Saluda Medical Center one option for uninsured medical care

After a night of deep rooted coughing and congestion, uninsured Polk resident Debbie Bell didn’t experience the distress others in her position might.
Instead she knew she could seek medical assistance even without an insurance card to brandish at the receptionist window.
Bell for the last 20 years has been a patient of the Saluda Medical Center. She first sought treatment there when she had insurance but learned the center’s true value after losing her industry job years later.
“It’s a godsend, it’s a relief. I got Medicaid for the kids but I’m in that age group where you don’t qualify for anything. You just pray you don’t get sick,” Bell said. “It felt great to not have to rush to the emergency room, which is what a lot of people do for their primary care.”
According to the County Health Rankings 2010 Snapshot of Polk County (www.countyhealthrankings.org/print/north-carolina/polk), 24 percent of Polk County’s adults under age 65 live without insurance compared to 17 percent for North Carolina. Polk County’s updated baseline measure of uninsured individuals for that same age range currently sits at 21.2 percent, which remains higher than the state average.
St. Luke’s Hospital in Columbus served 2,350 uninsured or underinsured patients in its emergency department during fiscal year 2010.
Hospital spokesperson Kathy Woodham said that amounts to a loss of $1,783,154.30 for the hospital just in emergency room visits. Costs accumulate beyond that when a patient is admitted, she said. All services related to uninsured or underinsured patents surpassed $2.5 million last year, according to hospital records.
It’s not just the loss to the hospital that concerns Woodham.
As chair of the Polk County Wellness Coalition, she said lack of medical care is high on their list of priorities.
“As a group of volunteers committed to making a difference, the coalition recognizes there are people in our county who need primary care but lack insurance coverage or means to pay for basic services. Thanks to some federal funding, we’ve been able to provide a safety net for primary care and medications,” Woodham said. “No matter what your income, or lack of, health education, early intervention or better yet, prevention are more cost effective to individuals and society as a whole.”
Polk Wellness Coalition members want to see the patient load at Saluda Medical Center increase from 10.5 percent of the county’s uninsured population to 16 percent by July 2013.
Saluda Medical Center currently serves about 230 uninsured patients, while the estimated number of uninsured residents with no primary care home is 2,350. The increase to 16 percent would cover 418 individuals.
Center director Amy Copeland said her staff sees two to three new patients a day.
She wants to increase that number as well, even as funds continuously hang in the balance because of state budget cuts.
“Until I came here, I didn’t know what my calling in life really was,” Copeland said. “I believe we can truly help people get the medical assistance they so desperately need.”
Copeland said a week ago two male patients came in for appointments who never knew the center provided help to those without insurance. Both men presented prolonged issues with either hypertension or diabetes, problems Copeland and her staff see on a regular basis in patients who have gone years, if not decades, without stepping foot into a doctor’s office.
Copeland chalks this up to a combination of lack of insurance and lack of education.
A not-for-profit 501(c)(3), the Saluda Medical Center opened in 1974 via a community-led effort to provide healthcare and health education.
The center falls under the auspices of the North Carolina Office of Rural Health and Community Care, which provides funding. Patients receive financial assistance for their medical bills based on a sliding scale up to 200 percent of the federal poverty level with the amount of assistance received determined by the number of people within the family unit and the amount of income available for that family, Copeland said.
Copeland explained the center’s breakdown of patients as 30 percent Medicare, 30 percent Medicaid, 30 percent uninsured and 10 percent insured.
Bell has required the center’s care at times when she’s had insurance and times when she hasn’t.
“You still worry about the catastrophes but for the little stuff – the coughs and the colds, the small aches and pains I’m not sure about – [the center has] been such a blessing,” she said. “I had been off and on, employed and unemployed, and they’ve worked with me.”
The center provides all the typical services a family practitioner might, Copeland said, as well as a few extras such as mole removal, treatment for ingrown toenails, suturing, EKGs for irregular heart beats and well-woman exams including pap smears.
Staff members also facilitate prescription assistance for more than 800 people within surrounding communities regardless of state or county lines. The program was established about a decade ago to connect those in need with pharmaceutical companies that provide assistance and often free medications.
The medical center helped Bell receive five of her prescriptions through the assistance program, even alerting her when one of her medications recently fell under the program when it had not before now.
Bell said the paperwork for some drug programs appeared so monstrous in the past she wouldn’t even attempt to apply for them on her own.
“I don’t have to look into any of [the paperwork or requirements for each drug company’s assistance programs]. They take care of it for me,” Bell said.
Copeland said the program uses MARP, a high-tech software program, to track the number of people receiving medication, when said medication is due for renewal and the amount of money provided via medication vouchers.
This program then seeks out which company provides assistance for a patient’s needed medication and supplies that patient with an application form to be sent by mail to the applicable company.
Many of their patients now come through needing assistance with medications, some which can run from $50 a month to more than $100 without insurance coverage.
Copeland said last year the center assisted in obtaining medications worth $4,653,705 in retail costs. They also processed more than 15,300 requests for medication.
Polk County’s Wellness Coalition works to educate the staff of St. Luke’s Hospital and DSS about free or reduced services currently available to residents who might come through their doors. Someone then connects with those residents to direct them to services that might benefit them.
Through the Coalition’s Access to Care team, patients who are un/underinsured are identified and directed toward primary care providers that receive funding through the Community Care of Western North Carolina (formerly Access II Care). Approximately $100,000 in state funding has been committed to Polk County to provide primary care and prescription assistance to low-income, uninsured Polk County residents.
In addition, Access to Care has twice secured the Men’s Baptist Dental Bus to provide basic dental needs to Polk County adults. The team is also working with Saluda Medical Clinic to bring the N.C. Farm Bureau Mobile Screening bus to Polk County later this spring.
The Farm Bureau bus will provide blood pressure screenings, blood glucose checks, dexa scans to measure bone mineral density, lipid screening, dietary counseling and some ultrasounds at no cost to patients seen. Copeland said she hopes 200 people will be able to be seen through the mobile unit when it comes.