Healthcare Access Grant Lifting Barriers
Grant funds increasing access to healthcare services in Cenla
A grant opportunity created by The Rapides Foundation is providing children and adults living in some of the most rural communities of Central Louisiana better access to healthcare services.
The Healthcare Access Grant is a three-year grant that funds federally qualified health centers to provide services either through a new access point or through a school-based health center throughout Central Louisiana. These clinics offer primary care, behavioral health and dental services to make it more convenient for people to get the healthcare they need.
Nurse Practitioner Tracy Kelone assists patient Katie Stutson at Harrisonburg Family Health.
Research shows rural areas disproportionately experience diminished access to healthcare. This results in significant health disparities – including higher rates of chronic disease and indicators of poor overall health – compared to urban communities.
To address this problem, the Foundation in 2014 began accepting proposals to fund efforts to reverse the cycle of poor health outcomes and lack of healthcare access. Specifically, grants valued at $300,000 a year were awarded to FQHCs and FQHC Look-Alikes to expand critical services to underserved areas in Central Louisiana by expanding their primary care access with integrated behavioral and oral health services or establishing new “access points” for services.
“Access to quality healthcare is important to reduce health disparities and improve health status for people in our service area,” said Joe Rosier, President and CEO of The Rapides Foundation. “We know that financial barriers, personal and cultural barriers, not knowing what to do or where to go, physical or geographic barriers, and shortages in healthcare professionals and facilities are factors that limit people’s access to quality healthcare. We believe our Healthcare Access grant opportunity has lifted some of these barriers and provided residents throughout Central Louisiana with increased access to vital healthcare services.”
Healthcare Access grants are being used to fund the following clinics:
• The Winn Community Health Center, in partnership with the Rapides Parish School Board, is establishing school-based health centers in five Rapides Parish schools. Clinics have already opened in Alexandria Middle Magnet, Huddle Elementary and Peabody High Schools. The locations for the remaining two centers have not been announced.
• Winn Community Health Center, in partnership with the Grant Parish School Board, opened a school-based health center at South Grant Elementary to serve students at five rural Grant Parish schools.
• A grant to the Outpatient Medical Center, in partnership with the Natchitoches Parish School Board, established a school-based health center at L.P. Vaughn Elementary, serving students in both L.P. Vaughn and Natchitoches Junior High schools.
• Winn Community Health Center was awarded another Healthcare Access Grant that funded creation of a new FQHC, the East Grant Community Health center in Pollock.
• The Iberia Comprehensive Community Health Center will use its grant to expand health center services in Vernon Parish.
• The Catahoula Parish Hospital Service District #2 received a grant that expanded primary care services at Harrisonburg Family Health clinic.
• Access Health of Louisiana received a grant to expand primary care services at the Woodworth Community Health Center in Woodworth.
The Healthcare Access Grant is part of the Foundation’s Healthcare Access Initiative, which addresses medication access and cancer screenings; fosters the establishment and expansion of primary care access with integrated behavioral and oral health services; and addresses related medical manpower issues. The Initiative falls under the Foundation’s Healthy People priority area.
SCHOOL-BASED HEALTH CENTERS OFFER PREVENTIVE, BEHAVIORAL HEALTH CARE FOR STUDENTS, STAFF
School-based health centers are currently operating in L.P. Vaughn Elementary in Natchitoches Parish, South Grant Elementary in Grant Parish, and Alexandria Middle Magnet, Huddle Elementary and Peabody High schools in Rapides Parish. The clinics are open during school hours and serve students whose parents have signed consent forms. School staff also can use the school-based health centers, saving them time away from work to go to medical appointments.
The school-based health clinics are staffed by nurse practitioners and other medical professionals, including licensed practical nurses and social workers. The centers each have a collaborating physician who is available for consultations, and patients with critical needs are referred to specialists.
The Outpatient Medical Center team at the school-based health center at L.P. Vaughn Elementary School, from left: Jackie Carroll, Medical Assistant; Shelby Beaudion, Licensed Practical Nurse; Katie Lovell, Medical Assistant; and Mary Lancaster, Family Nurse Practitioner.
The school-based health centers offer the same primary care services offered in physician’s offices. This includes well-child checks, immunizations, sports physicals, pediatric and adult medicine, behavioral health treatment and evaluations and, in some cases, dental care. The centers also offer urgent care services.
“The programs are designed to keep children in school and parents at work. We try to become part of the landscape where students are comfortable coming to seek healthcare, and our mission is to keep them well and in school. We try to remove any barriers to learning that we can in the healthcare arena,” said Deano Thornton, CEO of Winn Community Health Center, which also operates as Trinity Community Health Centers.
The school centers also employ Licensed Professional Counselors and Licensed Clinical Social Workers to provide condential mental and behavioral health services for students and staff. This includes private counseling for students who suffer from ADHD, anxiety disorders, bullying and family problems. In addition, the school-based health centers offer group counseling to help students cope with the pressures associated with high-stakes testing, Thornton said. “We are there to make it a better learning experience for the child.” Clinic staff members keep up with each student so they know when the student is due for immunizations, wellness checkups and dental cleanings, Thornton said. Billing is handled directly through the patient's insurance company.
Thornton said about 90 percent of the students treated at the school-based clinic are on Louisiana Medicaid. Parents on private insurance sign their children up for clinic services because they enjoy the convenience and the staff, he added.
