When Grayson County Judge Drue Bynum tasked former county Health Director John Teel with creating a clinic to meet the health needs of poor Texomans, the facility was nothing but a pipe dream. The idea was to use a federal Medicaid exception called an 1115 waiver to create a one-stop-shop for those with little or no health insurance.
“Very few states are experimenting with this (waiver) — California, Texas and I think Louisiana … said if you’ll give us federal funding to do weird, new, cool projects, we’ll change the rules of Medicaid,” explained Teel. “And Judge Bynum read something on an email, thought the whole thing up from scratch, and assigned the health department to read up on it.
“I said, ‘I don’t even know what it is.’ He said, ‘Well, read up on it, and this may be fantastic for Grayson County.’ And it turned out to be fantastic for Grayson County.”
The clinic was established with the goal of siphoning uninsured individuals from area emergency rooms, redirecting the costs associated with treating those patients to a less expensive arena. The Grayson County Health Clinic opened its doors in Sherman last August, and the early results have exceeded expectations, according the clinic’s executive director, Nanette Pinckney.
“It’s actually been remarkable,” said Pinckney. “We’ve had a lot of really positive response from patients. … We don’t want them not to go to the ER if they really need to, but if it’s just a fever, cough or a cold, we obviously want them to wait and come see us.”
And they have. Clinic leaders said nearly 1,400 people have been treated at the clinic during the first six months of operation, with that number expected to skyrocket once GCHC receives its Medicaid credentials this summer.
“We definitely expect to see our volume go up,” said Pinckney. “Every day, we have patients come in looking for Medicaid providers, especially pediatrics. And we do see quite a few of those on a private-pay bases, on a sliding fee scale just like we would any other private-pay, unfunded patient that comes through the door.”
A few miles north at the Greater Texoma Health Clinic in Denison, initial trepidation over GCHC’s opening has given way to relief, said Executive Director Cathy Perkins. A patient pool that was expected to overlap considerably with that of the Sherman clinic has proven to be even deeper than imagined, she explained.
“Of course we thought, ‘OK, this could affect our patient volume,’ but it has not. And I think it’s because we have 27 percent of Grayson County that’s uninsured,” said Perkins. “Those ERs were busting at the seams with patients with colds and things they should have been seen in a clinic. And (GCHC) has been very successful; those patients that had previously presented at the ERs are now coming over to that county clinic.”
The Greater Texoma Clinic has seen exponential growth over the past few years — literally, in fact, as patient numbers rose from 3,600 in 2012 to more than 8,000 last year. Perkins pointed to children on Medicaid as a main driver of the explosion.
“The pediatric side of our clinic is just booming because so many local pediatricians are not accepting any new Medicaid patients,” she explained. “Their panels are full and that’s their prerogative to do that. So these kids have nowhere to go but Dallas. So we are the only ones that are accepting new Medicaid for a pediatrician.”
Expected competition between the two clinics hasn’t materialized in the least, said both executive directors, with cooperation going as far as inter-agency referrals. Pinckney said it’s been a goal of GCHC from the start.
“She has a very compassionate heart for this clinic,” said Perkins of her counterpart. “We’re offering very similar services, but they’re pulling those ER patients — more sick, urgent care. They’re also seeing long-term patients, but that’s more of what we see. We are a ‘medical home,’ meaning patients with diabetes or high blood pressure, things that need to be seen every four to six weeks.”
Perkins said GCHC’s only negative effect on Greater Texoma has been financially, as grantors have seemed less willing to write checks now that they’re no longer the only show in town. Unlike Grayson County, GTHC does not receive any government funds, making private donations all the more important, Perkins said.
“One grant specifically said, ‘How is that county clinic going to affect you?’ And ultimately we did get a response that they had denied us. So there is some suspicion that could have led to their decision, but we don’t know that for a fact.”
Money issues aside, both Perkins and Pinckney emphasized that the first six months of operation for the Grayson County Health Clinic have produced a positive effect on the community. That success means the clinic is already looking to expand, with two new staffers expected to start soon and Saturday office hours coming this summer.
“I believe that it has helped a lot of the patients that were not getting primary care before,” said Pinckney. “I can think of one patient who’s come in and told us numerous times, ‘You guys have saved my life; You got me on medications; You have me stable.’ And that’s keeping her from going to the emergency room for primary care.”