Prince William officials described a health system for the poor that is in crisis, straining government resources and the county's two private hospitals.
The problem, health leaders told the Board of County Supervisors on Tuesday, is that the system for taking care of the county's indigent is not a system at all. It is rather an informal patchwork of programs that cannot keep up with growing demand, said Alison Ansher of the Prince William Health District. In Northern Virginia, 11 percent of the population is considered medically indigent, Ansher said.
The solution, leaders said, is a community health center partially funded by the federal government. Prince William might qualify for one or more clinics, which are also found in poor rural areas and inner cities. An effort is underway to apply for such a clinic.
Currently at risk are many pregnant women and children, who are not getting the care they need, Ansher said. The county's pediatric primary care project had a waiting list of 410 children as of June 30. The wait time for an appointment for prenatal care at the county health department's two clinics was 12 weeks in July, up from eight to 10 weeks just a month earlier.
Many women who need the services speak little or no English, putting additional pressure on the programs and staff members, said Anne Terrell, a nurse manager for the Health District, which includes the county, Manassas and Manassas Park.
The county's two hospitals provided more than $40 million in uncompensated care in 2003, up from $30 million in 2002. Last year Prince William Hospital provided 87 "drop-in" deliveries -- women who had no prenatal care -- up from 15 in 2002. Potomac Hospital showed a smaller increase.
In addition, many additional deliveries at both hospitals were paid by Medicaid, the government health program for the poor, which does not fully cover the hospitals' real costs, said Bob Riley, chief financial officer of Prince William Hospital.
Adding to the problem is that Inova Fairfax Hospital is no longer donating delivery care for indigent pregnant women referred from Prince William and Loudoun counties. That responsibility will fall back to county health officials and local hospitals, county officials said.
Supervisor Hilda M. Barg (D-Woodbridge) called for the board to lean on state officials and the area's congressional delegation to make sure the health center is approved.
"The numbers [of uninsured] are not going to go away, they are going to continue to go up," Barg said.
Corey R. Riley, a Centers for Disease Control and Prevention specialist who is on loan to the Prince William Health District, said the clinic could be up and running by this time next year if all the approvals go through.
Riley and Asher said the clinic could focus on providing chronic care based on income. That would relieve pressure on other programs and on the emergency rooms of local hospitals, Asher said.