12/17/2011

By GORDON D. FIEDLER JR.

Salina Journal

Local social service workers were as stunned as were most Salina Journal readers when they read in the Dec. 11 Journal of a Salina Christmas Fund applicant who admitted getting pregnant so she could qualify for Medicaid.

At the time, the woman held a low-paying food service job, had no insurance and was in need of significant dental work that she claimed she couldn't afford. The pain in her teeth was so severe it sent her to the hospital emergency room, where doctors told her the problem was only going to worsen and eventually degrade her overall health.

The pregnancy automatically qualified her for medical assistance that paid for her dental work. The woman also said it wasn't the only time she'd done that, and she said that others had done the same.

Salina Emergency Aid/Food Bank Director Kathy Jackson can sympathize with the Christmas Fund mother and her extreme solution to what for many blessed with good health insurance would be a painful but minor inconvenience.

"Should I be surprised?" Jackson asked herself of the young mother. "Probably. Am I surprised? No. Do I support what she did? No. But I understand it."

The here and now

The hungry who are drawn to the Food Bank are more worried about the here and now rather than what may lurk down the road. Jackson cited an example of one Food Bank client who is now out of work because of health issues.

Two days after helping her at the Food Bank, Jackson saw her in the grocery store.

"She looked like somebody beat her up," she said. "What happened was she had an abscessed tooth. Two days before she didn't have it. She couldn't go to work because of the pain. When she went to work she couldn't stay because of the pain, so she lost her job."

Some people in tough situations will do things they normally won't do, she said.

Some clients will confess to her they are driving without car insurance because the premiums went up and now they can't afford it.

"We see people taking desperate measures because of jobs. They are in lower-paying jobs, the working poor. Everything has gone up. Car insurance has gone up, rent has gone up, food has gone up, gas to get to work as gone up," she said.

Human face on the needs

The Christmas Fund, in its 27th year, raises money this time of year to provide gifts of food, clothing and other assistance to local needy families. What money that isn't used through Christmas is dispensed throughout the year to eligible applicants. It is administered by the Salvation Army.

As one of the sponsors, the Salina Journal helps underwrite administrative costs and selects a representative sample of Christmas Fund applications and publishes interviews in an attempt to put a human face on the needs in the community.

Shocking, but not illegal

Technically the young mother didn't abuse the system because what she did was quite legal. She didn't fake the pregnancy or hide income. In her view, with her health in jeopardy, she felt desperate and took desperate measures. She readily admits if she was working in her present job, which has affordable health insurance, she wouldn't have gotten pregnant.

"I was shocked," said Roxanne Matous, office manager and caseworker for the Salvation Army, when she read the story.

Her office fielded calls from people questioning the Army's screening process.

"If people have gotten pregnant as a way to get benefits, they haven't told us," she said.

"It's sad she had no other avenue that she had to go to extreme measures to get help," she said.

The woman's best bet

The Salina Family Healthcare Center, 651 E. Prescott, a federally qualified health center, would have been her best bet for dental care.

The facility is unique among such centers because it also is affiliated with the Smoky Hill Family Medicine Residency Program.

It serves the insured, underinsured and uninsured. Low-income patients pay on a sliding scale set by income and family size. The minimum charge is $25 for each visit.

The clinic's dental program offers a wide range of services. According to its website, staff dentists can provide routine check-ups, X-rays, cleanings, fluoride treatments, partial and complete dentures, crowns and bridge, root canal therapy and more.

"Some procedures are considered major procedures and they do have a separate pricing structure," said Ann Feil, director of operations for the center. "Root canals, crowns, and other procedures are classified as major procedures and fall outside that minimum."

In addition, the clinic requires payment up-front.

Haven't heard of it

Pregnancy-for-health care is a new one to Bryan Anderson, administrator of the Ashby House, a shelter for homeless families.

"We haven't run into that situation," said Anderson, who knows that people chose unwisely when in survival mode.

The shelter provides counseling and other life-skills to its residents in hopes of aiming them in a more self-sustaining direction.

"We work with them on goals and what they want to accomplish," Anderson said.

The Kansas Department of Social and Rehabilitation Services is a rich resource for the shelter, Anderson said.

"(SRS) bends over backward to provide any benefit the folks are eligible for," he said.

Those who seek shelter at the Ashby House often don't think long-term because they are more concerned about the moment, he said.

"If you can't put food on the table today you can't think about tomorrow," he said.

--Gordon D. Fiedler Jr. can be reached at 822-1407 or by email at gfiedler@salina.com.

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