Task force hears ideas on health safety net. - The Knoxville News-Sentinel (Knoxville, TN)

Byline: Carly Harrington

Mar. 18--Extend clinic hours. Encourage tort reform. Expand the telemedicine network.

Those were among the recommendations made by the public Thursday during a forum held by Gov. Phil Bredesen's Task Force on the Healthcare Safety Net at the City County Building. About 50 representatives of Knoxville's health-care community and TennCare enrollees attended the forum.

The 25-member task force is holding a series of regional health forums across the state to gather ideas on how to care for the more than 300,000 people who will be cut from the TennCare rolls.

The suggestions will be considered by the task force and may be included in its recommendations to Bredesen on May 1, said Melissa Knight, task force member and executive director of Knoxville's Interfaith Health Clinic.

Randal Dabbs, president and chief medical officer for Southeastern Emergency Physicians, a division of medical staffing firm TeamHealth, said he was concerned about the impact the proposed reforms would have on hospital emergency departments, which are already 'overcrowded and underfunded.'

Dabbs said there is 'an unfunded mandate' to fully screen patients who come to the emergency department, which puts a tremendous burden on their resources. 'What's the true safety net when you're sick and don't have access to a physician or it's a holiday? It's the emergency department,' Dabbs said. He suggested extending the hours of primary care and urgent-care settings and providing enough access at those clinics during normal hours.

Others concerned about the seriously mentally ill wanted reassurance that the existing infrastructure for those patients would be protected.

Cliff Tennison, a psychiatrist and chief clinical officer at Helen Ross McNabb Center, suggested protecting certain groups from proposed cuts. Pediatrician Mark Gaylord touted a 'very innovative plan' that is being done in Nashville and Chattanooga called Project Access. It enrolls a network of local physicians to care for a certain number of people without insurance, he said.

'There is a lack of providers who will help care for the uninsured. This leaves a few who are overburdened,' Gaylord said.

And without tort reform, there is a concern among physicians to take uncompensated care when there is a risk of liability, Gaylord said.

With a quarter of children eligible for TennCare but who aren't enrolled, Gaylord also suggested making the enrollment process easier by allowing local health departments and hospitals to sign up eligible participants. Currently they must go to the Department of Health Services and Development Agency. Peter Kraslawsky, a University of Tennessee graduate student in medical ethics, said the committee should look at recent technological advances in telemedicine that uses the Internet and Web cams to diagnose patients.

Several people suggested the governor expand the task force -- which includes doctors, hospital administrators, legislators, mayors and state officials -- to include representation from Knoxville area hospitals and TennCare enrollees.

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