Marshfield Mobile Clinic reps meet with Colfax business owners
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By LeAnn R. Ralph
COLFAX — Representatives for the Marshfield Clinic Mobile Primary Care Unit have met with Colfax business owners as part of an effort to provide healthcare to the area with the mobile clinic.
Judy Kruse, director of business strategy and operations, and Tanya Sherf, manager of business health solutions, met with a variety of business owners in Colfax along with Lynn Niggemann, village administrator-clerk-treasurer, on April 21 at the Colfax fire station.
Earlier in the day, representatives for the Colfax school district as well as several other businesses met with the representatives from the Marshfield Clinic Health System to tour the mobile primary care unit and to ask questions.
During the afternoon session, businesses represented were Woods Run Forest Products, Big Timber Sawmill, Colfax Chevrolet and A Little Slice of Italy. Lisa Bragg-Hurlburt, director of the Colfax Public Library, also attended the meeting.
Marshfield is working to design an access to healthcare for people in Colfax and the surrounding area and for businesses located in Colfax, Kruse said, noting that the Marshfield Clinic Health System has a focus on providing rural healthcare.
The mobile unit has a private exam room and a lab station and will have a nurse practitioner on board to provide healthcare, along with another mobile technician who is also certified as a phlebotomist.
The mobile primary care unit will provide minor acute care, such as treatment for upper respiratory infections, sore throat, ear infections, sinus infections, urinary tract infections and skin rash, and assistance with chronic disease management such as high blood pressure, diabetes, high cholesterol and heart disease.
The mobile unit will not provide acute care. If someone is having a heart attack, that person should be on the way to the emergency room, Kruse said.
Several of those attending the meeting pointed out that since Colfax no longer has a clinic, if people are having a medical emergency, they will sometimes go directly to the Colfax Rescue Squad location on Railroad Avenue.
Kruse and Scherf said they had met with representatives from the Colfax Rescue Squad during the morning session and had heard about people going directly to the Colfax Rescue Squad for medical emergencies.
The Colfax Rescue Squad will be able to assist the mobile primary care unit in that if someone shows up at the mobile unit with the symptoms of a heart attack, for example, the nurse practitioner will be able to assess the situation and then will call 911 to dispatch the Colfax Rescue Squad to the mobile unit, Kruse said.
Patients
People who seek care at the mobile primary unit will be registered as Marshfield Clinic patients, even if they are Mayo Clinic patients, for example, and then their medical care will be documented and the records will be sent to the appropriate healthcare system, Kruse said.
People do not have to switch to using Marshfield Clinic as their primary care provider and do not have to arrange for all of their medical records to be transferred to Marshfield Clinic, she said.
For people with health insurance, as long as Marshfield Clinic is in the network for their health insurance provider, then the normal co-pays and deductibles will apply, Kruse said.
The mobile unit initially will be able to treat patients who are 14 years or older, but pediatric services for children aged two or older are expected to begin in July, she said.
Marshfield Clinic is working on lining up nurse practitioners, and some of them have more pediatric experience than others. The mobile unit also must procure equipment that is geared toward pediatric care, Kruse said.
The mobile primary care unit will probably never offer healthcare for infants, she said.
“The little ones crash fast and should be seen in an emergency room,” Kruse said.
The mobile primary care unit will be able see Medicaid and Medicare patients too, she said.
No insurance
As everyone is probably already acutely aware — health insurance is expensive.
And because health insurance is so expensive, most of the employers in Colfax are unable to provide health insurance for their employees.
The employers in Colfax could form a coalition to bring the mobile primary care unit to Colfax for their employees for one day per week or a couple of days per month, Kruse said.
The cost is $155 per hour, and the coalition would pay for six hours for a total of $930 for the day, she said.
The mobile primary care unit would then be able to see as many as 15 employees during the six-hour period at no additional cost to the employers or the employees, Kruse said.
