A sign beckons patients to sign up for Covid-19 vaccinations at the RKM primary care clinic in Livingston, seen Saturday, July 3, 2021.

CLINTON — Buoyed by federal aid, an East Feliciana health clinic plans to grow the services it provides vulnerable patients via smartphone, tablet and computer — a perennial sticking point not only for health providers, but all residents of this broadband-lacking corner of Southeast Louisiana.

RKM Primary Care’s flagship Clinton-based dental clinic in June earned a $79,560 grant from the Federal Communications Commission to expand remote treatment, including video visits and remote patient monitoring. The services will target 200 low-income and veteran residents who suffer from health afflictions ranging from opioid dependence to COVID-19, according to the federal agency.

The Clinton site has yet to receive guidelines from the feds describing how, exactly, it must direct the grant money, said Ariana Smith, an outreach coordinator for the clinic network.

Regardless of those specifics, the grant offers new opportunities to expand care for the headquarters of a network that has in recent years become a model for rural health access.

Launched by local nurse practitioner Ginger Hunt in 1999, the Clinton clinic sought to fill a gap in healthcare access for impoverished residents in the rural town of roughly 1,600. Since then, it has expanded into a network that now includes multiple sites in Livingston Parish, one in Tangipahoa Parish, several in West Baton Rouge and two new clinics in East Feliciana.

Run as a collective 501(c)(3) nonprofit, the clinics each offer reproductive health check-ins, mental health counseling, dental care and more — all services that are scarce for impoverished patients in South Louisiana. Whether they are regulars or in search of one-time emergency care, visitors can pay through Medicare or Medicaid enrollment.

If they aren’t insured — as is frequently the case for the Florida Parishes’ poorest residents — patients can pay on a sliding scale based on income.

The network’s philosophy boils down to not turning patients away at the door.

“We don’t deny care for people who can’t afford it,” Smith said.

That system has been a boon to needy residents of Livingston Parish, where many patients hover just above the threshold at which they would qualify for Medicare or Medicaid coverage, but still can’t afford private insurance.

After Gov. John Bel Edwards expanded Medicaid eligibility in 2016, Louisiana’s base qualification for the program rose to include households whose incomes amount to 133% of the federal poverty level.

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Still, the Livingston clinic “has a lot of cash patients who arrive to come and get affordable care,” said Nichole Whetstone, practice manager for the clinic.

In an era when access to psychiatric care for school-age children is lacking — especially in poor, rural parts of the United States, where students cope with mental health challenges at higher clips than elsewhere — the Livingston Parish clinics also supply behavioral health specialists to most local public schools.

Some counselors work on multiple campuses. But the majority of schools have their own mental health counselor supplied by the clinic.

“That has been a lifeline for kids,” Whetstone said.

Unsurprisingly, the number of patients the Livingston clinic serves surged in the pandemic: 12,000 people visited the site in 2020 compared to around 15,000 at the halfway-point of 2021, according to Whetstone.

Much of the care patients needed over the past year involved mental health, Whetstone said.

As the Clinton clinic prepares to spend the federal grant on expanding remote services in the broadband-deprived area, it will have a model in Livingston: Her clinic staff focused much of its energy during the pandemic on growing its capacity to see counseling patients remotely, Whetstone said.

“If patients were too scared to leave their home, they didn't have to, or if they didn't feel safe leaving their home because they weren't vaccinated they could still have the service,” Whetstone said.

RKM clinics also pitched in on COVID-19 vaccine outreach efforts this spring. In Livingston, the clinic at one point filled a waiting list for people hoping to receive their shots — an unexpected occurrence in a parish with an anemic inoculation rate.

Whetstone believes that shows evidence of the trust the clinic developed among its patient base.

“Some people you think would definitely get the shot,” she said, “while the people you think are going to get it, they don't.”

James Finn writes for The Advocate as a Report For America corps member. Email him at JFinn@theadvocate.com or follow him on Twitter @RJamesFinn.

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