For the past 15 years, a non-profit program in Sedgwick County called Project Access expanded options for uninsured patients by increasing access to health care and coverage. Now, the program is forced to retool its budget after unexpected cuts from the city and county. KMUW’s Deborah Shaar has the story...
Dr. Debra Messamore is doing a final re-check on her patient, Stephanie.
It’s been about two months since Dr. Messamore performed a much-needed operation on Stephanie, ending five years of pain and suffering.
“I had constant pain every single day," Stephanie says. "I have been from one doctor to another doctor to another doctor, and the only thing they would do is prescribe pain pills. You know, trying to fix the problem with pain pills or muscle relaxers. Never any answers.”
Stephanie desperately needed answers. She is 32 years old. A mother of five girls, all under the age of 13. The daily pain was affecting her home life, and it took its toll at work.
As the general manager of a Wichita restaurant, Stephanie took time off on the bad days, but other times, she just worked through the pain.
“There were different times where we were in the middle of a major rush and I needed to be paying attention to what I was doing," she says. "The pain was too much; I’d have to just go sit down.”
Late last year, a doctor at a community clinic referred Stephanie to a program called Project Access, which then in turn sent her to Dr. Debra Messamore.
“Project Access patients come in not expecting anything, just wanting a little bit of help, and they are just so grateful," Messamore says. "They understand that we are not getting paid to take care of them and the hospital is not getting paid to take care of them; that we’re doing it for free for them.”
Dr. Messamore is one of more than 600 family doctors and specialists in Sedgwick County who donate their services to help people who need care but don’t have insurance.
“Most of the time, when we do the surgery, it eliminates whatever problem they’ve been having for a number of years," Messamore says. "It gets them back to where they can actually get a full-time job and work all the time and it relieves their pain and suffering."
Project Access began in 1999 as a unique collaboration of doctors, dentists, hospitals and pharmacies willing to address the health needs of the uninsured.
The program coordinates donated medical care and also provides prescription medicines and medical supplies.
From the County Commission Meeting, Jan 21, 2015
“Commissioners, my name is Anne Nelson and I’m the executive director of Central Plains Health Care Partnership. We are a non-profit affiliate of the Medical Society of Sedgwick County, and we do administer Project Access.”
Anne Nelson has been the director of Project Access since day one. She says the program is successful because it provides options for people to see specialists when primary care is not enough.
“The safety net clinics have grown in this community, and that’s wonderful," Nelson says. "They’re providing a lot more primary care to a lot more people in Sedgwick County. But what happens when those patients need something beyond the scope of those clinics? That’s when we step in.”
Over the years, Project Access has leveraged about $170 million worth of donated medical care to help more than 12,000 people in Sedgwick County.
Lab work and diagnostic testing such as MRIs are donated as needed.
The annual budget of $800,000 only covers the program’s complex administration and some prescription medicines.
Funding comes from The United Way of the Plains, the City of Wichita and Sedgwick County. All three provided the initial support needed to create Project Access.
Director Nelson says the funding stream has been consistent but, when both the city and county made cuts in recent years, it has been tough.
“If you think of our funding base as a stool," Nelson says, "two legs of that funding stool have been cut and we’re concerned, at some point, that the stool is just going to tip over. We’ve implemented a pretty significant fundraising development plan, but we’re really counting on the United Way, the City of Wichita and Sedgwick County to continue their support.”
The city reduced its funding by $50,000 last year to $175,000.
Knowing that the cut was coming, Nelson applied for and later received a grant from the Kansas Health Foundation to make up for that loss.
But then came the blow from the county.
“The reality is that the economy is tough," County Commissioner Jim Howell says. "We have to constantly review and evaluate what we are doing here.”
At the January 21 meeting, Commissioners Howell, Richard Ranzau and Karl Peterjohn voted to cut the funding to Project Access to $175,000 equal to the city’s funding level.
This reduction occurred despite the fact that commissioners had approved $209,000 back in August when they finalized the county budget, before Howell’s election.
Howell says he voted in favor of the $34,000 reduction because he questioned whether Project Access was considered an essential government service.
“There was some discussion that maybe this should go to zero," he says. "Is the glass full? No, not all the way full. But it’s mostly full. So you know the $175,000 that the county approved was in many regards a great success for those who support this program.”
Commissioners Tim Norton and Dave Unruh voted against the cut and were in favor of maintaining the previously budgeted $209,000, the same level of funding the county provided the past two years.
Commissioner Unruh calls the cut short-sighted.
“Sedgwick County has been a good partner in Project Access for all these years," he says. "To try and split hairs on the funding when it was approved in our budget, does not seem to me to be the right course of action.”
Project Access Director Anne Nelson is now reworking the current budget, and she says the outcome will be disappointing.
“We will have less prescription support available for patients this year, and I’m very concerned about that," Nelson says. "The other option was to cut a staff position and we can’t do that. If we cut one direct service staff position, we serve 350 fewer patients this year. That’s not acceptable.”
Dr. Donna Sweet has been a doctor and professor of internal medicine at KU School of Medicine - Wichita for 33 years. She’s currently serving on the board for the Central Plains Health Care Partnership and is the past president of the board for the Medical Society of Sedgwick County.
She says she’s worried about the funding cuts coming to Project Access.
“It seems paradoxical that we as physicians in the health care system have to work so hard to be able to give away our time and services," Sweet says. "All we’re asking is some infrastructure money to help administer the program. To be done well, you have to keep track of patients. You have to enroll them and make sure there are no other ways that you can get them health insurance. “
As Dr. Messamore wraps up her visit with patient Stephanie, she knows her work has changed Stephanie’s life.
“Five years ago I would have never thought I would have a day without pain," Stephanie says. "To actually to have a day where I'm not just going through the physical pain is amazing.”
Improving access to health services in the county for patients like Stephanie is one of the five health priorities the county identified back in 2010.
The county health department created a “Community Health Improvement Plan” in 2013 that, among other things, specifically calls for increasing the number of patients served by Project Access.
The plan’s deadline for implementing its strategic measures is the end of this year.
Sedgwick Co. Community Health Improvement Plan
Listen to part two of Deborah Shaar’s series looking at the county commission‘s recent decisions involving health issues in the community here:
http://kmuw.org/post/sedgwick-co-commission-change-philosophy
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