EDITOR'S NOTE: This is the fourth and final installment of a four-part series in which The Columbia County News-Times is examining poverty in the affluent area that is Columbia County in a time of festivities and thanksgiving.
When most people get a cold or the flu, the first thing they might do is head to a doctor's office for antibiotics and advice.
Although Columbia County is an affluent community overall, there are many residents who won't go to a doctor because they have no health insurance and can't afford doctors or emergency-room visits.
"We definitely have people who have access-to-health-care issues," said Phyllis Roland, the facility manager for the Columbia County Health Department.
According to 2000 Census figures, the most recent data available, Columbia County had more than 4,500 people, or 5 percent of the county's population, living below the federal poverty level. Pam Tucker, Columbia County's Emergency Management Division director, said those numbers are always very conservative, and she estimates the number to be closer to 7,000 people.
"There is a need throughout the county," Harlem Mayor Scott Dean said. "But the concentrated area is in the Harlem and Grovetown area."
A census map showing the distribution of county residents living below the poverty level shows that 12.1 percent live south of Interstate 20 in areas surrounding the two cities. Of the nearly 8,000 people living in that area, almost 1,000 were considered to be living in poverty.
The cost of health care continues to rise, and state and federal aid programs such as Peachcare for Kids and Medicare gradually are being downsized and ended. Dr. Terrence Cook, the president and chairman of the board for Richmond County Medical Society's Project Access program, said that people who are uninsured or underinsured are having more difficulty getting primary medical care.
The program, underwritten with $400,000 from the Richmond County government, provides primary medical services, diagnostics, X-rays, lab work and inpatient and outpatient services for Richmond County residents who qualify by being between ages 18 and 64, being without health insurance and earning less than 150 percent of the federal poverty level.
"Unfortunately, we're seeing access to care just disappear from the landscape," Cook said. "All these programs are just disappearing from the landscape, and there needs to be something to take their place.
"We're hearing from the federal government and the state government, who are less and less willing to pay for these (primary) services, and more and more people are being cut free."
Roland said her office offers mostly preventative care such as immunizations and birth control, treatment for a limited number of illnesses such as sexually transmitted diseases and the identification of conditions that need medical attention. Many programs were cut because of a lack of funding. Roland said the state Legislature is discussing the fate of the state health department and whether it will continue to provide clinical services.
"As the county continues to grow, you can't ignore the people that need care," Roland said. "It's quality of life and quality of health in the community."
Roland said that her staff refers patients to several other clinics such as the Healthcare for the Working Poor Clinic on Wrightsboro Road in Augusta, the Good Samaritan House in Dearing, the Tri-County Center in Warrenton and Wesley United Methodist Church's Faith Care Clinic in Evans.
Volunteer medical personnel at the Faith Care Clinic, operated by Dr. Al Lightsey, treat uninsured Columbia County residents with minor illnesses, primary medical care, counseling and some prescription drug assistance. The Faith Care Clinic has seen about 250 patients, mostly single mothers, in three years and treats between 80 and 90 for management of illnesses such as hypertension and diabetes.
"It's more of a caring place than a curing place," Lightsey said, Each patient is not only treated but also talked with and acknowledged, which he said is very important. Lightsey said his clinic can help patients fill out forms to qualify for discounts or free prescriptions.
"We are maximizing what we have for these folks,'' the doctor said. "Unfortunately, it's not meeting all the needs out there, to say the least."
Cook said he was invited to explain his program to Columbia County Commission earlier this year in hopes of moving the program to Columbia County. With a location to operate from, the program would cost the county $200,000 annually, which mostly would go toward paying for patient prescriptions.
Commissioner Tommy Mercer, who also is on the county's board of health and is an active volunteer known for his generosity, said the commission did not fund Project Access because the money just wasn't available. As much as Mercer said he wanted to fund the project, the funds just were not available.
"That was a significant amount," Mercer said. "That's a lot of money. We're spending taxpayers' money. That's another consideration we have to make, to make sure the charities we give to offer services to a broad base of people. We get the most we can out of our money."
Julie Miller, the coordinator of the Family Connection of Columbia County, said quality health care is essential to maintaining the good quality of life that Columbia County is known for.
"(Project Access) is not a charity," Miller said. "Health care, to me, is an essential service for people. If you don't have your health, what do you have? You don't have anything. It is a small amount of money in the overall context of the money in Columbia County ... We want (good quality of life) for all our citizens, not just the ones who can afford it."
In August, Miller and the Rev. Roger Vest, the Family Connection board chairman, invited Cook to make a presentation to city officials from Harlem and Grovetown, representatives from the county school system and Roland's department, among others.
City officials from Grovetown and Harlem said they'd like to get involved, but on a smaller scale to serve the residents of the two cities. A location and start-up funding to pay for tests and prescriptions is all that is needed.
"We need to become involved in it," Grovetown Mayor Dennis Trudeau said. "They are offering their services, which is something great. We certainly need it."
Trudeau already has offered the use of Grovetown City Hall and possibly a space in the city's new community center, which is scheduled to be completed by the end of 2006. Dean said a Harlem doctor has offered the use of his building, too.
The funding is a little more difficult.
"We're still working on it," Miller said, adding that she has been searching for possible funding opportunities for Project Access through grants and donations. "We're not giving up."
"We're trying to find a way," Dean said. "It's slow, but we're trying to find a way. If there's one out there, Julie will find it."
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