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Plan offers new focus in care of indigent

Hoping to better serve the medical needs of poor, uninsured residents, the Hernando County Health Care Advisory Board on Thursday unanimously endorsed a new indigent care model for the medical community.

The program, called Access Hernando, would have physicians volunteer time in their office instead of at a centralized clinic. A survey showed many doctors would prefer to provide care in their offices.

Other medical providers, such as hospitals, pharmacies and laboratories, also would be asked to donate services.

In exchange for the free services, doctors would have the opportunity to gain protection through the state's sovereign immunity program from medical malpractice suits brought by the indigent patients.

The cost to run the program would be about $110,000 a year, about how much the county now gives to Hernando Doctors' Clinic, a non-profit organization that has provided indigent care for the past eight years. The clinic's contract with the county expires Sept. 30.

Representatives from the clinic came to the board demanding to be included in the process, which they called "rushed" and "ill-informed."

"There's no way in the world I'm saying anything negative about what you're doing," said Walter Dry, who represented clinic director Clinton J. McGrew Jr. and called himself the county's "godfather of indigent care" with McGrew. "But you're missing some things, and I want to fill in the gaps for you."

Board members indulged Dry and McGrew to a point, agreeing to listen to their concerns and to tweak the model as it progresses, if necessary. But they also refused to budge from their position that the service needs to change so more doctors participate and, as a result, more patients get timely care.

Bryan Marshall, a local dentist, said the board began looking for alternatives specifically because McGrew had been shouldering too much of the indigent care burden and had talked about alternatives. Marshall said no one wanted to boot the clinic from the program, and that it should be integrated into Access Hernando.

Whether the clinic can remain viable without county money was the big question, one that this board could not answer because the County Commission holds the purse strings and will make the final call. Currently, $100,000 for the clinic appears in the proposed fiscal 2002 budget.

"You're not going to be able to fund both entities," said Elizabeth Callaghan, head of the county Health Department. "As the budget is stated, there's not enough money to meet both."

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