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There is one physician for every 1,723 residents in St. Mary’s County, a smaller ratio than the state and national average, said Joan Gelrud, vice president of MedStar St. Mary’s Hospital in Leonardtown. And the number of visits to the hospital’s emergency room have been on the rise each year, indicating that more people don’t have primary care doctors.

With the state’s recent designation of Lexington Park, Great Mills and Park Hall as a Health Enterprise Zone, tax incentives can be used to help bring in more doctors and expand the range of medical care to an area in need, she said, “providing health care in the right place for patients.”

Two physicians have practices and a mobile Health Connections vehicle in what is now the Health Enterprise Zone, “and that’s all,” Gelrud said. There are 30,902 people living in the zone and there are no medical offices south of Lexington Park.

In 2009, the hospital had 48,259 emergency room visits. In 2012, there were 57,028 visits.

“A lot of the visits are related to primary care,” Gelrud said, and so the emergency room becomes the de facto medical provider.

“They don’t have access to a doctor and they don’t have transportation,” she said of some of those seeking treatment. There were 19 applicants for the new state designation, and St. Mary’s County was one of the five selected. Over the next four years, the St. Mary’s Health Enterprise Zone can use $3.4 million in state funds. A significant portion of the grant will be used to provide incentives for providers to bring in more physicians, Gelrud said.

On average it takes 10 years for a physician to repay student loans. Grant money can be used to help pay down that debt for doctors, nurse practitioners, physician assistants and social workers to come to the targeted area of St. Mary’s. There are also income tax reimbursements for new practices within the zone. “These folks have to practice in the Health Enterprise Zone and participate in the data collection that’s required,” Gelrud said. The practice should also have 40 percent of its patients on some form of medical assistance.

“Once practices are set up they don’t move around too much,” she said. The challenge is to bring them in.

While the ratio of physicians to St. Mary’s County residents is 1 per 1,723, it is 1 per 713 in Maryland and 1 per 631 nationally, Gelrud said. There are complicated reasons behind that, she said, but “reimbursements for physicians is less in Maryland than other states.”

MedStar St. Mary’s Hospital is a not-for-profit group and doesn’t receive any tax breaks under the program. Some dollars associated with the grant go into recruiting providers that bring both primary health and behavorial health services. The program also plans to start running a 12-passenger van with room for two wheelchairs on a 16-mile route taking patients from neighborhoods in the zone to doctors’ offices, grocery stores and parks. If there is room, the van can be used to take people to work as well, she said. “This is like a little medical route” in the Health Enterprise Zone, she said.

The 13-year-old Health Connections vehicle will be outfitted with dental equipment and incentives will be offered for dentists and dental assistants to volunteer to bring service to those without dental insurance in the Lexington Park area.

The Mission of Mercy brought free dental work last year at Chopticon High School for those in the region without dental insurance. There were more than 900 served during two days, showing the need, Gelrud said.

The St. Mary’s Hospital Foundation has pledged $250,000 for the purchase of a new mobile outreach center, to be named after the late Dr. J. Patrick Jarboe. Another $250,000 is sought in donations, said Holly Meyer, the hospital’s director of philanthropy.

This summer, Cherry Cove Land Development is due to start work on a three-story, 44,500 square-foot medical arts building on Great Mills Road that could serve as a central hub for the Health Enterprise Zone. “We hope to be a tenant,” Gelrud said, along with other services like the St. Mary’s County Housing Authority, the social services department, Health Connections. Medical providers recruited to practice in the area “we hope, could be in that building,” she said.

The coalition with MedStar St. Mary’s Hospital aiming to increase services in the Lexington Park area includes Walden Sierra, the St. Mary’s County Health Department, social services, Great Baden Medical Services, Minority Outreach Coalition, the Community Development Corp., the department of aging and human services, the housing authority, the Southern Maryland Center for Independent Living and others.

Brian Norris, chief executive officer of Cherry Cove, said last week, “We gave the coalition a discount on the rent,” saving $900,000 in five years. The new building should be ready for occupation in the summer of 2014.

“That is a goal, to be in one central location,” Gelrud said.