Filling the Gap

About four weeks into chemotherapy treatments it happens – your hair starts to fall out.

“You might not consider how important your hair is to you until you start to loose it,” said Kamron Collins-Johnson, Missouri program manager for mission delivery for the American Cancer Society. “Offering free wigs is just one thing we can do to make the process easier.”

The ACS is one of a handful of nonprofit organizations across southwest Missouri offering free medical treatment and assistance. From wigs to blood tests, there is a plethora of options available if a patient knows where to look.

Despite the fact more Americans than ever have insurance plans under the Affordable Care Act, the Kaiser Family Foundation estimates roughly 30 million adults remained uninsured at the end of 2014 and one in three lacked coverage because of the cost.

The foundation estimates only 48 percent of the uninsured are eligible for assistance under the law, leaving more than half of the uninsured struggling to find help.

Breast Cancer Foundation of the Ozarks Executive Director Crystal Webster said that’s where many nonprofits come in, filling the gap for traditional health care systems. But while the services might be free to patients, they aren’t free for the nonprofits that serve them.
 
Meeting a need
Last year, the ACS gave out 235 free wigs in Greene County and 1,238 wigs across the state of Missouri. At roughly $50 each – totaling upwards of $61,000 – Collins-Johnson said any cancer patient in treatment in Missouri could receive one free wig a year.

“That’s part of our budget set aside for wigs,” she said. “That money is through our fundraising efforts.”

Collins-Johnson said the program almost exclusively serves women and the ACS operates wig shops in its local office, at 3322 S. Campbell Ave., and inside Mercy’s Cancer Research Center.

“We don’t do special orders, but we try to match what they want the best we can,” she said. “A lot of the women want something different. It’s a good time to try a new look. We get a lot of requests for red hair.”

The ACS offers additional services for cancer patents. While all may not directly concern their immediate health, Senior Market Manager for Community Engagement Kim Edwards said many factors go into a patient’s treatment.

“We can offer assistance for anything from rides to treatment and hotel and lodging to insurance navigation and information about their treatment,” she said, via email. “We also have a very large resource connection that we keep updated to connect them with other organizations in their local community that may be able to fill a need that we aren’t able to fill.”

Across town, the AIDS Project of the Ozarks is filling another health need – free HIV and sexually transmitted disease testing.

“Springfield has a fairly large mobile population; we have a lot of colleges,” said Bob Holtkamp, director of outreach and prevention, addressing the large need. “These people don’t often have access to health care because they don’t have insurance or can’t settle down enough to establish a primary doctor. But they still have health care needs and issues.”

Holtkamp said organizations such as Jordan Valley Community Health Center help, but sometimes patients still can’t afford a reduced payment.

Last month across it’s 29-county service area stretching from Joplin to West Plains, APO administered roughly 150 syphilis tests, 100 gonorrhea and chlamydia tests and 140 to 170 HIV and Hepatitis C tests.

Holtkamp said APO budgets about $300,000 annually for the blood tests with funding from a variety of sources. The Centers for Disease Control and Prevention, in conjunction with a Missouri Foundation for Health grant, provides the majority of testing materials.

In addition, the APO Clinic also sees several hundred people living with HIV in the Ozarks, covering HIV-related laboratory and infectious-disease care for HIV-positive individuals who have no insurance or other benefits and who are within the income guidelines.

Somebody has to pay
While the majority of services are covered, Holtkamp said there’s still a gap. APO fills the void through private funding and donations.

“APO has been functioning for 25 years and funding is always in flux,” he said. “Over that last three or four years, CDC funding has gone down by about 10 percent.

“A change in funding means we have to adjust our activities, but it doesn’t adjust the need.”

At BCFO, Webster knows the funding flux with government all too well.

The nonprofit provides free screening mammograms to uninsured and underinsured in southwest Missouri who meet its financial criteria.

Webster referenced the federal Breast and Cervical Cancer Prevention Project program, funded at a federal level, with state matching dollars applied.

Administered by Missouri Department of Health and Senior Services, that becomes the Show Me Healthy Women program in Missouri. To qualify for a free breast and or cervical cancer screening, women must meet certain age, income, and insurance guidelines.

“That program runs out of funding consistently, every year,” she said during Springfield Business Journal’s recent CEO Roundtable on the nonprofit industry. “We know, come about May, we will have a big increase in the number of screening mammography referrals from the uninsured across the state. The folks would normally refer to Show Me, but it has no funds left, so they send them over to us.

“We see referrals increase from county health departments specifically and some of hospitals as well. For several months, we have the high demand, then they come back into funding again and it goes back to normal.”

According to HSS, the objective of the SMHW program is to offer screening services to women who are considered high risk.

High risk women include, but are not limited to, women with low income, women over 50, women with no or little insurance, women who have rarely or never been screened, rural women, women of color and women with disabilities. There are approximately 164 facilities throughout the state that provide these free cancer screenings.

Webster said, fortunately, BCFO never has had to turn away any qualified patients. But if funding runs dry, that might change.

“If we had to pay the normal reimbursement rate, we already might be positioned differently. We have favorable contracts because the hospitals understand what we are trying to do. They have taken a cut on the pricing of their services to be able to pitch in on this community problem,” she said. “If Show Me Healthy Women were eliminated at some point because of funding, we would really have to put our heads together to figure out how to pay for the glut of mammography that would be demanded of the foundation.”[[In-content Ad]]