Adam Wilson

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Adam Wilson expounds on Washington state government, workers and politics. Wilson began covering those issues for the Olympian in 2004. He can be reached at: awilson@theolympian.com.

Health clinics miss out on the better pay for kids docs

• Published August 07, 2008

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Took some time to catch up on the Community Health Network yesterday, a group of clinics that serve (by their own figures) 10 percent of the state population, and a third of its uninsured. When you show up at the emergency room with a minor ailment but no money and no health plan, you are often referred to one of these 130-odd clinics.

As you might guess, these places serve as a front line in efforts to expand access to medical care, including the Democrats’ plan to cover all kids in the state by 2010. How’s it going? I got some interesting responses from a group of folks at Olympia’s Sea Mar clinic.

For instance, remember that big push to up the amount Medicaid would pay pediatricians? The idea was to make sure that a doc seeing a poor kid would be paid as much as he or she would make seeing a state worker’s kid.

But that doesn’t help community health clinics, which see about half of the states uninsured children, said Molly Belozer, of the network. The clinics are paid a flat per-patient, per-visit fee, based on a complicated formula, she said, but it does not include the pediatric rate.

And how about that plan to spend $1.25 million to expand a school loan repayment program for doctors willing to work in underserved areas? It was supposed to add 60 slots.

Shanon R. Hardie, vice president for Sea Mar’s operations statewide, said clinics are just now putting in requests for some of those slots. But they haven’t been opened yet.

Which brings us to an interesting theme: some of the big expansion ideas the Democrats have pushed over the last few years are just now going into effect, even as the budget picture darkens.

New figures on the number of uninsured kids left won’t be ready until October or November. About $2 million to increase dental care access was just released. The additional slots added to the Basic Health Plan are finally being filled out.

And now Bellozer and her crew are bracing for a defensive game (my terms there, not hers) in the next session. With a $2.7 billion projected deficit, the trims are a-comin’ and the health care advocates want to at least hold on to the gains they’ve made.

Without evidence ready at hand to show how effective they’ve been, it’ll be a tougher sell. We’ll see how much data will show up between now and January.

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