×

Rural access to health care

HANCOCK – For people living in rural communities, getting access to health care can be difficult. Federally qualified health centers are intended to address that issue.

According to the U.S. Health and Human Services website, the federally qualified health center (FQHC) designation is for qualifying facilities to receive “enhanced reimbursement from Medicare and Medicaid, as well as other benefits. FQHCs must serve an underserved area or population, offer a sliding fee scale, provide comprehensive services, have an ongoing quality assurance program, and have a governing board of directors.”

Elise Bur, administrative director of the Upper Great Lakes Family Health Center located in the UP Health System-Portage hospital in Hancock, said UGLFHC started in 2009 with clinics in Gwinn and Sawyer. It now has 11 clinics at nine sites in five U.P. counties. They also have clinics in Sault Ste. Marie and Baraga, which serve only Native Americans.

Bur said the organization is serving enough clients to keep it going, but they would like more.

“Everything we’re doing now is sustainable,” she said. “We are constantly looking to assist more people in need. There’s a lot of people we’re not reaching.”

Part of her job is educating people about what services the UGLFHC offers and how the clinics can keep people healthy.

“People don’t go to the doctor for preventative health care,” she said. “They say, ‘I feel fine. Why should I go to the doctor?'”

If those people get ill, they often end up in the emergency room of a hospital, which is much more expensive than having a personal doctor who can help keep them from getting sick.

If people are involved with managing their health care, Bur said, it is less likely they will end up with a serious illness.

Bur said with the implementation of the Affordable Care Act, health-care providers will no longer be reimbursed by insurance companies solely by how many patients they have but rather how many of their patients have positive outcomes from the care they receive.

“It’s headed that way in the future, which is a whole different type of mentality compared to what it was the last 50 years,” she said.

Bur said FQHCs do participate in the ACA.

“It doesn’t matter where people are receiving their medical care. It’s just a service we provide across the board, no matter where they go,” she said.

The UGLHC has office space in the UP Health System-Portage building, but Bur said it is not a part of the hospital. There is an arrangement between the two organizations which allows Portage doctors and nurses to work at the clinic.

The UGLHC puts no restrictions on the patients they treat.

“Whoever presents for an appointment, we will see, whether they have insurance or not,” Bur said.

All FQHCs have sliding fees depending on patient income and family size, Bur said.

“That comes into play for somebody who has difficulty affording health care,” she said. “We won’t refuse to see somebody.”

The FQHCs also accepts patients who have their own insurance and would have no trouble paying for care. In rural, low-population areas, those facilities might be the only places where health care is available.

Bur said FQHCs provide more services than medical care. Community health workers also provide mental health care, help with finding housing, help with finding food and even help with transportation to those resources.

“(Community health workers) actually try to break down the barriers that are preventing people from receiving care that they might need, even if it’s beyond the physical care,” she said. “We will hook them up with community resources. We will assist them with getting connected with the right people who can help provide them resources.”

Bur said UGLHC provides discounted prescription drugs to patients who qualify. The organization is planning to provide dental services, also with a sliding fee based on income.

“Within the next year we will have a few dental sites at some of our clinics,” she said. “When we get to that point where we can actually offer those services here, that’s going to be tremendous.”

If a health center patient needs a medical specialist, Bur said, they will help the patient find a specialist. However, that specialist may not provide a sliding fee for payment.

“We do everything we can with the other entity, as well as the patients to try to get them affordable health care,” she said.

Bur said major funding for FQHCs comes from government.

“We have a base grant from the government that funds out initial operations,” she said. “In addition to that, we apply for other grants through the state or federal government.”

Bur said payment at the clinics can be made by cash, check, credit or debit card.

Bur said besides providing health care, FQHCs have a positive local economic impact.

“It really creates jobs in the community,” she said. “It gives back to the community.”

Newsletter

Today's breaking news and more in your inbox

I'm interested in (please check all that apply)
Are you a paying subscriber to the newspaper? *
   

Starting at $4.62/week.

Subscribe Today