SIKESTON, Mo. -- Many of the Bootheel's rural poor routinely go without medical care because they don't have health insurance, can't afford a doctor's bill and feel neglected by county health departments, say those who work with grassroots health coalitions.
Some of the poor are unemployed. Others are the working poor who don't even qualify for government-funded Medicaid.
In many areas, there are few doctors and either limited or no public transportation, making it even harder to get medical care, they say. Many ill residents simply stay home.
The Missouri Foundation for Health could change all that.
Foundation officials held a public forum at the Ramada Inn in Sikeston on Saturday. The two-hour meeting was the first of seven scheduled around the state.
The foundation, created two years ago, plans to award grants to health-care organizations and programs for medical services to the poor and elderly in St. Louis city and 84 counties in the state. This includes all of Southeast Missouri and most of the rest of the state, excluding the Kansas City area.
The foundation's assets are about $950 million, making it the largest health foundation in the state. It's run by a 15-member board aided by a 13-member advisory committee. The foundation has a 14-member staff.
About 70 representatives of health-care organizations and grassroots groups from Scott, Mississippi, New Madrid, Pemiscot, Dunklin and Butler counties attended Saturday's meeting.
Many said there needs to be closer collaboration among existing medical services in the region.
Dorothy Walton of Caruthersville, Mo., volunteers her time with the Pemiscot County Heart Health Coalition. She said health screenings do little good because the poor can't afford follow-up visits to the doctor.
"I am concerned about the ones who do not have a job, that have no health insurance," she told foundation officials.
Nichole Gant, mayor of Wilson City, Mo., a town of about 220 people in Mississippi County, said many residents in her community are poor and elderly. Many don't drive. The town has no doctors. The closest medical care is at least seven miles away, she said.
"I sometimes take them to the doctor," said Gant, who wants the foundation to provide funding so residents can get shuttle-bus service to and from doctors' offices.
Susan Smith, a family nurse practitioner from Cape Girardeau, said many of the underserved are black. Smith urged foundation officials to award grants to grassroots health organizations that are reaching out to the needy rather than county health departments.
"The community groups have passion," Gant said.
Former state senator Jerry Howard of Dexter said many women in the Bootheel get little pre-natal care. There's little in the way of preventive health care in rural areas, he said.
Lack of health insurance remains a major problem, he said.
"We continue to have a high population of under-insured and uninsured, with black males and the unemployed topping the list," Howard said.
The foundation began accepting grant applications on Saturday and plans to award its first grants as early as September. In all, the foundation plans to hand out $20 million in grants this year, said Dr. James Kimmey, foundation president.
Kimmey said the foundation staff plans to monitor closely how the grant money is spent.
William Darrell Jean, chief operating officer for Pemiscot Memorial Health Systems in Hayti, Mo., wants some of that money. He didn't say how much.
Pemiscot Memorial, a non-profit venture, operates a hospital in Hayti and four rural health clinics serving residents in Pemiscot, New Madrid and Dunklin counties.
Jean said 90 percent of patients admitted to his hospital are elderly, poor or disabled. The hospital wrote off $2.4 million in uncompensated medical care over the past year.
The hospital delivers about 200 babies a year. Eighty percent are born to unwed mothers, he said.
The hospital, he said, is the medical system of last resort for poverty stricken residents who have nowhere else to turn.
But Jean said that without added funding, the hospital will continue to struggle to recruit doctors and nurses to an area that desperately needs medical care.
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