One of the key challenges facing consortium activity in Southeastern Kentucky is the relative lack of federally sponsored consolidated health centers that serve this area. While there are 14 consolidated health centers in Kentucky overall, only one of these, a health care for the homeless (HCH) center, is located within the four-county region served by SKYCAP (the majority of Kentucky’s consolidated health centers are located in or near Louisville). The only 330 grantee FQHC in the Southeastern region sits outside the SKYCAP service area. Some of its satellite clinics are located within the SKYCAP region but are generally too small to participate in the consortium. Aside from these satellite clinics, several free clinics, other primary care clinics and two public hospitals serve the uninsured and underinsured within the SKYCAP service area. Two of these clinics are considering applying for consolidated health center status.
Demographic data from the SKYCAP service area demonstrates the extent of the poverty and health problems affecting this region. In 2003, between 20 and 40 percent of the population was without insurance in the four-county target area. It is estimated that 24 to 45 percent of the population in Harlan and Perry counties live in poverty compared to the state average of 16 percent6. These counties also have the highest rates of asthma, diabetes, heart disease, hypertension and severe mental illness in the state. Hospitalizations for these diseases exceed the rates in the rest of the state by 2 to 10 times7.