The mobile primary care unit also could do physicals for a Commercial Driver’s License (CDL) or hearing checks for employees, she said.
Several people at the meeting wondered if a private individual could pay for the mobile primary care unit for a day to provide free healthcare for anyone in the community who does not have health insurance — or if organizations could sponsor the mobile primary care unit, or if the cost of the unit could be covered by bake sales to raise money or by some other means.
Kruse and Scherf said they would check into whether it would be possible to sponsor the mobile primary care unit for anyone in the community who does not have health insurance.
One person asked if it would be possible for the Colfax school district to sponsor the mobile primary care unit for a day for students who need healthcare, or employees, or for students who need sports physicals.
For the students, parents would have to sign a permission form, but bringing the mobile unit to the school district once a month or once every couple of months for students and employees might be a possibility, Kruse and Scherf said.
The employers asked if Kruse and Scherf would be willing to come and talk with their employees to answer questions — and the answer was “yes, of course.”
Kruse said Marshfield Clinic is currently working on a menu of “prices” for various healthcare services.
The employers wondered, too, if it would be possible for people with no insurance to pay cash for services at the Marshfield Mobile Primary Care Unit.
The mobile unit would not be set up to take cash payments, Kruse and Scherf said, adding that they would have to do additional analysis to see how it could work for people with no insurance who want to pay for services on their own.
Several people at the afternoon session said they were concerned about what people who have no health insurance would do if a condition was discovered at the mobile primary care unit, such as a lump that could be cancer or if it was determined that someone has diabetes.
What will those people do about additional care that they might have to get at other facilities? they asked.
Kruse and Scherf said they would work on identifying a list of resources and referrals for people who would need additional care beyond the mobile primary care unit but who do not have any health insurance.
Survey
After Mayo Clinic closed the location at the former nursing home in Colfax, the Village of Colfax sent out a survey about healthcare services to obtain information with which to approach other healthcare providers about putting a clinic in Colfax.
Another survey might be a good idea, Niggemann said.
The survey could be sent out, but it could also be online and available to anyone who might be interested in receiving healthcare, she said.
In 2016, a total of 1,519 surveys were distributed, and 202 surveys came back, representing a response rate of 13.3 percent. The response rate for the Village of Colfax was 25.5 percent.
Here are some of the results from the 2016 survey:
• Age group of respondents: 36 people were under 18; 22 people were between the ages of 19 and 26; 118 people were between the ages of 27 and 62; and 129 people were 62 years or older.
• “Would you be willing to use a medical provider other than Mayo, such as Marshfield, Prevea Health, or Oak Leaf Clinics if this provider had a clinic site in Colfax?”
Of those who responded to the survey, 171 said “yes”; 37 said “no”; 17 said Mayo only; 2 said “not Marshfield” and 7 said it depends upon their current insurance provider.
• “Which types of providers are you willing to see?”
Of those who responded to the survey, 196 said they would see a Doctor of Medicine; 110 said they would see a Doctor of Osteopathy; 173 said they would see a physician assistant; and 151 said they would see a nurse practitioner.
• “If the clinic is open only part time, what hours would you prefer?
Of those who responded, 123 said mornings (8 a.m. to noon); 79 said afternoon (noon to 4 p.m.); and 70 said 3 p.m. to 7 p.m.
Next steps
One next step in the process of bringing a mobile primary care unit to Colfax would be to survey people to see what they want for healthcare, Niggemann said.
The Marshfield Clinic representatives said they would plan to meet with employers again and to meet with specific groups of employees as well as various other groups, such as the representatives for the school district.
Two people who attended the morning session said they would be interested in serving on a planning committee for bringing the Marshfield Mobile Primary Care Unit to Colfax, Niggemann said.
When asked how many days per week the mobile primary care unit could or would be in Colfax, Kruse said it would depend on how many people used the service.
A dedicated appointment line only for the primary care unit will be set up, although the unit also will be able to take walk-ins, she said.