After-Hours Initiative Helps Improve Access to Primary Care in Metro Kansas City

Staffing problems, client-safety concerns and funding issues are threatening to shrink a regional initiative that has provided safety-net medical care to thousands of new patients by offering evening and weekend hours.

It appears that the after-hours initiative will move forward in its fourth year without the site in Kansas City, Kan., or the one in the Northland, according to program officials.

Location has been an issue at the Quindaro site in Wyandotte County, said Dr. Sharon Lee, chief executive with Southwest Boulevard Family Health Care Services of Greater Kansas City.

Most of the clients there either walk or use public transportation, she said, and patients have been reluctant to come after dark to a relatively isolated area they consider unsafe.

“Clearly, in the winter time, when it gets dark early, we have not had a situation where people want to come to the clinic,” Lee said.

Samuel U. Rodgers Health Center operates the clinic on North Oak Trafficway in Kansas City, North.

The health center has had trouble finding a provider willing to work in the evening, according to Scott Lakin, director of the Regional Health Care Initiative, a program of the Mid-America Regional Council (MARC).

Samuel Rodgers chief executive Hilda Fuentes could not be reached for comment.

Though the fourth-year budget is not set, Lakin said it appeared the program would move forward with the three remaining participants: The Health Partnership Clinic in Johnson County, Kan., along with the Kansas City, Mo., sites at Swope Health Services and Kansas City Free Health Clinic.

The Health Forward Foundation and the REACH Healthcare Foundation have financed the extended-hours program with about $1.8 million in combined funding during the initiative’s first three years.

Lakin said he anticipated next year’s budget would be about $335,000 because REACH is not guaranteeing funding for the clinics next year.

Additional clinics might receive funding next year, Lakin said, if there is carryover money from the current year.

REACH committed $550,000 to the initiative in the first three years, said spokeswoman Pattie Mansur.

But the foundation considered the program a pilot, she said, and it’s now inviting the participating clinics to apply for REACH funding through its competitive grant process.

Lee said she doubted that Southwest would apply to REACH to fund hours at the Quindaro site, even though the after-hours initiative was the primary source of funding for that site. She said she would look to juggle staff hours and search for other partners to keep the Quindaro location open.

The program year runs from October through September and as of May, the clinics had already exceeded their 12-month goal of increasing the number of new patients seen by 4 percent over the previous year.
The total of 1,378 new patients exceeded the annual goal by about 8 percent. Southwest Family Healthcare and Samuel Rodgers accounted for about 10 percent of the total, officials said.

Like Samuel Rodgers, Swope Health Services had staffing problems at its clinic, which stays open from 5 p.m. to 9 p.m. on weekdays.

The clinic suspended the hours in April because it had no backup staff to cover vacations and other contingencies.

But Swope now has a backup provider at the ready, said Danielle Foster, director of compliance, risk and business process.

With limited marketing dollars, Foster said another challenge has been informing patients of the service.
“I talk to folks all the time who say, ‘I just went to the ED (Emergency Department),’” she said. “We’ve got to figure out a way to help them understand there is another option.”

On the plus side, she said, the care coordination piece of the after-hours program has paid off.
For instance, she said, Swope linked up one client with some additional specialty care by working with the Kansas City Free Health Clinic.

The Health Partnership Clinic has used the program dollars to provide evening hours and Saturday appointments at its two offices.

On Thursdays, the Overland Park office stays open until 9 p.m., and Sandra Lee of Overland Park was among the patients in the waiting room last week.

As a part-time nurse, she does not qualify for employer-provided health insurance. The evening hours really worked well with her schedule, she said.

“It’s just a really nice community service for people who are falling through the cracks,” Lee said.

The Health Forward Foundation is proud to partner with the Kansas Health Institute news service to provide weekly health stories about health and policy issues impacting the greater Kansas City region. This News Service is an editorially independent program of the Kansas Health Institute and the Health Forward Foundation and is committed to objective coverage of health issues.

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