CLINC WOULD TREAT MEDICAID PATIENTS

Medicaid patients in Cape Girardeau, Bollinger and Stoddard counties would have regular access to a doctor if federal funding is received to establish medical clinics, a local health official said Friday.

The clinics would also serve others as well, including those on Medicare and the uninsured.

The Cape Girardeau County Public Health Center and the health departments in Bollinger and Stoddard counties plan to seek a federal grant this summer to establish clinics in the three counties, said Charlotte Craig, director of the Cape facility.

The grant would provide up to $500,000 a year for three years under a program providing for "community and migrant health centers." Continued federal funding could be sought every three years, said Craig.

"We are submitting it the first part of June." She said they should know by September if their plan will be funded.

The centers would operate independently of the county health departments, she explained.

Currently, there are about 15 such centers in Missouri. "The closest one we have is in New Madrid," said Craig.

If the plan is funded, a clinic would be opened in Bollinger County. But the ultimate goal, she said, would be to have a center in each of the three counties.

She said the proposed centers would have doctors on staff. "It is the equivalent of the physician's office," she noted. "It will be just like a new doctor's office coming to town."

Such centers would be open to all patients, regardless of their ability to pay. But Craig said, "If you can afford to pay, you will pay."

She said there are a lot of "working poor" in the three-county area. In 1991, almost 40,000 people in Cape Girardeau, Bollinger and Stoddard counties had an income that was below 200 percent of the poverty level.

As of January, the poverty level was $1,196 a month for a family of four.

Many of the working poor don't have Medicaid or private health insurance, she said.

In 1991, more than 13,000 people were Medicaid eligible -- 6,144 in Cape Girardeau County, 5,330 in Stoddard and 1,523 in Bollinger County.

Craig said there's a need for more primary care doctors in the region. Bollinger County, for example, has only one doctor. Cape Girardeau County also needs more physicians.

There's such a demand, said Craig, that when a new doctor moves to town, he or she generally has to stop taking new patients within six months.

Craig said she and her husband even had trouble finding a new doctor when their previous physician left town.

Medicaid patients have a particularly tough time, she said. "Medicaid patients have a great deal of difficulty getting in to see a physician because Medicaid insurance does not pay what it should on a physician's visit or a hospital (visit.)."

Primary care doctors in this area are generally not taking new Medicaid patients, she said. A recent survey showed that about 12 to 15 percent of area primary care physicians' patients are on Medicaid. For some doctors, the percentage is as high as 20 percent, said Craig.

The proposed centers, she said, could provide primary medical care for many area residents who currently don't have a family doctor.

She pointed to the success of the Primary Care Clinic for Children, which operates out of the Cape County health center. In its second year, the clinic's staff treats children of low-income families, including those on Medicaid.

"Will the same thing work for adults? The answer is yes," said Craig.

Even with the clinic, hospital emergency rooms still treat many sick children, she said.

Craig said family physicians, and representatives of the two Cape Girardeau hospitals and the health department have met several times since last fall to discuss what can be done to improve access to primary health care for area residents.

Right now, those discussions are on hold. But if the health center proposal isn't funded, then "we will get real serious" in looking at ways to address the problem on a more local level, Craig said.