By Bill Zeeble, KERA News
http://stream.publicbroadcasting.net/production/mp3/kera/local-kera-907080.mp3
Dallas, TX – You need a doctor, lack insurance, but don't qualify for coverage at a County public hospital. What are you going to do now? This month our Monday economy segments take a look at health care access for those without insurance. KERA's Bill Zeeble has more on affordable options.
In this recession, as more people have lost their jobs and insurance, the number of those needing health care with no way to pay has risen. If you're among them, the first thing to do is call 2-1-1, the help assistance line. A qualified operator can offer options. If you're in Tarrant or Dallas Counties, try John Peter Smith or Parkland public hospitals. They also have satellite clinics. Both market affordable coverage plans. But not everyone qualifies, as Larry James can tell you. He's President and CEO of Central Dallas Ministries. It runs its own low-cost clinic.
Larry James, President, CEO Central Dallas Ministries: You know everything we do is fundamentally word of mouth. We have never had really a marketing plan for our services. Word of mouth on the streets among low-income people is a phenomenal way of communication.
That's how Mrs. Alvin Estelle heard of this clinic on Peak Avenue in Dallas. She, her son and disabled husband used to go to a Parkland clinic. But her salary as a dog-groomer priced her out of Parkland's low-cost plan. She couldn't afford the full fee, and her job offers no insurance.
Alvin Estelle: So we started looking around for an alternative clinic, because prices had gotten really expensive. And my baby sister told me about this. She was going to this clinic, and she called me Alma Fay, she said "Alma Fay, why don't you try and go to the clinic right here on Peak?"
She did, and found what officials these days call a "medical home." That's a health facility that low-income residents can call their own. Estelle pays $5 for blood pressure pills and a $20 co-pay for the visit. Some pay less, others more, depending on income. Larry James says the clinic is one among 42 loosely linked, low-cost clinics in Dallas. There are yet others. To get in, you're usually either referred to one, or, like Estelle, hear about from somebody else. The clinics try to maintain regular hours, with a doctor that patients come to know.
James: So that if you're part of our clinic, our doctors are going to take care of your needs just like my doctor takes care of me. People who come to us are uninsured , typically working, and for whatever reason aren't qualified for a public health benefit.
There could be several reasons for that. You might earn too much for Medicaid. If you rejected an insurance plan offered where you work, Parkland will deny you its low-cost coverage. You can still go to its emergency room or one in another hospital, and get treated. But you'll be billed for the full fee. If you have a condition needing a follow up, the ER is the wrong place for it. That's what 56 year-old Manuel Balderramos found out.
Manuel Balderramos: cause I went to the hospital in Farmers Branch, RHD, and they said they couldn't really help me because I didn't have any insurance, and the whole stuff. So I said "ok."
Balderramos thought he was having heart problems. But RHD diagnosed him with diabetes. The hospital put him touch with Project Access Dallas. It's a non-profit, health care network, organized by the Dallas County Medical Society. Project Access partners with hospitals, specialists, drug companies, volunteer doctors in Dallas, and low-cost clinics. It refers indigent patients to member clinics, and stays with that patient. Balderramos was referred to Project Access member Healing Hands. That's a faith-based clinic in Dallas. Balderramos: Manuel Balderramos: Come in this place, they treat you very, very well .Other places I've gone? You sit and wait, that's it.
Balderramos worked more than 30 years for a printing shop where he had insurance. But the business closed, and his insurance went with it. His Type II diabetes, a chronic ailment, requires ongoing attention, medical supplies, tests, and office visits. Healing Hands and Project Access provide those needs.
Michael Darrouzet ceo Dallas County Medical Society: The number of patients coming to these charitable clinics is on the rise. And we end up with more of a need to provide physicians to them and medical homes to get them out of the clinics and into specialty care.
Michael Darrouzet is Dallas County Medical Society CEO.
Darrouzet: The natural instinct for people without that kind of access is to go to the ER, any emergency room, not just Parkland's. We really try to intervene and ask the clinics to identify patients that would be better suited in a private medical home. So they're enrolled and assigned and educated that they need to change behavior and go to a private doctor.
If you don't qualify for Medicaid or a low-cost county health plan, one of these affordable clinics may work for you and your family. Again, in the case of a Project Access clinic, you're usually referred to it by another doctor or hospital, when they learn of your financial difficulty. When enrolled in one of these low-cost clinics, it's as if you had insurance.
For more information on low-cost health care in north Texas, visit KERA.org/economy
Low-cost providers & Info in Dallas County
Federal Government Clinic Assistance
The Texas Association of Community Health Centers