WellCommons

Dr. Steven Bruner receives a phone call from Lawrence Memorial Hospital's emergency room. A pregnant woman is in labor, and she hasn't received any care until now because she's poor and an immigrant, which means she is not eligible for Medicaid assistance.

Bruner, who is on call, doesn't know the medical history of the baby or the woman. There have been no tests, no monitoring and no education, and now he needs to deliver the baby.

•••

"It was a really bad situation," Bruner said, of the deliveries he faced a decade ago.

Fortunately, he said, the Lawrence-Douglas County Health Department stepped up to address the growing problem. "I think this is one of the best things they ever did."

The health department started what it calls a rotation system, where Lawrence obstetricians take turns providing prenatal and postpartum care and delivering the babies. The health department facilitates the system and finds volunteer interpreters to go to all of the appointments because most of the women do not speak English. The health department also makes sure the women fill out paperwork once the babies are born because they do qualify for emergency care under Medicaid for the delivery. By filling out the paperwork, the doctors receive some reimbursement for their services.

"It's really a win-win situation," said Bruner, of Lawrence Family Medicine and Obstetrics. "They get better care and hopefully better outcomes, and we get paid something instead of nothing."

When the rotation system started in 2003, there were four patients. In 2011, there were 33, a 700 percent increase. There currently are 10 women in the system.

"It's important to have prenatal care and to start it relatively early, and that simply wasn't happening at all until the health department came up with this idea," Bruner said.

When it comes to prenatal care, Bruner said he typically sees a patient once a month for seven months and then every two weeks for two months. During the last month of pregnancy, he monitors the mother and baby every week. He said the visits allow him to monitor the growth of the baby, making sure he or she is developing and functioning correctly. He also screens the mother for diseases or other complications that can develop during pregnancy. Additionally, the prenatal visits allow him to educate the mother about nutrition and exercise.

"It gives us the opportunity to counsel women about the do's and don'ts of pregnancy and how to avoid alcohol and tobacco and drugs and X-rays and medications that aren't cleared," he said.

Between 2003 and 2011, the rotation system provided care for 207 immigrants.

'Great warriors'

Lawrence resident Aida Hernandez has volunteered to be an interpreter for the Spanish-speaking women for the past six years.

She goes to every doctor's visit and if lab work needs to be done, she goes to those appointments too. Sometimes, the patients develop gestational diabetes, and so she goes with them to get nutritional information.

And she's there for the delivery. She gives them ice chips, holds their hands, breathes with them and prays with them. If they need a cesarean section, she explains the procedure. If they are in pain, she lets the medical staff know.

"I love it," she said, with a big smile. "I love it because you have been working with them during the whole pregnancy and then experiencing the birth of a new baby is wonderful. It's amazing."

Hernandez said the most difficult hurdle is the first meeting when she has to earn the woman's trust.

"It is very, very important to establish a good rapport with these women because they do not speak English and they are really, really afraid and going through a lot of issues."

Hernandez said these women are from poor, rural areas in Mexico. Most of them are single, and, if they are in a relationship, it's often not a good one. She said they work tirelessly at low-paying jobs and then send money home to loved ones.

"They've left everything behind — family and sometimes children — and stay here for many years. It is a very difficult situation for them to leave," Hernandez said, adding that many suffer from depression. "They come here for the American dream."

Aida Hernandez

Hernandez said when she meets them, she assures them of confidentiality and lets them know that she, too, is from Mexico.

"When you open this window, then they feel really comfortable, and they are willing to talk about other things," she said. "These women are great warriors."

Hernandez estimates that she's helped 25 women, from ages 17 to 29. She said many do not know medical terms, and some have never had an examination.

"I am really happy that this program is happening in Lawrence," she said. "I am glad they are helping women from my country."

Gap remains

While the system is helping uninsured immigrants, health department leaders fear many low-income women are not receiving prenatal care because of the lack of affordable services in Douglas County.

Kim Ens, director of clinical services, said, these could be women who earn too much to qualify for Medicaid but too little to afford private insurance or a doctor's services.

