The federal government is providing more than $4 million this year to open six new health centers in Kansas. These clinics offer comprehensive primary care to everyone, whether the patient has insurance, or not. As Heartland Health Monitor’s Bryan Thompson reports, they can be a lifeline for people who struggle to pay for health care.
Rebecca Lewis says she’s been struggling to get out of poverty since she was 15. But 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, it was hard to make ends meet.
“My earned income was under $10,000," Lewis 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 coverage through the Kansas Medicaid program, it was hard to find a doctor who would accept them as patients. She could have taken them to a community health center 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," she says.
Relying on the ER for health care is expensive. It 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 couldn’t have its own safety net clinic. But McPherson isn't one of the cities receiving federal funding to open a new health center. 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 can be finalized, the committee plans to conduct a fund drive to raise the money to pay for the building and equipment.
"Then we will take over, in terms of providing the medical provider, and the support staff to deliver that care," says GraceMed CEO David Sanford.
On a recent weekday afternoon, GraceMed’s lobby is buzzing with patients of all ages. GraceMed currently operates 10 clinics, serving 35,000 patients in Wichita.
“I think 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," Sanford says.
Even without federal grant money, 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, Medicare, or Medicaid. Sanford says that target would be easier to meet if Kansas would expand Medicaid eligibility.
“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 are literally dying because of it, according to Krista Postai, who runs an expanding network currently at 10 health centers in four counties in southeast Kansas.
“Down in southeast Kansas, depending on what county you live in, you’re likely to die five or ten years earlier than other Kansans, and the number one reason for that is access to care, and that’s why every night when I go to bed I pray that Medicaid will expand some day," Postai says.
She says health centers provide basic care for people with no insurance. However, if they 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.”
Right now, 45 percent of the patients at Postai’s clinics have no insurance. She estimates that figure would drop to ten percent if Kansas expanded Medicaid. And Postai says there’s no end in sight to the demand: Her patient volume has been growing around 18 percent each year.
Bryan Thompson is a reporter with Heartland Health Monitor.