Mississippi Works to Restructure Health Care Services
[Sorry, the video for this story has expired, but you can still read the transcript below. ]
TOM BEARDEN, NewsHour Correspondent: For the uninsured, finding health care is a challenge anywhere in the country. It’s an even bigger challenge in rural Mississippi in the wake of Hurricane Katrina.
In the little town of Moss Point, on the eastern edge of the hurricane’s damage footprint, the only viable option is a small clinic temporarily operating in a converted classroom in the back of a public school.
NURSE: Costal Family Health Center, Janice speaking. May I help you, please?
TOM BEARDEN: It’s run by Coastal Family Health Care, a non-profit that specializes in treating people who don’t have health insurance or who rely on Medicare and Medicaid. It’s crowded and cramped, but Regina Johnson says it’s a godsend, because she has to refill her prescriptions often.
REGINA JOHNSON, Patient: My sister told me that they had reopened, so I immediately started coming back here. I was saved. I mean, like I said, they’re good people.
TOM BEARDEN: And it’s affordable care?
REGINA JOHNSON: Oh, yes, very affordable, very affordable. They ask you what you can afford to pay at the time of your visit. You know, they don’t just — I was going to a doctor where, if I didn’t have the money to pay for my visit, I didn’t get my medication, so that’s why I started coming here.
Federal aid promises are broken
TOM BEARDEN: Kristin Cahill is a nurse practitioner who came from Boston to volunteer in clinics like these. She says they're always busy.
KRISTIN CAHILL, Nurse Practitioner: The hours are long. Most people lost their primary care physician or their nurse practitioner in the hurricane, so now we see more and more patients without health insurance. It's either this or the E.R. And sitting in the E.R. for four hours for a cold is not a good option for people, and Coastal is the only option.
TOM BEARDEN: Before the storm, Coastal operated a string of clinics all along the Mississippi Gulf Coast. Executive Director Joe Dawsey says the storm took almost half of them out.
JOE DAWSEY, Coastal Family Healthcare: We're flooded, and we lost four of the nine clinics, were completely destroyed. And we've been doing temporaries in school houses, tents, lawn mobiles. There's one thing -- whatever we can operate out of is what we've been trying to do.
TOM BEARDEN: Coastal is now operating 15 makeshift replacement clinics in every thing from double-wide trailers to Winnebagos. Dawsey says Coastal had to do all this on its own, because federal disaster assistance officials repeatedly broke promises to help.
JOE DAWSEY: They were supposed to bring and put a mobile unit here. That the person that was sent in, originally the group that was sent in, said it would take 12 days to put a modular health clinic in. And we were going in with the local mental health and a local public health that Coastal -- we was going to have a joint clinic. And they said it would take 12 to 18 days. That was in September, and it's still not here, and it's not coming.
New clinic scheduled to open
TOM BEARDEN: Things will improve in Moss Point later this month when a new, permanent clinic opens. Volunteers from a organization called Hands On USA are in the final stages of converting five donated office trailers to house the new facilities.
Coastal hopes to eventually restore all of the damaged or destroyed clinics, but it's been a major financial struggle so far. They got $400,000 in cash from Project Hope, an international health charity, and $600,000 worth of donated pharmaceuticals.
DOCTOR: I'm going to look in your ears. Let me see.
TOM BEARDEN: But Dawsey says Medicaid still hasn't paid the company $800,000 in reimbursements for work done before the storm and also hasn't paid for any of Coastal's work for the last three months. A Medicaid spokesman says, while payments have been delayed, they are working to solve the problem.
DR. WILLIAM ROSS, Moss Point, Mississippi: We had 3,500 square feet that was lost to the flood.
TOM BEARDEN: Dr. William Ross will be one of the doctors in Coastal's new Moss Point clinic when it's finished.
DR. WILLIAM ROSS: This is a dual-dexter (ph). It's about a $65,000 machine. I had just finished paying for it.
TOM BEARDEN: Of course.
