The Free Press, Mankato, MN

State budget: a closer look

June 28, 2011

In case of state shutdown, Open Door for health care

MANKATO — The calls are already coming in from county officials in south-central Minnesota, according to Sarah Kruse, CEO of Mankato’s Open Door Health Center. If people lose health care benefits because of the state government shutdown, will the Open Door be able to help them?

Kruse’s answer is an emphatic “Yes.” And she’s looking to spread the message far and wide as Friday’s increasingly inevitable shutdown approaches. The door is open to people who might be dropped from state programs, to people who lose their jobs because of canceled state projects, to anyone who needs health care services.

“I really want them to know that Open Door is another safety-net option, and they don’t have to go to the emergency room,” Kruse said.

The ER is the traditional final option for uninsured people who need a medical appointment but can’t afford an out-of-pocket medical payment. Mankato’s hospital is bracing for additional uninsured patients entering Mayo Clinic Health System in Mankato through the ER, as are others around the state.

But Mankato has an alternative to the ER on Holly Lane.

Open Door — which offers both medical and dental services — has been growing dramatically, especially since receiving a $1.3 million federal grant in 2009 as part of the American Recovery and Reinvestment Act. The clinic cared for nearly 3,000 people that year.

Appointments grew 70 percent in 2010 and continue to rise rapidly this year, Kruse said.

Viviana Salazar has seen a lot of that growth in the 12 months she’s been working in patient services at Open Door. Salazar and a co-worker processed 2,000 patients through the clinic’s sliding-fee payment system, checking what sorts of coverage they had or might be eligible for — spelling out what the patient would be asked to pay if they’re without coverage.

For many, the charge might work out to $25 for a procedure. If they can’t afford that, they aren’t shown the door.

“We ask them if there’s anything they’re able to pay — $5, $10, whatever,” Salazar said.

If that’s too much, the patient still gets medical care. They’re put on a payment plan, but there are no late fees and no interest charges.

And the clinic is a more efficient way to deal with routine health care appointments, including treatment of chronic diseases or the renewal of a prescription, than is an ER, Kruse said. Letters sent by the state of Minnesota in anticipation of the shutdown, however, specifically mention the ER as an option for people losing coverage and needing a medical appointment.

Along with being less expensive to the health care system and to the patient, Open Door offers services that an ER can’t, Kruse said. People like Salazar can help patients navigate, for instance, the complex application process for free prescriptions offered by pharmaceutical companies.

The looming shutdown is also on the minds of Mayo Clinic Health System officials. A Monday memo to all staff in Mankato and at other hospitals in the system’s western region provided an update on the impasse in St. Paul and listed some of the many questions that remain about the potential impact of a government shut-down.

“Will emergency volumes go up? Will our patients be able to refill medications at pharmacies if they are on Medicaid? ...” the memo stated. “As we learn, we will share the answers.”

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State budget: a closer look