The Collin County Observer

Clinics offer low-cost care for poor

County to subsidize $20 office visits at a cost of $400,000

12:00 AM CST on Saturday, January 13, 2007

By ED HOUSEWRIGHT / The Dallas Morning News

For the poor and sick in Collin County, help may be just around the corner.

PrimaCare?, which has clinics in Frisco, Plano and McKinney?, has begun offering $20 office visits for people who meet strict income guidelines.

For instance, a family of four can't earn more than $20,000 a year, and a single person can't make more than $9,800.

County officials contracted with PrimaCare? to provide the low-cost care, which will be subsidized with $400,000 in public funds.

Officials are hoping the public-private partnership will be an effective piece of an expanded effort to provide health care to indigent adults and children.

"I think it's a unique approach," commissioner Phyllis Cole said. "This is just another idea we're going to try. I think it'll work really well."

People seeking care should encounter little red tape. They must sign an affidavit attesting that they meet the salary guidelines, but they don't have to provide income documentation or fill out lengthy forms.

"I think it'll be good for patients," said Candy Blair, Collin County health care administrator. "It doesn't give people the stigma of having to get health care at a county facility."

For more than two years, Collin County officials have wrestled with ways to offer cost-effective care to the growing poor population. Government leaders around the state and country are taking stabs at addressing the complex health care issue.

In November, Collin County commissioners voted 4-1 to adopt a package of measures to offer more care. The agreement with PrimaCare? Medical Centers, which went into effect Jan. 1, was a key component.

Commissioners also allocated $400,000 in grants to nonprofit clinics that serve low-income residents.

Commissioner Jerry Hoagland cast the opposing vote. He pointed out that the county already provided more indigent care than the state requires.

"I am opposed to spending money that we are not legally required to spend," Mr. Hoagland said.

County officials met with two other private clinics – CareNow? and E-Care Emergency Centers – before choosing PrimaCare?.

The company has more clinics and offered a broader range of services at a better price, said Bill Bilyeu, Collin County administrator.

PrimaCare? has no other contracts with government agencies, said Jennifer Stephenson, executive director. "It's a different model, but I think it's something we can work with," she said.

PrimaCare? visits are for non-emergencies. For more complicated medical conditions, PrimaCare? will refer patients to a specialist. Subsequent treatments may or may not be covered by county subsidies depending on the patient's income and assets.

PrimaCare? has two clinics in Plano, one in Frisco and one in McKinney?. They are open from 8 a.m. to 9 p.m. Monday through Friday, and from 8 a.m. to 5 p.m. Saturday and Sunday.

By contrast, the county-run clinic is open from 8 a.m. to 5 p.m. Monday through Friday. Some nonprofit clinics that receive county grants are open only one day a week.

Commissioners said they would rather contract with PrimaCare? than build another county clinic.

"PrimaCare has the brick and mortar in place, the staff and the accessibility," commissioner Joe Jaynes said. "I'm really looking forward to seeing the results."

People can visit PrimaCare? for a $20 co-pay that will cover X-rays and tests. Patients may receive free medication or be given a prescription that they can fill at a pharmacy at their own expense.

Commissioners said the $20 fee should be affordable for most people. By comparison, people receive free care at the county clinic and at some nonprofit agencies.

"People need to have some investment," Mr. Jaynes said. "You can't just have a government giveaway program. If you make it free, you open it up to abuse."

E-mail ehousewright@dallasnews.com