"Grateful to have found this resource': Austin pediatric clinic cares for uninsured children

AUSTIN (KXAN) --- There's a clinic in Austin taking on a huge challenge to help kids in need.

Specifically it is helping uninsured children in Texas.

'Felt like I was in a desperate position'

Yanaisa Martinez's children are among the thousands of children in Texas without health insurance.

Through a translator, Martinez told KXAN she had nowhere to take them for a doctors visit.

"I actually felt like I was in a desperate position because I didn't know where to take my son," the Spanish-speaking translator told us Martinez said.

Martinez had nowhere to turn to until she found Lirios Pediatrics in South Austin.

It's a non-profit, located at 4201 South Congress Avenue, that services uninsured children.

"We are the only completely free clinic that exclusively serves uninsured children in the state of Texas," said Executive Director and Co-founder Monica Simmons. "If they have Medicaid, if they have MAP, if they have insurance, there are other providers in our community that can fill those needs. But the uninsured children in our community have very little access to care."

Simmons said they offer a variety of services including:

• Primary care visits
• Immunizations
• Mental health counseling
• Pharmacy
• Lab work

"When we can administer their vaccines at no charge, instead of an administration fee of $10 or $15, that's the difference between their family eating that week, and their child being able to go to school," Simmons said.

Along with that, the clinic also offers clothing and food for those who need it.

Simmons said families are coming to them from as far north as Jarrell to as far south as San Antonio.

"They might have moved from another state and don't have their Medicaid in place. They might be new to this country and have not had time to apply for benefits," Simmons said. "They might be two working parents, and those parents can't afford to put the kids on their policy because the premiums are too expensive."

Simmons said they get a majority of their referrals from local school districts.

Because the clinic doesn't take payment from patients, it relies solely on donations and grants.

"Anybody who is willing to make a one time or more recurring donation, you can do that directly on our website. We appreciate it," Simmons said. "Every dollar makes a difference to a child."

Simmons said they've been open for nearly a year and have already had 1,400 visits.

For Martinez, this clinic gives her peace of mind knowing that her children will get the care they need.

"She said the message for the clinic is that I'm very grateful to have found this resource," said Martinez's translator.

Texas leads the nation in uninsured children

The clinic also tries to help guide families through the process of getting insurance.

Pediatrician Valerie Smith said trying to get coverage can be overwhelming. Smith is on the Texas Medical Association's Committee for Medicaid, CHIP and the Uninsured.

"The system for enrolling in Medicaid is not simple. It's complicated. It requires a lot of documentation," Smith said. "It requires some tech knowledge and a little bit of health literacy. That can be barriers for many of our patients."

Smith said clinics, like Lirios Pediatrics, are desperately needed across the state.

"Texas unfortunately leads the nation both in the percentage of children in our state who are uninsured, which is at almost 11%," Smith said. "So more than 10% of kids in Texas don't have insurance."

Smith said studies show when children have access to care, they have better health outcomes.

"There's really good data that if you have health insurance, you are more likely to get preventive care," Smith said. "You are less likely to need to access emergency care and kind of catastrophic care because you are able to go and get care before a problem gets out of control."

But Smith said lately, there are a large number of children disenrolled from Medicaid for procedural reasons.

"It's not that somebody was able to look and verify that their family is not eligible anymore. It's that something didn't get turned in or got turned in incorrectly," Smith said. "Or sometimes the computer glitched and didn't acknowledge that something was in or maybe a family didn't get the packet because they have moved."

Smith said its important to have resources available to families to make sure that children who are eligible are connected to those services.