Written by Karen Carlson • Photography by Jason Johnson
A flip chart stands next to the desk at the SIU Center for Family Medicine in Springfield. In the pen of Dr. Janet Albers, it reads, "Did you know we are accepting new patients – with or without insurance?"
That flip chart represents a new direction for the Center, which has been designated a Federally Qualified Health Center (FQHC), thanks to a grant from the U.S. Department of Health and Human Services, Health Resources and Services Administration. The grant, awarded in June 2012, totals more than $1.2 million over two years.
The Center transitioned into the FQHC model beginning October 1, 2012, becoming a viable health-care option for nearly 100,000 residents of Sangamon County (about 48%) who are either uninsured or use Medicaid or Medicare. FQHCs care for 1.2 million Illinoisans and more than 20 million patients nationwide.
Thanks to the federal grant, the SIU Center has added patients, people, partners and payment options.
The FQHC designation will allow the Center to not only provide essential primary care health services for all patients but welcomes low-income and uninsured patients. An additional 2,000-3,000 patients may be added initially to the 14,000 already established at the Center located at 520 N. Fourth St. in Springfield, says Janet Albers, M.D., chief executive officer of the Center. "In simplest terms, if you need a doctor but don’t have insurance, we want to see you," says Dr. Albers, professor and associate chair of the SIU Department of Family & Community Medicine.
As it has for decades, the Center provides a complete clinical services menu, from well-child care and immunizations to obstetrical and gynecological care; screenings for cancer, communicable diseases, blood pressure and cholesterol; diagnostic and procedural services; geriatric care, including nursing home and home visits; and on-site mental health services.
Three new physician providers, one midlevel provider, a financial counselor, quality director and care coordinator have joined the Center to help meet the needs of additional patients. Care coordinators help transition patients between the hospital, clinic and home. Financial counselors help patients navigate payment options for the uninsured patients. An outreach coordinator will raise awareness by meeting with groups and educating the public about SIU programs.
As part of its new designation, the Center has added extended hours, with evening clinics on Mondays and Wednesdays. Future initiatives may include a walk-in clinic.
"As an FQHC, we are able to provide an even better quality of care, including affordability for medications through the 340b Federal Drug Pricing Program," Albers says. The FQHC designation provides for cost-based reimbursement to the clinic Medicaid and Medicare patients. Uninsured patients benefit from a sliding-fee scale, made possible by a combination of federal, state and local grants.
All these efforts are leading to better health care for the target population — residents with incomes below 200 percent of the federal poverty level. In the SIU service area, that’s about 22,714 people, or 26.6 percent of the target population . That’s more than the average for Illinois (23%).
Studies show that FQHCs improve health for these citizens. A study in the American Journal of Preventive Medicine by Stanford University professor Randall Stafford, M.D., Ph.D., (July 10, 2012) showed that federally supported community health centers actually provide better patient care for the underserved and uninsured patients they serve than private practices.
Fewer than 5 percent of the Center for Family Medicine’s patients were uninsured at the time the grant was awarded. Deputy Director Iris Wesley says a major goal is to serve more uninsured patients. Uninsured patients receive an FQHC card to present for hospital-based services, including laboratory or radiological studies or hospitalization, as well as for referrals to subspecialists when needed. All of the FQHC services and referral services are charged at a sliding fee. Through a partnership with Complete Care Pharmacy and the federal drug-pricing program, patients can obtain reduced-cost medications, a major benefit for patients who previously couldn’t afford their medications. FQHCs are a community effort — for the community and by the community. Community Health Centers are required to have an extensive, board-approved quality management plan and must report annually on numerous health-care indicators.
To ensure this compliance, FQHCs have a governing board composed of at least 51% patients of the Center, a unique requirement. Dr. Gerald Suchomski, a privately practicing family physician in Sangamon County, serves as President of the Governing Board for the Center for Family Medicine.
The Center for Family Medicine is unique as an FQHC in that its Board and the Southern Illinois University Board of Trustees are listed as co-applicants. As a public entity, Southern Illinois University maintains control over personnel and serves as the fiscal agent. Most FQHC’s including Central Counties Health Center (CCHC) in Springfield are stand-alone centers. "Central Counties Health Center has been very helpful in our transition to an FQHC," Dr. Albers says. "We look forward to expanding our existing partnership." SIU providers help manage CCHC’s obstetrical patients and also assist in seeing their hospitalized patients. CCHC sees SIU’s patients referred for dental services.
This kind of collaboration is key to the health of the community. Other partnerships include Memorial Medical Center and St. John’s Hospital, the Mental Health Care Centers of Illinois, Triangle and Gateway, Prairie Heart Institute, Hope Institute, Prairie Eye Center and the Sangamon County Department of Public Health.
On a daily basis at the Center, Michal Dynda, M.D., chief medical information officer; Laura Loesel, M.D., chief medical officer, and Lois Harber, RN, director of quality, ensure the Center meets quality measures. "We are using integrated teams to support clinical and operational quality and safety issues," Dr. Dynda says.
"We want everybody to be able to obtain health care," Dr. Loesel adds. "The FQHC will help us expand services to the entire community, regardless of whether patients have insurance." Current patients may not see much difference in the care that has always been available. But the FQHC designation helps the Center open its arms to even more patients — especially those in need.
Wesley says the Center will be able to reapply for grant funding after two years, possibly receiving ongoing funding in three to five year application cycles. With the FQHC designation, additional federal funding may also be within reach, allowing the Center to provide additional services and resources for patients.
"We are a community health center," Albers says. "We are here to serve, and we welcome anyone in need of a medical home. We hope people will refer those they know who don’t have health insurance. We also want people with insurance to know that they can continue to come here for their health-care needs. If patients don’t receive regular and consistent care, it increases the patient’s suffering and strains the health-care system overall. Our goal is a healthy community."