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Government awards $3 million to Missouri's safety net health centers

Michael Guthrie signs up for an appointment at the mobile health clinic.
File Photo | Carolina Hidalgo | St. Louis Public Radio
Michael Guthrie signs up for an appointment at a mobile clinic operated by People's Health in June 2018. People's Health is one of the 29 Missouri health centers receiving $3 million in grants from the federal government.

The U.S. Department of Health and Human Services announced Wednesday it’s giving nearly $3 million to 29 community health centers in Missouri. The money is awarded based on how effectively and efficiently the centers provide services to their patients.

Federally qualified community health centers are one part of the government-supported health safety net for low-income individuals in medically underserved areas. The federal government requires them to offer services on a sliding pay scale and serve people regardless of whether they have insurance or not.

Because they are less profitable than traditional health-care providers, the health centers depend on federal money, said Andy Grimm, CEO of Northeast Missouri Health Council in Kirksville, Missouri. He said his clinic offers services to many self-employed farmers and construction trade workers in the area who don’t have company-provided insurance.

“To have sliding-fee scale that we can apply to those working families so they can get a discounted rate, that ability to be able to provide health care to everybody would not be possible if it weren’t for this type of [federal] support,” Grimm said.

Grimm said nearly 18 percent of the clinic’s operating costs come from federal grants such as the one awarded Wednesday. The government awarded Northeast $164,464 for preventing and treating chronic diseases in its patients, among other efforts.

The government distributes grantsbased on how wellhealth centers ensure that the care they provide is cost-effective, addresses health problems across racial and ethnic groups and embraces technology. It gives more money to clinics that exceed government benchmarks.

Another grant awardee, St. Louis’ Family Care Health Centers, received close to $108,000.

The clinic has been exploring why patients don’t follow up on appointments or stay away from the doctor, said Dr. Caroline Day, who practices family medicine there. 

“When you think of population health, it’s not always just the patients who are coming in for appointment — it’s everyone who has designated their health center as their place to get health care,” Day said. “We reached out to patients who aren’t coming to us and tried to figure out what's keeping them from us and thinking about the different social detriments of health that may be making it difficult to follow through on their care.”

The clinic found access to transportation was often a factor in whether someone would visit the clinic. As part of the solution, the clinic now tries to get as many services into one visit as possible.

“We’re trying to pull together all their resources they might benefit from while they’re here with us,” Day said. That includes keeping a behavioral-health specialist and a nutritionist on hand that can see patients the same day they come in for other appointments.

Transportation is also an issue among the rural populations the Northeast Health Council reaches. Grimm said the clinic plans to use some of its grant money to buy ophthalmologic equipment to help its diabetic patients.

“One of the most important facets of diabetes care is an annual eye exam,” Grimm said. But many of the patients at Northeast Health Council don’t live near an eye doctor.

“It’s really important for them to have that for proper care and management for diabetes. We’ll most likely be looking to add that equipment to do diabetic eye exams as part of routine diabetic visits, as a one-stop shop,” Grimm said.

Follow Sarah on Twitter: @petit_smudge

Sarah Fentem is the health reporter at St. Louis Public Radio.