"I do feel there is a gap. I think it is something that our community really needs to discuss," she said.

Lawrence has two safety net clinics, Health Care Access and Heartland Community Health Center, but they do not provide prenatal care, and neither does the health department. Leaders with the organizations said they do not have the funding, staff or equipment to provide such services.

However, the Leavenworth County Health Department offers a Maternal Infant Program, which provides prenatal care, referrals for clients who need high-risk care and delivery services. They are able to provide the care through a partnership with Kansas University Medical Center and KU Hospital. The care is provided by resident physicians.

Last year, 29 Douglas County residents participated in the program: 26 from Lawrence, two from Eudora and one from Baldwin City. Twelve Douglas County residents are in the program now.

Ens said those numbers are concerning because Douglas County women are needing to seek care elsewhere and finding transportation is not easy for low-income residents.

"We want to look at this gap in services in our community and see what we can do about it," Ens said. She gave a presentation about the issue at a recent health department board meeting, and members asked what the solution might be.

Kim Ens

Director Dan Partridge said one possible solution would be for Heartland Community Health Center, located in the east end of the Riverfront Mall, to become a Federally Qualified Health Center or FQHC. If it did, Heartland would receive a $625,000 annual grant, enhanced Medicaid and Medicare reimbursements and federal tort coverage. They likely would be able to offer the full spectrum of services, including prenatal care.

Heartland applied for the status last year and was denied in August because of lack of government funding. New federal funding has become available, and Heartland leaders have their fingers crossed once again. They expect to hear in June about whether they've been accepted.

In the meantime, the health department plans to seek resources to fill the gap, which was brought to light during its community health assessment. Assessment results will be discussed during public forums next month.

"Prenatal care is going to result in healthier babies. Without such care, they may end up with birth defects and fighting illnesses, and we don't want that," Ens said.

PUBLIC HEALTH FORUMS

The Lawrence-Douglas County Health Department will be hosting a series of public forums to discuss the findings of a community health assessment. They will be:

• May 9 — 3:30 p.m., Lawrence's Community Health Facility, 200 Maine.

• May 15 — 7 p.m., Eudora Community Center, 1630 Elm St.

• May 16 — 7 p.m., Baldwin City Library, 800 Seventh St.

• May 17 — 7 p.m., Lawrence's Community Health Facility, 200 Maine.

Dr. John Listerman, left and Allison Veeder, ARNP, confer about a patient Wednesday, March 30, 2011, at Heartland Community Health Center. The center provides medical care for low-income residents. by Mike Yoder

Heartland Community Health Center, a safety net clinic in Lawrence, is having a fundraiser April 28 at Himmel’s Rand Farm near Eudora.

The event, which begins at 6 p.m., will feature a three-course meal created by Lawrence chef Robert Krause and live jazz music. Heartland CEO Jon Stewart will give a short presentation.

The event will raise money for the center, which provides health care for low-income residents. In 2011, the clinic had 5,016 patient visits, a 38 percent increase from the previous year.

“The entire night will be focused on the idea of service. As the name of the event, ‘Fill Up, Pour Out,” suggests, we want to inspire attendees to fill up through community and pour out into the community,” Stewart said.

Tickets are $150 each, $275 for a couple, or $1,000 for a table of eight. To purchase tickets, visit heartlandhealth.org/help or contact Ali Edwards at 841-7297, Ext. 208, or aedwards@heartlandhealth.org.

Flyer for benefit. uploaded by by kbritt

Emily Cox, Lawrence, has volunteered to join Heartland Community Health Center as its pharmacist in charge to oversee the center's involvement with the state's Unused Medication Repository program. Cox surveys some of the center's current medications in its storage area. by Mike Yoder

Since its inception in July 2009, the state’s Unused Medication Repository program has provided more than $6 million worth of unused drugs for free to Kansans who can’t afford them.

While it’s being touted by lawmakers and state health leaders as a successful program that’s kept drugs out of landfills and is helping low-income Kansans, it also may be putting some Kansans at risk of medical complications.