Carl Walters II is CEO of Outpatient Medical Center Inc., which operates the school-based health center at L.P. Vaughn in Natchitoches. “To see this health center positively touching children’s health on a daily basis is overwhelming for me as the CEO of this system. I can tell you firsthand there are kids who are getting services via this school-based health center that they might not otherwise be receiving,” he said. “To see these kids not having to come out of school, to see school administration, staff not have to take time off work to go off campus to see a doctor or to be seen for their services, it’s just profound.”
Mary Katherine Lancaster, Family Nurse Practitioner at the L.P. Vaughn school-based health center, said parents and caregivers appreciate the convenience and the attention center personnel give to their loved ones.
“Some grandparents are raising their children’s children, so you hear the struggles they have and they are just very appreciative of the services,” she said. “Parents and grandparents love that we can write a prescription and go ahead and get it to the pharmacy for them. With the children, seeing their faces has been very rewarding. You can definitely tell that they feel loved when they come in here.”
COMMUNITY HEALTH CENTERS EXPANDING WITH HEALTHCARE ACCESS GRANT FUNDING
Healthcare Access grant funds are being used to either expand services or establish new access points at health clinics in four Central Louisiana parishes. The clinics accept Medicaid, Medicare and private insurance, and apply a discount fee schedule for families who do not have health insurance.
East Grant Community Health is an FQHC that opened its doors in Fall 2017 on U.S. Highway 165 in Pollock. Winn Community Health Center already operated a community health clinic in Colfax, but recognized the need for healthcare services on the other side of the parish, Thornton said.
The new clinic was built to accommodate three primary care providers and a behavioral health counselor, and the architectural design allows for future expansion. The center serves insured and uninsured patients, Thornton said. “Billing for our uninsured patients is based on household income on a sliding scale. So people who qualify can be seen by a physician for as little as $20.”
Approximately 10 employees, including two nurse practitioners and a licensed social worker, work at the site, which is open Mondays through Fridays. Because it is a primary care facility, scheduled appointments take priority, but the center does handle walk-in patients.
“Many people are challenged to find access to quality healthcare. We are making it available in Grant Parish. Most of our employees are residents of Grant Parish and they want to do things for their community, and we are giving them the opportunity to do that.”
All of the health clinics are designed to be self- sustaining once the three-year grant cycle ends. “That’s the way the grant is designed, and that’s the way we approached it, to be able to build up the program to where it will sustain itself at the end of the three years of funding provided by the Foundation,” Thornton said.
The staff of Harrisonburg Family Health, from left: Front Office Manager Judy Chappell, Nurse Practitioner Tracy Kelone and LPN Amber Scroggs.
Debra K. Miesch, CEO of the Catahoula Parish Hospital District #2, said Harrisonburg Family Health provides a service that is much needed in a rural community like Catahoula Parish.
The Rapides Foundation grant allowed the district to expand services at a clinic that was located at the Harrisonburg Medi-Thrift Pharmacy. Harrisonburg Family Health is one of five parish clinics operated by the hospital district. A nurse practitioner and other medical staff offer primary care services at the Harrisonburg clinic, and patients are referred to other clinics in the district for dental and behavioral health services. The hospital district provides transportation between the clinics for the convenience of the patients and to continue its mission of providing cost-effective care to residents of Catahoula Parish.
“With the funding from The Rapides Foundation, we are able to keep the provider in the office full time, we are able to keep our doors open and we are able to expand our services,” Miesch said. “Here in rural areas, people do not always have transportation to drive to Alexandria or Monroe or Natchez for medical services. Over 80 percent of our population is at 200 percent of poverty or below in this area. So they don’t have a lot of money.”
Patients who do not have insurance are charged according to family income and family size. “We plug that information into the federal fee scale that tells us whether you are going to pay the minimum, which is $20, or whether you are going to pay 30 percent to 75 percent of the total charge.”
The Woodworth Community Center in Rapides Parish expanded its services in 2016 when the South Louisiana-based Access Health Louisiana assumed operations with funding from The Rapides Foundation’s Healthcare Access Grant. Access Health, the largest network of Federally Qualified Health Centers in Louisiana, was operating 10 clinics and 10 school-based health centers in South Louisiana when it began operating the Woodworth clinic, Access Health President and CEO Mark Keiser said.
“From a population health perspective, rural America is underserved and less healthy than suburban and urban areas, and it doesn’t have facilities. Fortunately it’s not a long distance from Alexandria to Woodworth. It’s only 15 minutes or so, but for some people those 15 minutes could be 150 miles if you don’t have transportation. And then when you compound that with poverty, because rural areas tend to have more poverty, put that in the equation and now you have less healthy people, less availability of providers, and we have less money to pay for things that we need,” he said. “Access Health recognizes that. We understand those social dynamics.”
In its first two years as part of the Access Health network, the Woodworth Community Center won the organization’s Most Successful Location award in terms of quality performance, Keiser said. “They set a standard for us.”
Iberia Comprehensive Community Health Center, based in New Iberia, currently operates health centers in six parishes. It was recently awarded a Healthcare Access Grant that will be used to provide primary care, dental and behavioral health services in Vernon Parish.
Keiser and others credited The Rapides Foundation with identifying a healthcare need and providing funding to address it. “Healthcare in Central Louisiana would be considerably less developed and successful had The Rapides Foundation not taken the initiative they’ve taken, and Access Health is just one small example of it. It is extremely important, vitally important to the people of Woodworth and to us at Access Health,” Keiser said.
“We are forever in debt to The Rapides Foundation for their commitment to making sure everyone has access to culturally sensitive, medically appropriate primary care services. We could not have done what we have accomplished here without their ongoing support,” Walters said. “I think the community at large owes them a great sense of gratitude for helping to improve the health and well-being of our children.”