Community Health Center Snapshots Profile Impact of Medicaid Documentation Requirement:  COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, PITTSBURG, KANSAS

Pittsburg, Kansas, situated in a former coal mining area with a population of 20,000, is in the poorest region of the state. Cherokee County to the south, where CHC/SEK has outreach clinics, was a former lead mining area and an EPA Superfund site. CHC/SEK serves approximately 12,000 patients annually delivering 40,000 encounters. Ninety percent of all patients are White/non Latino, 40 percent are covered by Medicaid, one third are uninsured, and 6 percent are Medicare beneficiaries. 94 percent of patients have incomes below 200% of the Federal Poverty Level. The health center delivers 150 babies a year and features the largest dental clinic in the state.

Jason Wesco, chief operations officer of the center, reports that the documentation rules have had significant ramifications, with major delays in the application and payment process. The rules are putting an additional strain on an area affected by several simultaneous changes. According to Wesco, “We had the document change, and then we introduced two new managed care organizations to Medicaid. Three big changes all at the same time.” Wesco notes the area is characterized by wide health care inequities – “health disparities are ungodly here” – and that the center is predominantly populated by people actively trying to dig out of poverty. “Most of these folks are working and some are working multiple jobs. For those who have been poor and uninsured, it’s not a lifestyle, it’s a short-term circumstance.”

In Pittsburg, the requirement changes are most acutely affecting children. Wesco says, “Representatives from the state agency said that about 10,000 of the kids [who are waiting] were formerly eligible for Medicaid. These kids have done what they were supposed to do, and there’s a stack of papers sitting in Topeka.” The application backlog caused by the documentation requirements has generated a 100 percent increase in uninsured children coming to the center for care. Because the center’s patients have significant health issues that must be addressed regardless of the patient’s status, the center continues to care for the children without guaranteed compensation.