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Critical condition
Medical community tries to cure ills of health-care system after TennCare cuts hit Hispanics hard

By BRYAN MITCHELL AND LOLA ALAPO, mitchellb@knews.com; alapo@knews.com
November 23, 2005

Normally held on the last Saturday of the month, the People's Clinic of the Volunteer Ministry Center began offering a Hispanic Health Day in April 2004.
The number of clients has jumped in the past 18 months, climbing more than 100 percent.

That's where Dora Moreno brought her two children, Lupe Moreno and Stephanie Salazar Moreno, both 4, last month.

Lupe needed a physical before she starts preschool.

"Sometimes, we cannot go to the doctor because they're so expensive," Dora Moreno said. "Sometimes a lot of people don't go to the doctor because they don't have the money. They go to Wal-Mart and get pain medicine."

Meanwhile, in Parrotsville, Tenn., more than a dozen people fill an austere building in this rural mountain town halfway between Newport and Morristown on an otherwise quiet Tuesday morning.

And they are all lined up to see Dr. Edward Capparelli, who has seen his practice experience a dramatic increase in Latino clients in the last decade.

When Capparelli arrived at the clinic in 1993, no more than 20 percent of his clients were Hispanic. Today, the number hovers around 50 percent.

"And it's growing each day," he said.

As an increasing number of Hispanic laborers migrate into East Tennessee, they are finding their way to similar low-income clinics across the region.

Lourdes Perez, acting director of the Roman Catholic Diocese of Knoxville Hispanic Ministry, said health care is an emerging issue for East Tennessee's growing Latino community. She described the current situation as less than adequate.

"They are not getting proper medical health care, and it's scary," she said. "Many Hispanics are waiting until it's an emergency until they see a doctor."

The recent cuts to TennCare have exacerbated the situation.

She said many Hispanics, including undocumented workers, were on the state-provided health service before the massive cuts earlier this year.

"They got very limited benefits, but they did not have to prove they had documentation," she said.

Roughly 34,500 Hispanics were enrolled in the TennCare program as of July, according to a state report. That number represents 2.6 percent of the TennCare population.

Just less than a quarter of that population resides in East Tennessee.

Perez's greatest concern is for pregnant women not receiving proper prenatal care.

"That is really scary and dangerous," she said. "Now we tell women to head to the local health department for prenatal care."

But for the rest of the Hispanic population, low-cost clinics are the best place to find reliable care.

In Knoxville, Perez directs people to Interfaith Health Clinic in North Knoxville or to the monthly Volunteer Ministry Center People's Clinic.

Dr. Bill Broome, a family physician at University Health Systems, treats patients at the downtown clinic.

Funding for the clinics is normally a mix of government grants and patient payments.

Larry Stanifer, CEO of Rural Medical Services, said 75 percent of its funding comes from billing patients while the remaining 25 percent is from federal grants.

Ginny Weatherstone, executive director of Volunteer Ministry Center, said the center receives a small grant from Knox County and also receives private donations.

Some clients make contributions.

Last month, an unemployed Hispanic man handed People's Clinic administrator Nancy Douglas $6 in cash for a previous visit.

"They're very grateful, extremely grateful," Douglas said.

Bryan Mitchell may be reached at 865-342-6306. Lola Alapo may be reached at 865-342-6376.