Lawrence pharmacist Jeff Sigler thinks some safety-net clinics may be misinterpreting the Kansas State Board of Pharmacy’s laws and regulations regarding the program.

He said the law requires an on-site pharmacist to affix a label to each medication that is dispensed to a patient. The label must include a doctor’s name, patient name, drug name and directions.

He thinks some clinics are dispensing drugs without all of the information or with information that’s not from a pharmacist. The other problem is some clinics may be dispensing the drugs as if they were samples.

“Samples are meant to be given for a short period of time, maybe a week to see if they can tolerate it. So, the chances of having a long-term medication error with samples is lower,” he said.

Program’s evolution

Krista Postai, CEO of the Community Health Center of Southeast Kansas, has been involved with the program since it began. She said the problem is that the program has changed since the Legislature passed the Utilization of Unused Medications Act in 2008.

It started as a program to allow nursing homes, mail-service pharmacies and medical care facilities to donate unused drugs to Federally Qualified Health Centers, indigent health care clinics and community mental health centers. To receive donations, clinics would deal directly with the donors and have pharmacists on site to oversee the dispensing of the medications.

Postai said the Pittsburg clinic ran into glitches. When the clinic received its first boxes of unused medications from nearby nursing homes, most of the drugs were outdated or not marked appropriately. It was a time-consuming process to sort them.

The clinic also began receiving large donations from mail-service pharmacies in bottles of 1,000 pills, which needed to be broken down into smaller supplies, and only a pharmacist can do that, which also is time-consuming.

Those involved with implementing the program also learned many areas of Kansas don’t have a safety-net clinic, so nursing homes didn’t have a place to donate unused drugs. Then, there were the clinics who received donations but couldn’t use them.

So, the Kansas Department of Health and Environment decided to provide about $140,000 in funding annually for the Community Health Center of Southeast Kansas, or CHC/SEK, to become a repository for the program. The money covers the salaries of a part-time pharmacist, a full-time coordinator and the costs for shipping.

The way it works is that the donors and recipients sign up to participate in the program through the Board of Pharmacy, and then can choose to participate in the repository. Through the repository, they can order drugs through an online system and then they are shipped to them.

But, clinics still need to have an on-site pharmacist to place the appropriate labels on the medications and oversee the program.

“We have to make sure that they have a pharmacist on that end so that the drugs are being reviewed and that they can attest to their safety as to where they’ve been stored and whether they’ve been tampered with,” said Debra Billingsley, executive secretary of the Kansas Board of Pharmacy. “It’s been problematic. A lot of the clinics have pharmacists who are there periodically but for them to actually go in and fill prescriptions every day, they almost need to be there full time, and that’s where we are having the difficulties.”

The Community Health Center of Southeast Kansas in Pittsburg serves about 22,000 people. It provides mental, dental and medical health services inside the building, along with a pharmacy. The center also serves as the repository for the state's unused medication program. by Kevin Anderson

Local impact

Lawrence’s Health Care Access was one of the first safety-net clinics to sign up to use the state’s unused medication program. The clinic distributed 700 medications worth about $60,830 to uninsured Douglas County residents, but then stopped using it last year after Sigler, which is the clinic’s pharmacist-in-charge, asked his pharmacy inspector to look into the regulations.

“A red flag went up,” he said. “I think for safety sake that once you start bypassing a pharmacist getting involved, I think that opens up some doors that we don’t want to open.”

Nikki White, executive director, said the clinic still provides medications through samples and patient assistance programs, where the labels are already affixed to the drugs when sent to the clinic. They also hand out as many low-cost prescriptions as possible, but sometimes patients can’t afford anything and that’s where the burden of not participating in the program hits the clinic’s bottom-line.

Lawrence’s Heartland Community Health Center recently found a volunteer pharmacist who will oversee its participation in the program.

Heartland CEO Jon Stewart said there has been confusion about the regulations, but the clinic will be adhering to the strictest State Board of Pharmacy rules.

