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Clinic may prove to be a key step in helping poor

By Times editorial
Published May 28, 2006

A $7.7-million hurricane shelter/health clinic is a substantial investment in Pasco County's medical needs.

Though highlighted by Florida TaxWatch as a budget turkey in Tallahassee, Gov. Jeb Bush recognized its value and correctly chose not to veto the appropriation. The building, likely to be constructed near Veterans Park in Hudson, will provide shelter for up to 1,000 special needs people during hurricane evacuations, but it will serve another purpose on a year-round basis. The building will double as a clinic for the medically needy, and could become the centerpiece of a public-private network intended to better serve Pasco's poor and to hold down health-care costs.

The county contract to run the clinic is expected to go to Premiere Community HealthCare Group in Dade City, which has been seeking to expand to west Pasco. Premiere would augment, not compete against, the Good Samaritan Clinic in New Port Richey. Good Samaritan is staffed by volunteers and treats only the uninsured. It had 5,000 patient visits last year.

At Premiere, which has a paid staff, about half of the 12,000 patients have no insurance or are considered underinsured, meaning they may have catastrophic coverage, but no other benefits. About 38 percent of the clinic's patients are covered by Medicaid, the state and federal health insurance plan for the poor. The remainder have private insurance or Medicare, the federal program for people 65 and older.

The state money will build the clinic, but operating dollars are another story. Premiere CEO Dorothy Knight said she expects to need a $1-million budget to treat 7,000 patients during the first year. State and federal grants, with a local contribution, are the likely financing source.

State Sen. Mike Fasano, R-New Port Richey, and County Commissioner Ann Hildebrand said they hoped Pasco's private hospitals also might contribute dollars to operate the community clinic. It is a reasonable consideration. The bottom lines of all hospitals would improve if uninsured patients stop using emergency rooms for basic medical care.

Treating uninsured or underinsured patients in Pasco's five hospital emergency rooms cost $26-million in 2003, a more than 200 percent increase from three years earlier.

An estimated 70,000 people in Pasco County have no health care coverage and more than 88,000 people have no personal health care provider.

Fasano, who also works at Florida Hospital Zephyrhills, was influential in obtaining the state appropriation for the clinic. He said he believed it will be the start of a countywide system that could develop over the next few years. A health care task force devising a long-term strategy to treat the uninsured briefly considered a new sales tax proposal to pay for the system, but abandoned the idea as politically unfeasible. Its focus, however, remains on Orange County's network of 20 hospitals and clinics as a potential model to be emulated in Pasco.

National figures show the uninsured are concentrated disproportionately in blue-collar jobs, which dominate the Pasco economy. According to data provided by Premiere, less than 24 percent of the workforce nationally is employed in construction, transportation, maintenance and farming, but those employees account for one-third of uninsured workers.

If it mirrors the pattern in east Pasco, a Premiere clinic in Hudson can expect its patient load to grow 10 percent annually.

It's a substantial problem. The new clinic is welcome, but it is not the exclusive solution.

[Last modified May 28, 2006, 10:16:45]