Anemia in Rural Louisiana Health Care for Minorities, the Poor, and the Elderly - Louisiana Illuminator

Anemia in Rural Louisiana Health Care for Minorities, the Poor, and the Elderly – Louisiana Illuminator

Karen Wyble kept a promise she made to the mother of a young sickle cell patient when she testified Thursday before a legislative committee. The woman’s daughter had refused to go to a hospital emergency department for her severe pain due to the treatment she had previously received.

“Mom, please just let me die at home. I don’t want to go back to the ER because they look at me like I’m here for drugs,” the daughter told her mother, according to Wyble, president of the Louisiana Rural Health Association.

Wyble used the story to illustrate the lack of accessible care for sickle cell patients in Louisiana. Citing figures from the Louisiana Department of Health, she said there were more than 100,000 sickle cell patients in the state – and no public clinics that could treat them.

“They’re labeled with the painkiller seeker stigma,” Wyble said. “They are desperate. They hurt.

Louisiana’s high poverty rate, combined with critical shortages of providers in the public health sector, exacerbates chronic problems in a largely rural state. That’s according to administrators who appeared before the House Health and Welfare Committee Thursday on National Rural Health Day, which is observed annually on the third Thursday in November.

Fifty of Louisiana’s 64 parishes are at least 92% rural with a combined population of 1.2 million, the majority of whom are minorities, elderly and live in poverty, Wyble said.

State health figures show that 73% of residents live in areas officially designated as having a shortage of health care providers.

Wyble also chairs a newly created task force on rural health disparities that will provide a report to the legislature next March 1 with policy suggestions to address what they deem to be urgent needs.

Medicaid expansion does not improve access

Meadha Kulharni is the administrator of federally licensed health centers in Allen and Evangeline Parishes. FQHCs are often the only facilities in a community that accept patients with Medicaid or who do not have health insurance. Her husband, Dr. Upendra Kulkarni, is Mamou’s only obstetrician/gynecologist, she said.

According to the state health department, more than one million people in Louisiana have medical coverage through Medicaid, most of them children under the age of 18.

Medicaid’s refusal to cover infertility treatments needs to be addressed, Kulkarni said. While acknowledging that the total cost – which she said averaged around $80,000 – is unlikely to be covered, Kulkarni said any assistance would go a long way to helping women pursue options such as in vitro fertilization. .

Roderick Campbell, CEO of Iberia Comprehensive Community Health Center, confirmed the impact of Medicaid expansion in Louisiana. His organization operates FQHCs in six parishes.

Ten years ago, 55% of patients seen in Iberia clinics were uninsured and only 20% were covered by Medicaid. The numbers have almost changed since then, with 55% of Iberia patients using Medicaid and only 10% uninsured.

Inadequate mental health staffing also affects access, administrators told the panel. Kulkarni said the growing number of chemical addiction units in the state are able to pay more mental health nurse practitioners than they would at public clinics like his.

Rep. Joe Stagni, R-Kenner, praised Gov. John Bel Edwards for expanding Medicaid coverage to more people in Louisiana — the first state in the Deep South to do so — but Stagni said the move had no impact. not improved access, especially to mental health. suppliers.

“If you don’t deal with their problems early, they’re going to be catastrophic later in terms of cost and for their families,” Stagni said.

Dentists hard to find

Health Committee Rep. Robby Carter, D-Amite, noted the shortage of dentists at public health clinics. In St. Helena Parish, where Carter grew up, there is a dentist in his 80s who is about to retire, he said.

Administrators agreed, sharing their difficulties in finding dental practitioners in their rural facilities. Campbell said he was currently trying to recruit a dentist for the Iberia Health Center in Many. Meanwhile, the dentist at his New Iberia clinic travels to Many — a 184-mile one-way trip — twice a month to see patients.

Campbell said the “bureaucracy” of accepting Medicaid patients also deters dentists from working in public health. Many private practices only accept cash or private insurance, he added.

There are 39 federally qualified health centers in Louisiana with some 300 affiliated satellite clinics, according to figures shared by Campbell. Although this appears to provide adequate medical infrastructure, the shortage of personnel in various health fields still limits access to care, he said.

To mark National Rural Health Day, state health officials touted his Rural Health Scholars Program. It connects students from Louisiana colleges and universities who are studying to become physician assistants or nurse practitioners with healthcare facilities in areas with shortages of healthcare professionals. The first 17 fellows to participate in the program’s first year were placed at 14 sites across the state.

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