DR. WILLIAM ROSS: And the insurance says that it's not covered.
TOM BEARDEN: His ruined medical building is just across the street. He also lost his home in the storm. Ross says he thought about giving up and moving away. He says he got a lot of offers to relocate, but he decided to stay because the need is so great.
DR. WILLIAM ROSS: We have lost other physicians in this area. In fact, if you survey the coast, I think you have a significant percentage of primary providers leaving. That's not just from the storm; it's from the financial uncertainty of primary medicine.
And we have many workers in Moss Point that have no insurance but do not qualify for the state assistance, and those are the ones I have been seeing quite a few of.
TOM BEARDEN: Dawsey says it's been a real struggle to keep medical professionals of all kinds in the area.
JOE DAWSEY: We've lost 66 staff members that didn't come back, so we had to try to replace them and do work around that. When you operate a mobile clinic or a small clinic, it's harder to do, because you have to have a provider or a doctor in there, and sometimes we only have one exam table.
And it's just hard to do, and especially with a short staff. We lost over half of our nurses. And right now, we're having a real problem trying to hire clerical personnel, because a lot of people in the community left.
NURSE: OK, now, Mr. Henry, five feet and a half.
Clinics are saving lives
TOM BEARDEN: Finding enough nurses has been an even bigger struggle than keeping doctors.
NURSE: OK. One more time.
TOM BEARDEN: Out-of-state volunteers have been filling in the gaps at sites like Coastal's clinic in Gulfport, one of the few medical facilities to escape major damage. Project Hope has been coordinating a steady flow of volunteer nurses in and out of the area. Jack Blanks supervises the program.
JACK BLANKS, Project Hope: They came to us and said: You know, we have this huge problem. We just don't have enough nurses to run the facilities that were as they were coming back online.
So we did a national sort of distribution of information saying that -- a call for nurses, if you will, and we've been recruiting volunteer nurses since February.
TOM BEARDEN: Volunteer Susan Cambria is a long way from her normal job as a nurse anesthetist in Connecticut. She's living in a tent city with other volunteers. Cambria says many people here have serious health care needs.
SUSAN CAMBRIA, Nurse: They need help in so many ways. And so many of them were living marginally, in that they were just barely getting the health care that they needed through -- they were employed, and they would pay for what they could. And now that many of them have lost their jobs, this clinic is extraordinarily important to them.
TOM BEARDEN: Do you think these clinics are literally saving lives?
SUSAN CAMBRIA: Absolutely. There's no question.
SABINA EXNER, Nurse: Are you feeling good? Well, I'm going to get a temperature on you right now, OK, so just...
TOM BEARDEN: Sabina Exner is a volunteer nurse from Boulder, Colorado. She says the whole coastal region is facing long-term health problems as a result of the storm.
SABINA EXNER: I think it is way more stressed now. It's increased in pressure because now, on top of everything else, you're adding tremendous post-traumatic stress. You're adding the stress of their lifestyle, which, of course, compounds the disease process. They're not getting good nutrition. I mean, it's just a vicious circle. And so with everything that's going on there has escalated in intensity.
Coastal is just barely hanging on
TOM BEARDEN: Dawsey says, for now, Coastal is hanging on, but just barely. The agency has applied for a $7 million federal block grant to continue rebuilding and is still pursuing $300,000 in pending Medicaid reimbursements, but he says they can't wait forever.
JOE DAWSEY: The only choice we have, if we don't get the funding from the block grant or from other sources, we'll have to just not have a clinic. For instance, here in Biloxi, we will just not have a clinic here. We'll consolidate over in Gulfport and that one site. That's the only choice we have.
TOM BEARDEN: What's the impact on your patients if you have to do that?
JOE DAWSEY: It will be a major impact, because they'll have to get transportation to get to the clinic. We don't have any patient transportation, and there's very little public transportation down here.
TOM BEARDEN: Dawsey says the last thing the devastated Mississippi Gulf Coast needs is even fewer options for people to find health care.