Community Health Center Snapshots Profile Impact of Medicaid Documentation Requirement:  HUNTER HEALTH CLINIC, WICHITA, KANSAS

Hunter Health Clinic in Wichita, Kansas, is one of the only 34 urban Native American clinics in the country. The health center furnishes care to approximately 18,000 patients, with 64,000 encounters annually. The patient population is: 41 percent White/non-Hispanic/Latino, 27 percent Hispanic/Latino, 18 percent African-American, 10 percent Native American, and 4 percent Asian-American. The center is comprised of one medical/dental/behavioral health site, three medical sites, one mental health site, and one inpatient social detoxification site for homeless persons.

Hunter Health Clinic reports that since the Medicaid policy requirements changed, they have witnessed a significant decrease in the number of Medicaid enrolled patients. In 2006, 18 percent of the health center’s patients were covered by Medicaid, and 76 percent were uninsured. This year, only 12 percent of total patients are covered by Medicaid, and the percentage of uninsured patients has increased to 80 percent. Susette Schwartz, the CEO of the center, says they are particularly concerned about the impact of the requirements on the Native American population, since the government will no longer accept the Certificate of Degree of Indian Blood as a primary source of documentation. Explains Schwartz, “For generations, Native American people have had to prove they are Native American to access health services programs such as ours. And now they also have to prove that they are documented citizens. Some were born and raised on the reservation and have been here in the U.S. their entire lives.” The center anticipates that this population will have great difficulty securing other proof of citizenship.

While Schwartz notes that Kansas has a history of actively supporting health care access initiatives, the citizenship documentation requirements are hitting hard. In an effort to cover the additional costs needed to help homeless patients and Native American patients with their documentation, Hunter approached the state for a $30,000 targeted grant to ease the financial strain, but at the last minute it was removed from the budget. Schwartz observes that the center sees many patients who “are even further away from Medicaid coverage,” including pregnant women and children, and notes that patients with disabilities in particular “may not have the fortitude to navigate the system.”