SUN JOURNAL NEW BERN: Craven commissioners approve adult clinic

Sue Book


2011-08-02
A primary care health clinic for adults who are uninsured or who receive Medicaid is expected to be open and operating at Craven County Health Department by October.

Health Director Scott Harrelson made a proposal to create the clinic and it was approved unanimously by Craven County Board of Commissioners this week.

The clinic is expected to serve primary care needs of about 2,000 adults annually, using a licensed practical nurse and full-time contract physician’s assistant. It is projected to cost about $181,750 a year.

Harrelson said that money, for the first two years at least, is expected to come from $40,000 in existing revenue, $40,000 from Office of Rural Health, $21,750 from state aid-to-counties funds, and $80,000 from Medicaid and payment by patients.

“What happens when or if that money stops?” asked Commissioner Tom Mark.

Harrelson said that despite deep cuts to many state programs, “those funds were never put on the chopping block.” Medicaid pays more to a government clinic than to a private provider through cost settlement. If there are funding cuts, uninsured individuals might have to pay a higher percentage of their cost, presently expected to be about 40 percent.

“According to the North Carolina Institute of Medicine, Craven County has approximately 12,000 uninsured citizens” and there are 5,627 adult Medicaid recipients, Harrelson said.

“There is a hole in the safety net,” he said. MERCI Clinic in New Bern sees uninsured adults not covered by government programs and whose earnings are 200 percent of the poverty level or less. But there are not enough doctors in the county to see adults in other categories quickly. They often end up at CarolinaEast emergency room for health problems that could be handled faster and less expensively at a clinic.

“By our own experience, it can take from four to six months to get a first appointment for a Medicaid adult,” he said. “The working poor above 200 percent of the poverty level are not supposed to be seen at the free clinic and they are not eligible for Medicaid and cannot afford private insurance.”

“CarolinaEast is seeing a good deal of non-emergency visits in their ER, which translates into the most expensive form of primary care,” Harrelson said. As provisions of the Affordable Health Care Act become active in 2014, the adult Medicaid population is expected to grow significantly.

Commissioner Lee K. Allen made the motion to give Harrelson permission to proceed with the adult primary care clinic. A retired Navy chief warrant officer and longtime civilian advocate for public health at the local, state and national level, Allen said, “If we don’t provide some safety net for those falling through the cracks, shame on us.”

(NOTE FROM LYNN:  Commissioner Allen has made it clear, he advocates public healthcare (i.e., given to the poor and paid for by the taxpayers of Craven County.  Socialism at the local level!  I hope Craven County voters will remember that in the next election!)
Harrelson said the clinic will help control some chronic problems by using preventatives before “it becomes a train and they are in the emergency room.”

Commissioner Scott Dacey said, “We are about to create a new government program. I want to make sure we are going to save money by diverting patients currently going to the emergency room” and that those using the clinic pay the fee.

Harrelson said he helped create a similar clinic in Duplin County that worked in saving hospital emergency room visits and that the clinic itself “broke even.”

Commissioner Jeff Taylor asked Harrelson to come back and report to commissioners after a year of operation.

Sue Book can be reached at 252-635-5665 or sbook@freedomenc.com.