A U.S. Census Bureau report released this week showed that the percentage of Warren Countians without health insurance was among the highest in the state.

Using a variety of sources, the report estimated that in 2007, 22.3 percent of the county’s 65-and-under population was uninsured, the highest in the region.

The percentage of uninsured ranged from a low of 15.7 percent in Simpson County to Edmonson County’s 21.8 percent.

It’s unlikely that percentage will change when the 2008 numbers come out. What will happen when more aspects of health care reform come into play is unclear.

“Just because the access is required doesn’t mean people can afford the co-pays,” said Carla Reagan, executive director of the Commonwealth Health Free Clinic.

Reagan said free clinics such as hers still will have a place in health care reform and are vital now with the economy still in the doldrums. The free clinic offers medical care for the working uninsured and dental services at a discount to anyone who does not have private pay dental insurance.

Reagan said CHC took over the dental services from Fairview Community Health Center in 2007 and since then the number of patients seen has steadily increased. Reagan expects to serve about 2,000 patients this year.

“We’ve seen an increase in the number of phone calls for our (medical) services,” Reagan said. “We see a set number of patients when we are open, so it’s hard to know how many more would be lining up. But our number of new patients has increased over the past six months, mostly due to the economy.”

Reagan said when the clinic is open two nights a week, patients are served on a first-come basis, mostly based on volunteer staffing that night.

“We need more doctors and clinical volunteers to help us see more patients,” she said.

Reagan said they have a list of about 25 volunteer doctors but would like more.

“There are a lot of things our volunteers can do, but if we don’t have a doctor, we can’t open that night,” she said.

In the nearly 15 years that it has been open, the clinic has provided nearly $35 million in services to the working poor, Reagan said.

When unemployed patients seek medical help, Reagan said, they are referred to Fairview, where services are offered on a sliding scale.

The CHC clinic also has a free prescription program. Last year, the medical clinic had 4,500 patient encounters and filled 8,900 prescriptions.

“What we are seeing is a lot of returning patients with chronic care needs who are adding more and more prescriptions that they can’t afford,” Reagan said. “The need for that help has definitely gone up.”

Kentucky Homeplace, a statewide organization that helps residents find free or low-cost prescription programs, sees a continued need for its services.

Last year, the agency helped 2,000 people access more than $2.9 million in prescriptions in this area of the state, according to Fran Feltner, director of the agency.

It wasn’t an increase over the previous year, but the agency wasn’t open year-round because of a lack of state funding.

“What we saw last year during all the layoffs was people who normally had insurance and then they didn’t,” Feltner said. “It was a whole new ballgame - a shock to go without insurance and then try to pay for medicine that could be $500 or more a month.”

Homeplace also tries to find patients access to preventive care, she said.

“If people don’t have a job or insurance, they are not thinking about getting mammograms, colonoscopies or other preventive services,” Feltner said. “But through networking, we are able to get them those services (either free or at reduced costs).”

Feltner said such preventive care is important to reducing future health care costs.

While it’s clear the percentage of uninsured remains high in the region, the actual percentage of uninsured patients being seen at Fairview has leveled off to about 42 percent, according to Chris Keyser, the facility’s director. Most of the other patients at Fairview are covered by either private or government insurance programs.

The percentage of patients on Medicaid has increased, something that is predicted to grow even more.

While private physicians may choose not to accept Medicaid patients because of what is perceived as a low reimbursement for services, Keyser said clinics such as hers don’t run into that issue.

“Because we are federally funded, our reimbursement is different than private practice physicians,” she said. “So there is a safety net ... that affords us a little better rate.”

From January to June, Fairview saw 7,075 patients.

“That’s definitely trending upward,” Keyser said.

Right now, any new patients are being booked into appointments six to eight weeks away, she said.

— To those working who need help or doctors who want to volunteer, the CHC clinic is open Tuesdays and Thursdays, beginning at 5 p.m., at 740 E. 10th Ave. and can be reached at 781-9260; Fairview Community Health Center is at 651 Seventh Ave. (783-3573); Kentucky Homeplace’s office for Warren and Barren counties is in Barren County, but appointments can be arranged in Warren County. For more information, call (800) 890-6368.