“We are excited that we have someone now who is willing to wade in while the Legislature and the Board of Pharmacy kind of sort out what those requirements really need to be,” he said.

Changes coming?

Billingsley admits the regulations need to be updated.

“We are talking with Pittsburg to do it more like a mail-order situation so that the prescription flows from the clinic to Pittsburg. They fill the prescription and have a pharmacist do it there and then it goes to the patient. That’s what we are trying to get into place next,” Billinglsey said.

While there were talks last summer, there have been no changes. Billingsley and Postai say there have been more pressing issues and the system is working.

In 2011, 23 clinics used the program to hand out more than $1 million in unused medications.

Billingsley said if a clinic was found to be using the program inappropriately, it would be educated first, and if the problem continued it would be told that it can no longer participate.

“Each case is going to be viewed individually, and I guess it would be dependent upon exactly what they did that was incorrect,” she said.

Ali Edwards, Heartland Community Health Center's development director, has found a life full of purpose and meaning working for the center and assisting people in holistic health care.

BY EILEEN RODDY

A late-night bathroom stop after a wild student party changed the course of Ali Edwards’ life. It led her to abandon Hollywood plans to take instead an AmeriCorps position at Heartland Community Health Center, then become the center’s development director.

Born in Meade, where her father farmed and her mother directed Minneola District Hospital’s obstetrics department, Edwards was known as a tomboy.

“I played outside all the time, made forts in trees, looked for action and was a huge KU sports fan,” she says. “My dad used to joke I was the son he always wanted because I was so into sports, whereas my three brothers weren’t.”

Edwards played basketball, was active in track and cheerleading, and by seventh grade she’d decided she’d become an athletic trainer.

She graduated from Meade High School in 2007, enrolled in KU’s School of Education athletic program and spent her first few weeks partying. After one party she stumbled into Campus Christian house, 1320 Ohio, searching for amenities.

“People were friendly, serving free hot dogs but no alcohol, and I wondered what it was all about,” Edwards says. “Someone handed me a card and invited me back.”

She returned to the house several weeks in a row but arrived late for services and left early to avoid getting involved.

“My family are regular churchgoers, and I’d say I was a Christian, but it was mostly words I didn’t fully understand, and it wasn’t really service-oriented,” she says. “I continued attending Campus Christians, and something of deeper significance starting happening to me.”

The athletics world lost its luster. Edwards stopped partying at the end of the first semester, transferred to the journalism school to study strategic communication, then decided to become a celebrity event planner in Hollywood. She became more involved in Campus Christian’s worship and Friday night service projects, and volunteered at Jubilee Café.

“I learned the importance of serving and loving others, and loving my neighbor as myself,” she says. “I was never consciously seeking God. It seemed God sought me and led me in a different direction to the one I’d planned.”

When (then) Campus Christian chaplain Rev. Tony Bedora encouraged her to apply for an AmeriCorps outreach position at HCHC, she resisted.

“I was determined to move to L.A. but decided to give the center one try,” she says.

Edwards met HCHC’s director Jon Stewart, learned about the center’s mission to provide quality holistic health care for those living below the poverty line, then applied for the AmeriCorps position. It was the perfect fit.

She gradated from KU this year, completed her AmeriCorps term and is now HCHC’s full-time development director.

“My work can be challenging because many deny poverty exists in Lawrence because they don’t see it. Many poor and suffering people look like us, they just don’t have good support systems,” Edwards says. “HCHC supports people to make healthy lifestyle changes and discover meaning and hope in their lives. I’ve changed, too. I’ll never be a Hollywood party planner. My life now has purpose, significance and meaning.”

Dr. Raul Morffi is the new medical director at Heartland Community Health Center.

Heartland Community Health Center, a Lawrence safety net clinic, has named Dr. Raul Morffi as its new medical director.

The former director, Dr. John Listerman, retired in earlier this month.

Morffi served as chief resident at Smoky Hill Family Practice, a federally funded Community Health Center in Salina. Heartland is working to become the first Community Health Center in Douglas County.

In 2010, Heartland served 1,104 patients through 3,305 appointments.

