Central  South  Dakota Medical News
The Clinical View
by P.E. Hoffsten, M.D.
August 8, 2002

UPDATE ON RURAL HEALTH CARE, INC

 Several times in the past, I have written columns describing the healthcare providers at your local clinics.  In the past year, there have been new developments that provided additional advantages to the patients who utilize their local clinics in Gettysburg, Onida, Highmore, and Murdo.  These clinics are supported by a federal grant that helps defray the cost of what would be an otherwise financially unsuccessful endeavor.  Put another way, there simply aren’t enough people living in these small communities to support a full time clinic.  In order to help provide medical care in these small communities, the federal government provides grant money to support the clinic.

   One might ask what the federal government expects in return.  The stipulations in the grant require the clinics to collect information on disease patterns in the communities they serve.  Several years ago an organized system to track information regarding diabetes in central South Dakota was organized within the five clinics mentioned.  Useful information to better serve those individuals with diabetes mellitus was collected to help better serve the community and diabetics in it.

   A second requirement from the federal government is that clinic hours be adjusted to better serve the community.  Specifically, each clinic is required to have after hours service each week in which late hours past the normal closing time are provided.  Each community clinic has a different time they remain open and you can call your local clinic to find out which time that is.

A third requirement from the federal government is that families and individuals with below average incomes and inadequate insurance are provided medical care at a reduced cost. Thus, the clinics have a sliding scale for the cost of office visits and various other tests.  As an example, a family of four with an income of less than $18,100.00 per year would have no expense going to the clinic.  Expense to the person, would increase to 40% of the normal charges if their income was up to $27,000.00 a year and up to 80% of the normal charges if their income reached $36,000.00 a year.  There are substantial savings available through these small community clinics for retirees and young families struggling with young children. This sliding scale fee structure applies to Medicare and insurance deductibles not just  the uninsured.

In Gettysburg only, the laboratory and x-ray expense is not part of the clinic sliding scale. A fourth purpose of the Rural Health Care, Inc. clinics is application of preventive medicine and immunizations for all children served by these clinics.

   A new project beginning over the next several years is a cancer screening program. Specifically, those cancers which can be most readily affected by early detection will be targeted in screening programs to identify individuals at risk before the tumor becomes incurable.  In South Dakota, it is felt that breast cancer, colon cancer, and cervical cancer of the lady’s womb are three that will be especially targeted over the next several years.

   As a fringe benefit, Rural Health Care, Inc. is served by various physicians from Pierre who travel to these outlying clinics one day a week.  The fee schedule for these physicians would be the same as for the clinic in which they are working allowing those families with strained finances to have appointments with the physicians in these outreach clinics at a reduced rate.  This applies to Drs. P. Hoffsten, D. Plumage, P Meyer, R.A. Allison, M. Holland, B.O. Lindbloom, and E. Becker.  Several other physicians who rent space in the clinics do not accept the sliding scale fee.  Please inquire in each case to avoid confusion.

   In summary, Rural Health Care, Inc. provides quality healthcare to the local community. You don’t have to travel far and the price is right.  If the service needed is not available at your local clinic, the healthcare providers in these clinics can get help quickly through more specialized facilities even up to Mayo Clinic if needed and wanted.