Health Care
Pettis County
Caring Communities Partnership
Core Result: Children & Families Healthy
Benchmark: Preventable Emergency Room Admissions
February 2002
Objective
To decrease emergency room admissions of Pettis County residents by 20% from 11,296 admissions in 1999 to 9,037 by 2003 (per MICA data)
Strategies
The most pressing health care concern for Pettis County is access for underserved populations to affordable, quality primary health care. Residents without health care insurance tend to delay seeking care – so that a preventable situation turns into treatment at an emergency level – are getting primary care in the ER at extraordinary cost.
Many newly arrived immigrants find themselves without health insurance and a primary health care provider so their alternative is to seek help through the emergency room services. By having a free clinic available we are hoping that people will seek medical care at an earlier stage and thus prevent an illness from escalating to an emergency situation.
Community Free Clinic – we will support the work of the Free Clinic, which provides medical services to the uninsured and underinsured, by providing volunteer staff through the RSVP program (Retired Senior Volunteer Program) at Pettis County Community Partnership. The Executive Director of Pettis County Community Partnership serves on the board of the Free Clinic.
Emergency Medical Fund – is available to cover over-the-counter medicines such as aspirin and pain relievers, cold medication, etc rather than having citizens go to the emergency room for these types of medication.
Health & Safety Fair – will educate the public on the risk factors and warning signs of heart disease and stroke.
Spanish Speaking Interpreter – will help Latino families with medical needs.
Successes:
Believing in the premise that all people should have access to medical care, community individuals and health and human service agencies got together to start a free clinic to help people in this community receive primary health care services. That one idea blossomed and developed into the Community Free Clinic. Many community organizations and individuals have contributed to the organization of the Community Free Clinic, they include: Pettis County Community Partnership, Division of Family Services, Pettis County Health Center, Center for Human Services, The Salvation Army, Bothwell Regional Health Care Center, Dr. D. Allcorn, Dr. T. Reed, Dr. A Gonzalez, Dr, V. Mangunta, Dr. K Azan, and Harmony Baptist Association.
The Community Free Clinic is totally staffed by volunteers including physicians, nurses, and receptionists. The financing to date has been from donations by patients and other interested persons.
Costs have been kept low by donations of supplies and pharmaceuticals from various drug representatives. The use of the building is donated by one of the physicians. Clients donate about $200 per week or average about $2.00 per person.
Challenges:
Physician staffing at the Community Free Clinic may escalate to crisis status soon as the two primary doctors who volunteer are already retired and need to cut back on the amount of hours they work. Without the free clinic, emergency room visits will undoubtedly rise well above acceptable numbers. Translated into dollars and cents that means people will pay up to three times as much for routine care as they would have paid at a physician’s office. These are people who are unable to afford the medical expenses in the first place.
Of the 11,296 local emergency room admissions in 1999 twenty-six percent of them were categorized as “self pay” or “no coverage” which translates into higher health care costs, as many individuals in this category will not be able to pay their bills.
A major employer of the Latino population here in Pettis County has mandatory health care insurance for their employees but the insurance does not go into effect for 60 days after the hire date. During that 60 day period the employee is on their own to pay for medical expenses, which they may not be able to afford.
Observations/Actions:
As a result of working on preventable emergency room admissions, we found that many families are going without proper dental care. Very few dentists take Medicaid patients so it is easier for families to do without than to drive out of town for a Medicaid dentist. The Multicultural Health & Welfare committee is working on strategies concerning dental care.
Just when we think emergency room visits have declined in the period 1996 through 1998, the numbers in 1999 indicate a rapid climb in just one year. A concerted effort is being made to understand this trend. Numbers for the year 2000 have not been released to date to see if this trend is continuing.
According to www.healthpages.com going to an emergency room instead of scheduling a doctor’s appointment has become a trend in this country. They go on to say that in 1996, a whopping 55% of the 90 million visits to emergency rooms were unnecessary.
Funding/Return on Investment
Caring Communities | $18,748 |
Local Investment | $21,850 |
Other State & Federal | $25,000 |
In-Kind | $426,937 |
Total | $492,535 |
For every Caring Communities dollar we receive we are able to leverage $23.94 to see that children and families are healthy.
The clinic is staffed by volunteers who include physicians, nurses, clerical staff and other caring and concerned citizens and the use of the building is donated by one of the physicians.
Noteworthy
- Several members of the Community Free Clinic board recently
visited the Family Health Center in Columbia, MO, which is a member of the
Missouri Primary Care Association.
- Because of the physician staffing problem going forward we may, in the long
term, consider becoming a satellite office of the Family Health Center in
Columbia. Or we may look at partnering with nearby counties to establish a
Federally Qualified Health Center (FQHC).
- RSVP spent 3,895 volunteer hours at the Free Clinic last year – making
appointments, filing records, seeing patients, etc…
