Smith is the chief executive officer of Cross Trails Medical Clinic, one of several health-care facilities and programs that have surfaced in Southeast Missouri in recent years to help address the medical needs of low-income and disadvantaged families.
While the needs seem endless, Smith says Cross Trails and other local programs continue to expand and improve the lives of many families.
"There is a special needs population here, those without insurance, the underinsured. We see Medicare, Medicaid patients, we see the indigent," said Smith.
In the past, such people may have accessed emergency room care for basic medical needs or have simply gone without care, said Smith.
Cross Trails offers a sliding fee and, in some cases, free care to families that qualify. There are facilities in Marble Hill, Mo., Advance, Mo., and Cape Girardeau that offer primary medical care and dental care. The clinic has a special program for diabetic patients, and Smith said they are currently working on setting up an in-house pharmacy.
"Our biggest need is for affordable medication," she said.
While Cross Trails currently works with pharmaceutical companies for discounts on prescriptions, the in-house pharmacy, which will initially be established in Cape Girardeau, will help expand the program.
While medical care represents a substantial need in Southeast Missouri, dental care for the disadvantaged is also hard to come by.
With that in mind, the Elks Mobile Dental Units travel around the state throughout the year, stopping in places such as Cape Girardeau to offer dental services to developmentally disabled and mentally handicapped adults and children as well as low-income individuals.
"Especially for our clients, it's difficult to get dental care," said Barbara Cushman, program manager for the dental units. "There are some dentists who serve the disabled but not as many as we'd like. We're always busy."
Cushman said recent Medicaid cutbacks have upped the number of patients the units help.
"We're swamped with calls. It's heartbreaking when we listen to these calls. Some of them we can't help," Cushman.
Three of the units -- vans equipped with basic dental instruments -- travel around the state offering routine care such as fillings, exams, cleanings and simple extractions.
"It's basically a dentist's office on wheels," said Cushman. "In some cases, it's like, if we're not there, who would be?"
Cape Girardeau's two hospitals also offer services that target disadvantaged families, from offering financial help to free preventive services.
At Southeast Missouri Hospital, social services coordinator Julie Metzger said Southeast's Patient Care Fund is helping people when they need it the most.
The Patient Care Fund, administered through the Southeast Missouri Hospital Foundation, Metzger explained, "enables us to help a lot of people in the short term while our social services department tries to help patients find alternate sources for long-term support if it's needed."
Saint Francis Medical Center also has several programs in place to help low-income and disadvantaged families.
According to hospital representative Trevor Sumner, Saint Francis' uninsured patient program, Sister Esther Fund, cancer fund and community charity program combine for $2 million in charitable work each year.
The programs provide not only medical services but also financing for transportation, hotel stays and other costs.
"Nationally, there are 44 million people without health insurance," said Sumner. "So there's definitely a significant need here."
To help cut down on future medical costs, Saint Francis also offers a variety of free preventive care for patients.
Sumner said such care includes free screenings and checkups for vascular problems, stroke risk assessments and mammograms through the hospital's Dig For Life program.
At Southeast, Metzger said medication is the biggest immediate need for patients who may be eligible for assistance through the patient care fund.
"Food or medications? It's a tough choice that too many people have to make every day," Metzger said.
When patients leave the hospital, most go with one or more prescriptions they need in order to avoid complications and possibly another hospitalization, she explained. "It's our goal to help get this immediate need met so that the patient can return to work and perhaps get on a medication assistance program."
But medication isn't the only immediate need.
"Patients also need help with medical equipment, nutritional supplements, even a ride home," Metzger continued. "We try to look at the whole person and how best to help his or her special situation."
One patient at Southeast, she said, was a new mother whose baby was born with a cleft palate.
"Because of that, she couldn't breast-feed but really wanted to. We were able to provide her with a breast pump. For most people, that's not a major expense. For her, it was. A very small dollar amount made a very large difference in the lives of this patient and her baby."
The greatest financial burdens often fall on terminally ill patients. Through donations to another fund, also administered by Southeast's hospital foundation, Southeast Hospice can provide assistance to those in need during their final days, including help with utility bills, meals, ambulance transport and, as in the case of a young mother, legal fees to allow her to appoint a legal guardian for her daughter. Medications and durable medical equipment are also provided under the hospice benefit to those who qualify.
"Imagine a program that not only takes care of your physical, emotional and spiritual needs at a time when you've been told that 'there's nothing more that can be done,' but will offer aggressive symptom management along with assistance for specific financial needs," said Sheila Beussink, Southeast's home care administrator.
335-6611, ext. 128