Your Community Health Center's LeeAnn Mentink addresses the Salem Area Chamber of Commerce last week.

In contrast to a small drop nationally, drug overdose deaths continue to rise in Missouri, according to a joint presentation to the Salem Area Chamber of Commerce by the Your Community Cares Rural Health Coalition and Your Community Health Center at its February meeting.

YCHC, a primary medical, dental and behavioral health clinic in Rolla, is the parent organization and home base of the Your Community Cares Rural Health Coalition. Coalition members include Healthy Dent County, Salem Memorial District Hospital, Salem R-80, Dent County Health Department, SEMO and Prevention Consultants.

The coalition is currently focused on meeting needs for Substance Use Disorder prevention, treatment and recovery services in Crawford and Dent counties, mostly through grants.

Based on 2018-19 data, the latest available, overdose death rates dropped 0.2 percent nationally.

“But Missouri is currently at a seven percent increase,” said Felisha Richards, the coalition director. “In this state we still have a lot of work to do.”

Help may be on the way. She noted that Missouri will be receiving a large sum of money from the multi-billion-dollar opiate lawsuits against pharmaceutical companies that were settled last fall. Richards said she would be meeting soon with representatives of the Eastern District U.S. Attorney’s office to advocate for funding for rural areas.

“We are one of four places they’re going to be visiting regarding specifically the opioid crisis and what that looks like for our area,” she told the chamber. “So, we’re excited to have that opportunity.” Missouri also continues to rank high in methamphetamine use, she said.

The coalition is now operating under a three-year, $1 million implementation grant after initially receiving a one-year planning grant.

“We are required to do prevention, treatment and recovery,” Richards said. “We actually appreciate that the federal government makes us do that because you can’t have one piece of the puzzle and be successful. Communities have to have all three pieces.”

Part of the funding for this year will go toward a holistic care bus mobile unit, she said. When completed, the bus will offer dental, medical and behavioral health services in different towns on a rotating basis.

“We’re not here to provide healthcare for Salem,” she said, deferring to coalition partners like SMDH and Mercy. “We’re just here to fill a gap.”

The unit will have multiple rooms and be handicapped accessible.

“We’re excited for what it will bring the Crawford, Salem and Dent County areas,” Richards said. “For scheduling, we’re looking at a week at a time in each community,” possibly the same week each month.

She also talked about upcoming community events, including the “Not My Child” video presentation at SHS Feb. 18 (Tuesday) about opioid awareness in families and the Maternal Health and Infant Mortality Summit in Rolla April 7, focusing on the topic of pregnant women with substance abuse issues.

One panelist will talk about medical marijuana in Missouri.

“We know as a state we’re getting ready to dive into something we’re not prepared for and that our medical community really isn’t prepared for,” Richards said.

The panelist is from North Dakota, which started dispensing medical marijuana last year. She’ll be talking to healthcare providers about prevention. Richards said pregnant women are hearing reports that marijuana is safe for them, that it’s all natural.

“But those women don’t realize the THC levels of marijuana today are not the THC levels of marijuana in the ‘70s,” she said.

Also speaking to the chamber was YCHC marketing director LeeAnn Mentink, who talked about services offered at the center, which was founded in 2014. Its mission is to provide access to high quality, compassionate healthcare to everyone, regardless of financial, cultural or social barriers, she said.

That includes helping people with filling out Medicaid, Medicare and other insurance applications, connecting them with discounted prescriptions and providing transportation to and from the clinic. YCHC works with a volunteer group called HealthTran that helps patients make it to their appointments.

One woman told Mentink she lived in town but had to take a taxi to the clinic.

“She said it would cost her more to get to the clinic than the cost of what she was coming in for,” she said. “It’s surprising how many people don’t have reliable transportation.”

The clinic offers its services on a sliding scale to those who can’t afford them, as well as payment plans and accepting insurance.

“Some people will just go to an emergency room instead of a healthcare provider because they have scheduling issues and financial issues,” she said. “We take same day or walk-in appointments.”

She called the staff “truly passionate” about providing healthcare to everyone.

“For us, this is our mission,” she said. “We don’t want people to fall through the cracks.”

YCHC will also help connect those in need to community groups that can help them with basic needs like food, clothing and shelter, she said.

Mentink also encouraged chamber members to sign petitions for a state ballot issue to expand Medicaid coverage. Efforts are underway to hold petition signing events in Rolla March 13 and Salem March 26.

She noted that working Missourians who earn less than $18,000 a year can’t afford private insurance and aren’t eligible for Medicaid. She was surprised to learn that 71 percent of those people have full time jobs. Another 14 percent are working part-time.

“Ten rural hospitals have closed in rural Missouri since 2014,” she said. “It is predicted that Medicaid expansion will go a long way to keeping rural hospitals open. In Dent County we understand this. Proximity to healthcare is vital, especially when there’s an acute care situation where time is everything... So, it’s important to keep our rural hospitals open.”

For those concerned about the cost, she said two-thirds of the states now have expanded Medicaid and there’s a record of how it is working and the price tag. It will also bring millions in federal tax money back to Missouri, she said.

Another argument is that uninsured families will often go to a hospital emergency room instead of a doctor.

“They’re going to take their kids where they can get care,” she said. “That costs taxpayers and hospitals a tremendous amount of money. It costs rural hospitals a tremendous amount of money, and that’s why many of them are closing.”

Once the 170,000 signatures are obtained, efforts will focus on educating the public about what they are voting on. There is currently no organized opposition, she said.