Friday, September 02, 2016
NOTES FROM THE SENATE, SEPTEMBER 2, 2016
GEORGIA'S CHARITY CLINICS
A number of healthcare issues will be addressed in the upcoming legislative session. Georgia's charity care clinics, though, already play a key role in providing basic health services to low-income, uninsured residents. In 2014, according to the U.S. Census Bureau, Georgia had just over 1.5 million uninsured residents, or 15.8 percent of its population. Charity clinics represent an important segment of Georgia's so-called "safety-net" of healthcare providers that offers care for this population, in particular low-income and those living in underserved communities. Other safety-net providers include community health centers, public hospitals, local health departments, and private office-based providers who offer free services on a limited basis.
WHAT ARE CHARITY CLINICS?
Charity clinics in Georgia include a network of independent, community-based non-profit organizations, some with religious affiliations, which provide basic health services to low or no income local residents either for free or minimal fees. There are over 90 such clinics across the state, although most are located in the northern half, with concentrations in metro Atlanta, Augusta, and Savannah. Altogether, Georgia's charity clinics served 197,334 unique patients in 2015, with 494,574 total patient visits.
Here in the Fourth District, the Hearts and Hands Clinic in Statesboro offers free primary care services to citizens of the Bulloch County area who do not have medical insurance and whose income is no more than 200 percent of the federal poverty level (FPL). In addition, the Mercy Medical Clinic in Vidalia serves some counties of the Fourth District as well with medical and dental services. Most charity clinics in Georgia provide services almost exclusively to uninsured residents. In fact, in 2015, 94 percent of charity clinic patients were uninsured, while 78 percent of patients were also employed.
In addition to focusing their services on the uninsured, most charity clinics have income limitations based upon the federal poverty level. In 2015, 62 percent of patients at these clinics in Georgia were in households living at or below 100 percent of the federal poverty level.
Each charity clinic establishes its own range of health care services, with an emphasis on primary care and prevention. They may offer medical, dental, vision, mental health, and/or pharmacy services. Treatment for chronic illnesses, such as hypertension and diabetes, makes up a large portion of patient visits, as 88 percent of Georgia patients treated in 2015 have one or more chronic illnesses. Clinics mainly rely upon volunteer staff to provide care, although paid providers are also utilized at times.
CHARITY CLINIC FUNDING SUPPORT
To fund operations and provide their various health care services, charity clinics combine a mix of revenues from grants, patient fees, and donations. Patient fees, where implemented, are minimal and based upon a sliding income scale. The Georgia General Assembly has recently supported charity clinics with an annual appropriation of $500,000 in both the fiscal year 2016 and 2017 state budgets. These appropriations help the clinics increase capacity and introduce new services to patients, such as oral health, behavioral health, and wellness services. They also will help the clinics broaden their information technology capabilities by purchasing, implementing, or maintaining an electronic health records system.
A GOOD INVESTMENT IN GEORGIA
Charity clinics provide a good return on investment for the support they receive through donations and grants. With a volunteer staff model, they are able to provide health care services valued at $7 for every $1 invested in them. In addition, advocates for the primary care and preventive services provided charity clinics often point to studies that show the value of these services in reducing long term health care costs through earlier identification of health issues and avoidance of more serious health complications later on. A 2015 study by the Economic Research Group within the College of Public Health at the University of Georgia provides further evidence in this regard, with specific research they conducted on hypertension treatment in the state's charity clinics. Their research indicated that every dollar invested in Georgia's charity clinics yields a net benefit of $1.60 in reduced healthcare system costs, through better health outcomes (lower blood pressure among patients), and through avoided emergency room visits and the high costs associated with these visits.
Charity clinics are but one example of how communities leverage local ideas, talent and effort, along with limited state support, to improve the lives of Georgia residents.
The FY 2017 budget (H.B. 751) may be found at http://www.senate.ga.gov/sbeo/en-US/AppropriationsDocuments.aspx. As always, I welcome any questions you may have.