By Kathy Chaffin
kchaffin@salisburypost.com
Rowan County Board of Health members voted Tuesday night to charge a $40 flat fee for initial primary-care visits.
“We’re trying to get people to understand it’s not free,” said Health Department Director Leonard Wood. “You’ve got to pay for it.”
The $40 comes nowhere close to covering the actual cost of the service, he said, estimating the per-visit cost to the department at between $150 and $180.
Once a person becomes an established patient, Wood said the fee would drop to $20 for follow-up primary-care visits.
The state does not require health departments to provide primary-care services, he said, and only 40 to 45 percent actually offer them.
Wood said the $40 fee is not meant to be punitive, “but there are a lot of folks coming here that are not taking any responsibility.”
There has not been a set fee before now, he said. For the past two years, said Patty Yost, a nursing supervisor for the department, the average fee collected for primary-care services has been $5.
The new fee would not apply to sick children, she said.
Wood said he was looking at a date of Oct. 1 or Nov. 1 for implementing the fee.
Board member Rick Parker asked what would happen if someone comes to the Health Department for primary-care services and simply can’t afford to pay the $40.
“We say goodbye,” said board member Mike Fuller.
“Do we not have some responsibility to refer them to somebody else?” Parker responded.
Wood said his personal opinion was no, but that he would like to hear the opinions of board members.
Parker, vice president of clinical and support services for Rowan Regional Medical Center, said he would hate to see people who can’t afford the fee end up going to the emergency department for primary-care services.
Yost said they could go to minor emergency facilities, but added that Health Department staff don’t provide them with any information about what’s available. “It would be up to them to find them,” she said.
Parker asked if health department staff had a list of physicians they could give out. “I would encourage you to give them out,” he added.
Novant, which recently merged with Rowan Regional, does not turn patients away, he said, to ensure that their conditions do not worsen and require even more expensive care. Parker said he would like for the Health Department to try to help people who can’t afford the fee by at least providing a list of alternative sources of primary care.
Wood said he did not believe $40 is an unfair rate, but said of Parker’s comments, “I think you have a good point.”
Yost said staff members do tell people who can’t afford the fee for primary-care services about the Good Shepherd Clinic and the Community Care Clinic, both of which offer health care to low-income people.