By Derek Spellman

dspellman@joplinglobe.com

Elizabeth Zimmerman said she had to quit her job at Scholastic Inc. in Neosho to take care of her son, who at 5 weeks old suffered from spinal meningitis and a stroke.

She has been without health insurance ever since.

Zimmerman this week was at the Access Family Care clinic in Joplin for treatment of a cold that had been going through the family. Her son is now 15 months old.

“Otherwise, I wouldn’t be able to afford a doctor,” she said of Access, a service that she characterized as “awesome” for those who lack insurance.

Separate from the swirling national debate about health care reform, state lawmakers in Missouri next week are expected to start reviewing a bill that would cut state funding for federally qualified health centers like Access Family Care.

Lawmakers need to make budget cuts amid a still struggling economy, but health officials say that weakness is likely to fuel an increase in demand for services that could be cut — in this case, for services like Access.

Appropriations bill

Access Family Care is the only federally qualified health center in the Joplin area, and it uses a sliding fee schedule based on household income for uninsured and Medicaid patients.

Access Family Care operates clinics in Joplin, Anderson and Cassville. Those three clinics last year saw a total of 40,000 patients. Total patient visits increased 26 percent in 2009 compared with 2008, factoring in all three clinics.

“I would definitely think the economy,” said Don McBride, chief executive officer of Access Family Care, when asked about factors behind the surge.

A bill approved Feb. 16 by the Missouri House Appropriations Committee for Health, Mental Health and Social Services would eliminate the entire $9.25 million in state grants that are typically distributed among Missouri’s 23 federally qualified health centers, including Access. The health centers would still receive their Medicaid payments.

Current budget

For the current fiscal year, Access Family Care received more than $561,000 in state grant money, according to the organization. Its total operating budget is more than $4.85 million.

McBride said he understands that the state faces a budget crunch, but he questions why the committee opted for a complete cut in the grant money, especially at a time when people are still losing their jobs and, with those, their health insurance.

Dr. Charles Bentlage, medical director for Access Family Care, said the cuts would be coming at a time when Access is seeing “an ever increasing demand for services that we provide.”

Offices of state lawmakers were closed this week with the Legislature on spring break.

Messages left on the answering service for the state office of Rep. David Sater, R-Cassville, the appropriations committee chairman, were not returned. Multiple efforts to reach Sater at his home in Cassville were unsuccessful Wednesday.

Messages left on the answering machine at the Capitol and at the home of the appropriations committee vice chairman, Rep. Raymond Weter, R-Nixa, were not returned Wednesday. Efforts to reach Rep. Robert Wayne Cooper, R-Camdenton, a physician and another committee member, also were unsuccessful.

Gov. Jay Nixon met privately last week with House and Senate members to warn them that state tax revenues are falling short of expectations and that his original budget plan no longer was feasible. On Saturday, Nixon said about $500 million will need to be trimmed from his Missouri budget proposal for next fiscal year.

Rep. Rebecca McClanahan, D-Kirksville, said the Feb. 16 appropriations committee vote fell along party lines. She told the Globe in a phone interview Wednesday that she voted against the bill, which also includes cuts in subsidies for domestic violence shelters and for crisis pregnancy centers, because she thought those cuts were “disproportionate” and hit services that already have suffered budget cuts in the past.

“Many of those programs are direct services” to people, she said.

Asked where else the state could cut when facing a shortfall in revenue, she suggested that the state take a closer look at its tax credits and “carefully sort” those credits that work from those that do not.

McClanahan said a House committee substitute for the appropriations bill proposes to restore some of funding for the federally qualified health centers, although those funds would be restricted to dental care only.

The bill is now in the hands of the House Budget Committee, which is scheduled to start hearings on the bill Monday. Among the members of that committee is Rep. Tom Flanigan, R-Carthage.

Flanigan said in a phone interview Wednesday that the budget committee is “just now starting the process,” and that the appropriations committee’s recommendations are still under review.

“It’s far, far, far from a done deal,” he said.





Background



Access Family Care was established in 1996 as the Ozark Tri-County Health Care Consortium. The nonprofit organization is committed to providing comprehensive and preventive health care for low-income residents of McDonald, Barry, Jasper and Newton counties.