Central Missouri Health Care Outreach (CeMo)

Lack of transportation and an organized referral system further exacerbated the barriers to accessing health care. Another major barrier was the cultural customs of Mennonite and Ukrainian residents. Welfare and insurance programs are not widely accepted by Mennonites, and although Ukrainian families typically are willing to enroll their children in Medicaid, adults usually are not willing to enroll themselves.

The project consortium comprised three organizations:

• The Morgan County Health Center located in Versailles is a local public health agency that had an established relationship with Mennonite and Ukrainian communities.
• Matthew 25 Ministries is a nondenominational group of churches with more than 22 volunteers trained to provide home health, transportation, and other services.
• CeMo CARES, a nonprofit organization focused on improving access to health care for a seven-county region, has operated the volunteer-based Jefferson City Free Medical and Dental Clinic (JC Clinic) since 1995.

Thanks to the grant, the project opened the Dr. Jack Gunn Community Clinic that operated out of the Morgan County Health Center. The clinic provided primary care, mental health services, as well as pharmaceuticals, medical supplies, and referral services at no cost to low-income, uninsured individuals. Clinic staff includes a clinic coordinator and a part-time nurse, along with volunteer physicians, nurses, and clinical staff. The project provided a comprehensive referral system that included case management and assistance in accessing services, and helped to create an integrated health care delivery system. The program also purchased two seven-passenger vans to provide transportation from the clinics to local physicians and other services.

By running sister clinics, the project was able to share administrative staff and medical supplies. This approach significantly reduced costs and helped the Gunn Clinic become fully operational much sooner than most startup clinics.

Although many challenges can be anticipated, others cannot. The clinic’s namesake and medical director, Dr. Jack Gunn, died suddenly just a few months before the clinic opened. This was a substantial blow to both the community and the viability of starting a new free clinic. At the same time, the project lost a second physician who retired early to be closer to his children. A few months later, a third physician was dispatched to serve in the war. These losses constituted 50 percent of the community’s physician base. Because of the clinic’s sister-clinic relationship, Dr. Jeff Sanders of the JC Clinic volunteered his services at the Gunn Clinic—in addition to his other volunteer commitments.

• Clearly define the roles of the consortium members—in writing.
• Seize opportunities to expand the network and provider involvement whenever possible.
• Plan well, and evaluate activities on a regular basis.
• Maintain strict but balanced governance of the project.
• Make sure the project has several sources of revenue.
• Ensure that the project’s structure and network benefits all of the partners.
• Always do what is best for the patients because it is the only way to operate.

Both clinics will continue at the same levels achieved under the grant. The Gunn Clinic has institute a modest fee schedule for clients able to pay. Seniors now have access to the Prescription Assistance Program at a fee of $5 per prescription. The JC Clinic is in the process of taking over CeMo CARES, which dissolved in July 2005. JC Clinic staff members now work on a part-time basis, but the clinic also expanded its arsenal of volunteers to support administrative functions. The United Way covers the cost of medications provided via the JC Clinic. Meanwhile, both clinics are actively seeking new sources of grant funding.