CLEARWATER — Almost 60 percent of Lealman residents admitted to emergency rooms live below the federal poverty level and need help paying their medical bills.
That number rises to almost 66 percent in St. Petersburg. Many of those admitted have no regular doctor and need help with issues such as obesity, alcohol abuse or diabetes, meaning they end up becoming inpatients.
The cost to treat them is staggering. Emergency room bills for underinsured or uninsured patients total $612 million a year and, combined with in-patient costs, top $2 billion, according to county records.
“The method is wait until it really hurts and call EMS,” said Gwen Warren, Pinellas County director of Health and Human Services.
Now, the county is moving ahead with a plan to tackle those costs by trying to bring preventative medical care to some of the estimated 68,000 Pinellas residents with no access to primary health care.
The plan is to create health clinics in high-poverty areas that would also serve as one-stop centers for other social services. That would include help for homeless people and counseling for people struggling with drug and alcohol abuse and other issues to provide what officials call a “continuum of care” that gets people out of the poverty cycle.
On Tuesday, Pinellas County commissioners gave initial approval for the county to apply for an expanded federal designation for its health care system, so it can serve low-income poor residents in addition to homeless people whose bills it currently picks up.
The one-stop centers would be sited in five high-poverty areas where at least 16 percent of people are at or below federal poverty levels. The communities — South St. Petersburg, East Tarpon Springs, Highpoint, part of Lealman and North Greenwood — are home to almost half of the poor people in Pinellas County, according to a 2012 county study.
“Where primary care is provided and is accessible, the emergency room visits drop significantly,” Warren said.
Funding for the project would come from a variety of sources, including additional Medicaid reimbursements, the county’s general fund and from partnerships with local hospitals, which would benefit by lowering their costs. County leaders were at pains to point out that they will not necessarily build five new clinics but will use existing facilities where possible.
But nonprofit groups are warning that the county may be duplicating services already provided.
Community Health Centers of Pinellas, which has six clinics throughout Pinellas, provided primary health care and pediatric services for 104,000 patients in 2012.
The clinics are operating at only 72 percent capacity, said Joe Santini, the group’s director of business development.
If the county is granted its new federal designation, it would directly compete with the nonprofit agency for federal grants to build new clinics.
“We have the infrastructure already in place to do what you want to create,” Santini told commissioners. “I never thought we [would] become true competitors in grant opportunities. We never thought we’d be in that position with our partners.”
The five communities identified in the poverty study have higher unemployment and drop-out rates than the rest of the county, suffer from poor transportation links and have less access to low-priced healthy food and health care.
The county’s goal is to reduce poverty in the five areas over the next 10 years. Proposed plans include designating community redevelopment areas in each community to help the county compete for federal grants and to enable a portion of property taxes to be spent on infrastructure improvements, better housing and job training.
County officials also plan to tackle the county’s growing homeless problem. The per-capita rate of homelessness in Pinellas now exceeds Miami-Dade and Los Angeles and is the highest in Florida, said Warren,
Commissioners also gave initial approval for the county to move ahead with design of the Bayside Health Campus, a clinic for homeless people that will include behavioral counseling services.
The $5 million construction costs are being met from a federal grant. It will be located close to the Pinellas County Jail and criminal courthouse in Largo.