Pasco County has always devoted the bulk of its federal health care money to Good Samaritan Health Clinic, a nonprofit in New Port Richey that provides free care to the working poor.
But this year, for the first time, county officials are spreading that money across the county so that homeless people can get dental care.
Premier Community HealthCare Group, a nonprofit that offers a network of primary clinics on both sides of the county, is slated to get half the $40,000 health care pie that would have gone to Good Samaritan, a move that has the west side agency concerned about how it will make up difference.
"Our patients pay on a sliding scale (based on income)," said Cheryl Pollock, business development director for Premier, based in Dade City. But any fee could be too high for homeless people who "need to eradicate any intolerable pain to be able to get out and be productive and find a job."
The federal money will pay for emergency dental care for the homeless, such as exams, X-rays and possible extractions.
"There's a great need" for dental care, said George Romagnoli, community development manager, at a county commissioners meeting Tuesday in which commissioners gave preliminary approval to about $2.5 million in federal allocations, which include the health funds. The projects still have to be approved by the U.S. Department of Housing and Urban Development.
The most recent figures from the Suncoast Health Council, which tracks Pasco and Pinellas counties, show that Pasco has 30.4 licensed dentists per 100,0000 people. That's less than half the state average of 63.
"It's definitely an underserved area," said Elizabeth Rugg, the council's executive director. She said the number of dentists licensed to practice in Pasco, about 400, hasn't changed over the past decade despite population growth.
"Demand is growing, and more research shows that maternal and child health is impacted by good dental care or the lack of it." Rugg said. "It really is critical that the community have access to dental care."
Under terms of the grant, a homeless person could get emergency services through Premier at its Dade City dental center. The bill would be submitted to the county, which would reimburse Premier.
Pollock said Premier works with the new mobile medical unit, which refers those needing dental care to her agency.
Pasco isn't alone in its dismal dental services.
A new Pew Charitable Trust survey found that in 2011, 76 percent of Florida's child Medicaid enrollees failed to receive dental care — the worst rate in the nation. The state also ranked last for 2010. It also showed that 18 percent of Floridians live in areas with a shortage of dentists.
But sending the money to dental care "will have a huge impact on our agency,'' said Melissa Fahy, chief executive officer for the 23-year-old Good Samaritan Clinic.
She said the federal money pays for lab work and stocking the on-site pharmacy, where the most common medications are for diabetes, high blood pressure, asthma and cardiovascular problems such as high cholesterol.
During the last quarter of 2012, the agency had to turn away new patients. "Our board decided, why accept patients if you can't pay for lab work?" she said.
The agency does not charge a fee, instead asking for a $5 donation or for help with odd jobs.
"That way they feel they are participating," she said.
Fahy said the clinic fills an otherwise unmet need. Residents ages 55 and older can get care at the CARES Claude Pepper Senior Center in New Port Richey, but it doesn't have a pharmacy.
The county's mobile medical unit also has no pharmacy, and Premier "has a sliding scale for everything," Fahy said.
"So we really are unique in that we are that free-standing clinic," she said.
Fahy said the clinic will "just have to get creative" and ask partners for more help if the funding levels are cut.
Romagnoli told commissioners, who expressed concern about the cut's effect on Good Samaritan, that more money might be available near the end of the year as paving assessments and loans are repaid.
"We try to be very conservative in our budgeting," he said.
Fahy told commissioners Tuesday that the clinic serves the working poor, as well as recently released jail inmates.
"If we are cut, imagine the ripple effect throughout our entire community," she said. "Help us keep Pasco healthy."