because it made the most sense for us to file the application,” Brazil said. “But I can assure you that this is very grassroots. The process is wide open.”
Brazil and Schmidt each said they hope that their local clinics, once they are launched, will eventually become federally qualified health centers, a designation that makes them eligible for up to $650,000 a year in federal support.
Today, 13 of the state’s 44 safety-net clinics in Kansas are federally qualified health centers.
The planning grants are part of an $11 billion funding package tied to the federal Affordable Care Act. The grants, which are being distributed nationwide, are meant to encourage states to create and expand their safety-net clinic networks.
“That’s $11 billion over a five-year period that we just wrapped up the first year on,” KAMU’s Harding said. “We’ve been in touch with a lot of communities across the state, letting them know that if they’re interested in starting up a safety-net clinic, now’s the time to do it.”
Health Ministries Clinic, an existing safety-net clinic in Newton, also received an $80,000 planning grant aimed at helping it become a federally qualified clinic.
There are other developments under way that are expected to help increase access to health care.
In the northwest Kansas community of Hoxie, the Sheridan County Health Complex is using a $93,673 grant from KDHE to help underwrite the costs of paying six out-of-town doctors to staff its medical clinic.
The physicians — one from Colby and five from Quinter — will each spend one day a week working at the complex, which includes a hospital, nursing home, assisted living facility and the clinic.
“We lost our one full-time physician in 2008, and we’ve not had one since,” said Pam Popp, the clinic manager. “It’s very hard to recruit a physician to the western half of the state.”
The fact the rural clinic has access to six out-of-town physicians is unusual.
"That was one of the primary factors in our securing the grant," said Steve Granzow, the health complex’s chief executive. "We're cooperating with the physicians in our area instead of competing with them. It's a collaboration that’s providing us with a lot of access to care."
The clinic accepts patients who are uninsured, but those who are eligible are expected to apply for Medicaid, the state/federal program that provides coverage for the poor and disabled.
The KDHE grant also will be used to train and support a worker to help patients fill out Medicaid applications.
“We’re what they call a 'frontier county.' We have fewer than six people per square mile,” Granzow said. “That means we don’t have a (Kansas Department of Social and Rehabilitation Services) office in Hoxie, so we’d find ourselves seeing patients who in all probability were eligible for Medicaid but who couldn’t fill out the forms. And we didn’t have anybody within a couple hours of Hoxie who could help them.”
Those patients, Granzow said, tended to put off seeing a doctor until they were in crisis.
The social service director at the health complex’s nursing home is now trained to help patients apply for Medicaid.
“It’s a steady business,” Granzow said.