Chat about Douglas County's uninsured with Nikki King

December 4, 2006

This chat has already taken place. Read the transcript below.

Nikki King is the administrator for Health Care Access, which offers care to the uninsured of Douglas County. Lawrence Memorial Hospital is on pace to double the amount of money it spends treating Health Care Access clients in 2006.

Moderator:

Hi. I'm Chad Lawhorn and will be your moderator this afternoon. We are chatting with Nikki King, executive director of Health Care Access. We have a few questions, so we'll get started.

Nikki King:

Thank you so much for having me here today. We appreciate the opportunity to share more information about the Clinic in hopes of helping more uninsured in our community.

Moderator:

I'll get us started with the first question. Have there been any changes to the clinic's walk-in hours and practices, and if so, what drove those changes?

Nikki King:

In light of the increases in requests for services at the Clinic we have made some recent changes. Many individuals have been used to the practice that every morning we hosted a walk-in clinic serving the first 6 or 7 patients in the order in which they checked in. The downside of this has been patients waiting outside in our parking lot for an hour or each day to try to get one of those slots.

Nikki King:

So, starting this week we eliminated the first-come-first-serve format in exchange for same-day or next-day acute appointment additions to our schedule. This will be less stressful on our patients who are sick and seeking care.

Nikki King:

We hope this also adds to our capacity on the number of people we can help on a given day.

smitty:

What is the policy/criteria that allows HCA to distribute prescription drugs every three months without an office visit to check the patients condition?

Nikki King:

Our Medication Assistance Program consists of three means to acquire and distribute medication to our patients at little or no cost.

Nikki King:

First, samples are used as available for immediate distribution for appropriate diagnoses. Second, we are able to sell at nearly cost a variety of generic medications that we buy in pre-packaged form. Lastly is our medication acquisitions through more than 30 pharmaceutical companies' patient assistance programs. These are for patients with chronic conditions requiring pharmaceutical treatment on an ongoing basis. These companies entrust us to facilitate the paperwork to aquire needed medication for a patient, verifying income and diagnosis, and in return send to us three months supply of said medication.

Nikki King:

Housing those three months supply, and distributing to the patient monthly, we act as a refill source as a pharmacy would. Depending on the treatment required, an appointment may or may not be necessary with the provider for the refill, just as is the case in any private physician office.

Nikki King:

We offer this service to our patients, however anyone who may not have the means to afford their medication can peruse www.rxassist.com for a list of the pharmaceutical companies' offerings and apply themselves. This year through ONE staff person we will acquire over $800,000 worth of medication through this program alone.

midwestmom:

How many uninsured children are in need of medical & preventive dental care in Douglas County? What percentage of your budget is dedicated to the needs of these children?

Nikki King:

Latest statistics show more than 12% of Douglas County is without medical coverage. The last statistic I heard from the Lawrence Schools was 33% utilized the free-and-reduced lunch program that roughly follows our same income guidelines for the clinic. We help promote the State's health insurance program, HealthWave, that provide free or very affordable coverage for children in Kansas. However, children of State employees (KU, government jobs, etc) and children of undocumented parents are ineligible for HealthWave. Therefore we know there are large pockets of uninsured children in DG County, maybe as high as the overall number of 12%.

Nikki King:

About 10% of our patient population is under the age of 19. This number has crept up since the start of HealthWave in 1999 (we assumed the number would continue to decline). We serve any child without coverage whose family meets our income guideline (see link on www.healthcareaccess.org) and then help them sign up for HealthWave if they may be eligible.

Nikki King:

We spun off from our service the Douglas County Dental Clinic about 5 years ago. They provide dental care to uninsured, Medicaid, HealthWave, etc. and we cross refer to each other frequently.

Nikki King:

Probably a similar 10% or less of our budget is dedicated to serving our young patients.

Bassetlover:

Great job with the holiday tour yesterday! Will this become a yearly event? Our family would like to make it an annual tradtion.

Nikki King:

Thank you! This was our second year doing the tour. We will probably do it again next year, first weekend of December. Do watch our website for details. The event committee and staff did an excellent job again this year identifying terrific homes with a variety of locations and styles to showcase. These homeowners were very generous in sharing their homes with the community and to help us spread the word about our work. Our other fundraiser in 2007 will be the Lawrence Half Marathon & 5K on April 15. More details at www.lawrencehalfmarathon.com. Thanks to all those who helped and attended yesterday - it was fantastic!

Moderator:

This next question is from poster justthefacts. The poster asked a series of questions, and time likely won't allow us to get to all of them. I'll ask just a couple of them on his/her behalf. What is the aproximate average age and family/personal income of the people your service helps? And have most of the adults you help been under-insured or uninsured all of their lives, or do they need help with health care costs for just a short period of time?

Nikki King:

Most of our patients are between the age of 20 and 64, vast majority in their 40s. Incomes must be below 185% of the federal poverty guideline, again found on our website www.healthcareaccess.org. This guideline is based on the number in the household of the patient. We really see a mix of the newly uninsured and those who have been without coverage for a very long time. The latter present with much more serious health conditions that require usually more referrals to our 100+ volunteer physicians, more tests and services donated by Lawrence Memorial Hospital, and more medication from the beforementioned programs. We serve exclusively the uninsured, poor and the Heartland Clinic can help a lot of those not meeting our guidelines. The more individuals we can encourage to at least come in for a check-up, the better health they will have and will help save the health care system more expensive services.

Nikki King:

We are looking at serving a record number of patient this year in our 18 year history - up 22% over last year. We hope to continue to support the increased demand as we continue to try to reach those who need our services.

midwestmom:

Is there a way to make a direct donation to your agency, specifying that the funds may only be used for needy children & parent education?

Nikki King:

Yes, thank you. We accept donations by mail (1920 Moodie Road Lawrence KS 66046), on our website by credit card or dropping by the Clinic. We will restrict any donation to a specific purpose per directive of the donor without any problem. Only through the community support can we continue to care for this population. Our $10 requested fee to patients is only paid about 35% of the time due to our patients' circumstances. Keeping our community healthy helps their quality of life, keeps health costs down for the healthcare system, keeps their employers happy for less days off-the-job, and teachers happy for less sick days of children. We appreciate any support, big or small, as it all makes a difference.

Moderator:

Well, that's all the time we have today. Nikki, thank you for coming in and sharing information about Health Care Access. And thanks to all who submitted questions.

Nikki King:

Thank you Chad and the Journal World for letting me share more information about the Health Care Access Clinic and how we try to help keep our uninsured friends and neighbors healthy and active in our community.

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