Cape clinic marks 10 years of serving low-income patients

Monday, August 13, 2007
Cross Trails Medical Center chief executive officer Vicki Smith, right, discussed community health services with other local and state health-care stakeholders Thursday. Cross Trails, which is celebrating 10 years in Cape Girardeau, assists uninsured and underinsured residents with health issues. (Kit Doyle)

Nearly half of the patients treated at Cross Trails -- 44 percent -- have no insurance.

Sharon Fuller delayed taking care of a knee injury for a decade. Mary Campbell and her two children skipped dentist appointments for three years. Neither single mom felt they could afford to get medical treatment.

Each eventually made appointments at Cross Trails Medical Center at 408 S. Broadview St. in Cape Girardeau.

It cost Campbell, 43, of Cape Girardeau, $20 for a doctor's visit that she estimates would cost $60 to $80 elsewhere. She earns less than $8 an hour as a home health-care aide. She has no health insurance.

"I can afford to actually go to the doctor if I'm sick," she said, summing up her relationship with Cross Trails.

The clinic offers routine checkups; tests such as blood work, Pap smears or mammograms; discounted or free medication and education programs.

Vicki Smith, Cross Trails' chief executive officer, said people with little or no insurance often skip getting preventive health care.

"They don't have money, they don't have transportation or they don't know about Cross Trails," she said.

According the to Centers for Disease Control and Prevention, most uninsured and underinsured people end up in hospital emergency rooms, which are required by federal law to treat everyone.

Fuller, 59, quickly learned what it meant to have regular medical care. She repeatedly denied having chest pains -- worried about the cost of admitting to them -- but doctors and nurses saw symptoms of heart problems and tested her. Fuller, whose knee resulted in her being permanently disabled, was referred to a heart specialist. She has three stents, has lost more than 100 pounds and feels better.

"I wouldn't have gone to the emergency room," she said.

Like 20 other community health centers in Missouri and 1,100 nationwide, Cross Trails is the outgrowth of President Lyndon Johnson's War on Poverty campaign, which created clinics for low-income patients.

Nearly half of the patients treated at Cross Trails -- 44 percent -- have no insurance. Those with insurance make up 8 percent; 32 percent receive Medicaid and 16 percent have Medicare accounts, according to Chrissy Warren, Cross Trails chief operating officer.

Warren said not every patient is low-income. Four payment levels range from $20 for the poorest patients to full payment by those with insurance. Expansion plans are underway at each of its three locations -- in Cape Girardeau, Marble Hill, Mo., and Advance, Mo. -- and clinic operators hope to draw more insured patients, but area hospitals don't feel threatened. According to a CDC report issued in June, uninsured people make almost twice as many trips to the emergency room as those with insurance.

"We value Cross Trails and encourage its growth and development," said Linda Brown, director of emergency services for Southeast Missouri Hospital.

The clinic offers a diabetes care and education program now used by 600 patients, Warren said.

Cross Trails's patients are referred to specialists, but also encouraged to return for routine visits. A study released Aug. 6 by the National Association of Community Health Centers indicates health-center patients pay 41 percent less -- $1,810 per person -- compared with patients seen elsewhere.

Fuller, of Marble Hill, Mo., said she prefers driving to the Cape Girardeau office because she likes the people there. Not all those seen by the clinics' doctors and nurse practitioners return.

Wanda McGee of Cape Girar­deau stopped taking her blood pressure medication after getting frustrated by Cross Trails' paperwork. The single mother of five said she's looking elsewhere for her prescriptions but continues to bring her son, Myles, 17, to Cross Trails for health checks. She said she likes the doctors.

"It is a lot of paperwork," Warren said. "Every 90 days, they have to do new paperwork. That's not our requirement, that's required by the drug manufacturers."

Patients, she said, must decide if repeatedly filling out paperwork is "worth that to get your medication for free."

Patients who miss three appointments will not get another one, although they can sit in the waiting room for an open exam time. Those who fall behind in payments can also lose the chance to use the clinic's services.

"We're not a free clinic," Warren said. "We have a sliding fee scale. A person with little or no income pays $20 to see the doctor and get in-house labs and X-rays."

Warren said Cross Trails employs 50 people, including two dentists, two dental hygienists, three physicians and three nurse practitioners.

Patients who regain and retain good health find ways to give back, too. Fuller, who cares for her legally blind daughter, volunteers regularly for front desk and gift shop duties at Poplar Bluff Regional Center South, while her daughter attends classes at Three Rivers Community College. Campbell said she is attending classes to be a licensed practical nurse.

335-6611, extension 127

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