The Salt Lake medical outreach clinic: recommendations for improving health care delivery

The financing and provision of health care for medically indigent persons ineligible for Medicaid and Medicare has long been a problem for Utah. Utah's response has been the Utah Medical Assistance Program (UMAP), funded solely by state revenues and represented in Salt Lake County by the Medical Outreach Clinic. Because of reduced funding and a growing patient population, UMAP administrators have been forced to pare down program's services, leaving a minimum of health care available. Accompanying the reduction in services are economic, social, and psychological barriers to obtaining care. These barriers, most unintentional, discourage participation by eligible persons and may reduce short term expenditures. However, the barriers negatively affect the health status of the people for who the system was originally designed, an may ultimately cost the system more. I have reviewed the literature to determine how other communities have dealt with the medically indigent, and have drawn comparison with the distribution of services by the Utah Medical Assistance Program. A descriptive study of UMAP patients is presented to illustrate the scope of their health care needs and emphasize the suitability of Salt Lake Community Health Centers as a provider of care for this population. A solution to the problem of indigent care in Salt Lake County could involve a coordinated coalition of federal, state, and private resources.