The Union County Health Department and Memorial Hospital are working on a new initiative that could change the way many county residents receive their health care.

The Union County Health Department and Memorial Hospital are working on a new initiative that could change the way many county residents receive their health care.

Health commissioner Jason Orcena said that the two groups are currently working to create a community health center, with the overall goal of reaching the status of a Federally Qualified Health Center (FQHC).

"There is a whole spectrum of health centers in terms of how they are funded, and the (federal designation) is where you hope to be one day because that's where you get the most bang for your buck," Orcena said. "We're at the very beginning stages of starting a community health center, but the (FQHC) is where we want to be when that's all done."

Orcena said the idea behind a community health center is providing "quality primary care to the under-insured."

"Those who don't carry insurance and are self-pay, those could be independent professionals, and if you are self-pay or on Medicaid then a community health center is designed for you, to help control the costs associated with chronic diseases and other conditions," Orcena said.

According to the Rural Assistance Center, a FQHC is a type of provider defined by the Medicare and Medicaid statutes that qualify for several federal benefits, including enhanced Medicare and Medicaid reimbursement, medical malpractice coverage through the Federal Tort Claims Act, eligibility to purchase prescription and non-prescription medications for outpatients at a reduced cost, access to the National Health Service Corps, access to the Vaccine for Children program, and eligibility for various other federal grants and programs.

An FQHC is also required to provide primary care services for all age groups, in the form of preventive health services on-site or by arrangement with other providers. Other requirements include that they provide (directly or through arrangement) dental services, mental health and substance abuse services, transportation services necessary for adequate patient care, hospital and specialty care, according to the Rural Assistance Center.

Orcena said that community health centers help to keep residents and providers' health costs under control. If residents who might not be able to afford other care can use a health center today, the reasoning goes, it increases the chance that they won't be in the emergency room tomorrow, accruing even higher costs.

"This is all about keeping the quality of life and health care equal for everyone in our community," Orcena said.

He said the health department has spent about a year researching the level of access to health care in the community, compiling information from Memorial Hospital and other health care providers, insurance rates, and the needs of residents and providers alike.

"We have been engaged in the process and helped to analyze the data relative to bringing a Federal Qualified Health Care Center to the community," said Spence Fisher, Memorial Hospital's vice president of physician relations and business development. "The lion's share of the work to this point has been done by (the health department). We are hopeful this may come to fruition."

With that information, the health department applied to the federal government to be eligible for a health center. While the initial response to that request was that the county didn't constitute the best fit for a health center, Orcena said, the health department then petitioned the state government, which made a request on Union County's behalf. Persistence paid off.

"We pursued that, and we were granted our request from the federal government about a week ago," Orcena said Wednesday. "It took quite a bit of time to make that happen. We've been working on that since April of this year."

Approval allows the health department to apply for a federal grant to get the project under way, Orcena said.

"We don't have to have that grant, but it will provide a significant amount of funding to get this up and running," he said. "Without the grant we will still be pursuing a community health center, but we would have to go through some additional steps."

A governing board has been established for the new health center, Orcena said, comprised of community leaders and potential users. The government requires a governing board for FQHCs, and that they be made up of at least 51 percent from their health care subscribers.

A strong relationship between the health department and the hospital is key to the venture's success, he said.

"In order to make this work in Union County, there has to be a very strong partnership between the health department and the hospital to provide the resources needed to get off the ground," he said. "Sometimes this could mean cash, and sometimes in-kind services are just as important."

As an example, the health department may use some of its own educators to perform outreach, while the hospital could provide access to billing specialists, social workers and other skilled professionals.

"This will be a brick-and-mortar location, just like when you go to your family doctor," Orcena said. "We're right now talking with the hospital, the discussion is if we can use some space the hospital has set aside, or if we would use space set aside by the health department initially. Right now the hospital has been very encouraging."

After receiving federal approval to apply for the grant earlier this month, the next step is to complete the application for federal funding, which is due in mid-November, Orcena said.

"We're also pursuing the hiring of an executive director, and then we will be pursuing the final physical steps of securing physicians, a location, and getting other pieces like insurance into place. This is just like setting up a new practice. Once we have those in place, we will be transitioning our current care load from our primary care clinic which closed its doors in January; we'll be merging that with the community health center once it opens."

While a FQHC makes health care more affordable for residents, Orcena said, they should know beforehand that it doesn't make it free.

"From a philosophical standpoint, community health centers are not a free clinic - they are physicians' practices, that's their strength," he said. "You will be expected to pay something toward your health care, and to build a relationship with your physician, not to just come in when you're immediately sick.

"This is not strictly speaking a federally-funded program - it has to survive on what it can earn. There are benefits it receives for being federally qualified, but it is not a free clinic. This is about making health care affordable for the under-insured."

Orcena stressed that the health department's voter-approved levy will not be used to fund the health center, nor are they funding the executive director position.

"This is really a community-owned project," he said. "We are leading it because we have a vested interest in the community's health."