“I’m excited about the challenge of continuing to build a Community Health Center in Lawrence. We want HCHC to be a community-based effort, ensuring access to quality, holistic, patient-centered care."

— Dr. Morffi

Morffi, a Lenexa native, began treating patients today at Heartland on a part-time basis. He also treats patients at Marian Clinic in Topeka and is an employee of St. Francis Health Center.

Dr. John Listerman, left and Allison Veeder, ARNP, confer about a patient Wednesday, March 30, 2011, at Heartland Community Health Center. The center provides medical care for low-income residents. by Mike Yoder

Health and Human Services Secretary Kathleen Sebelius announced Tuesday awards of $28.8 million to 67 community health center programs.

A Lawrence safety net clinic wasn’t among them.

Heartland Community Health Center, located in the east end of the Riverfront Mall, sent in its 100-page application to become a Federally Qualified Health Center in December and learned Tuesday along with the announcement that the application was denied by the Health Resources and Services Administration.

If approved, the center would have received a $625,000 annual grant, enhanced Medicaid and Medicare reimbursements and federal tort coverage. As a result, the clinic would have been able to provide care for more low-income residents.

Heartland CEO Jon Stewart estimated that the center’s annual budget would have increased from $350,000 to $1.3 million, and its patient visits likely would have increased from about 2,500 to 10,000.

In return, the government would have held it to a much higher standard than other clinics. For example, it measures what percentage of children have been immunized and has the blood sugar levels of its diabetic patients improved.

There are more than 1,100 FQHCs nationwide, including 13 in Kansas.

GraceMed Health Clinic, of Wichita, and Community Health Center of Southeast Kansas, of Pittsburg, which already are FQHCs, received a total of $800,000 for expansions Tuesday.

Stewart said the center is now going to apply for the FQHC Look-Alike designation. It offers the same benefits except the $650,000 grant. It also would put the center in better position to be funded in the future. It expects to be able to apply by Jan. 1.

Dr. John Listerman, left and Allison Veeder, ARNP, confer about a patient Wednesday, March 30, 2011, at Heartland Community Health Center. The center provides medical care for low-income residents. by Mike Yoder

Heartland Community Health Center is offering deeper discounts and accepting Medicaid in an effort to provide more affordable health care in the Lawrence community.

“Our goal is to make health care accessible. I think our previous fee of $30 was too much of a barrier for a lot of folks,” CEO Jon Stewart said.

Now, a patient earning $13,612 annually or less will pay $10 for a standard office visit, instead of $30. For a family of four to qualify, its combined income is $27,937 annually or less for a $10 visit. Those annual income figures are 125 percent of the federal poverty level.

Other fees are:

• $30 — for a patient earning between $13,613 and $21,780. For a family of four, it’s between $27,938 and $44,700.

• $70 — for a patient earning $27,781 or more. For a family of four, it’s $44,701 or more.

Stewart said the average cost for an office visit elsewhere is $95.

In 2010, Heartland — a safety net clinic located on the east end of the Riverfront Mall — served 1,200 patients. Of those, 68 percent fell below 100 percent of the federal poverty level. Only 4 percent were in the highest income level.

Heartland recently received approval to accept Medicaid as a form of insurance in addition to Medicare and some private insurance.

In April, there were 9,200 people on Medicaid in Douglas County, and there were 300 licensed Medicaid providers. These include physicians, mid-level practitioners, nurse practitioners, therapists, audiologists, podiatrists, chiropractors and optometrists. Although these providers are licensed, they may not accept Medicaid patients.

“We’ve received a lot of calls in the past from Medicaid patients who didn’t know where to turn. They were having trouble finding a provider,” Stewart said. “So, I certainly anticipate that we will help fill a need in the community.”

Heartland received a two-year $200,000 grant from the Sunflower Foundation of Topeka in November that has helped hire a nurse practitioner and social worker.

On March 1, Karin Denes-Collar, a licensed clinical social worker at Bert Nash Community Mental Health Center, began providing screenings and therapies alongside primary care providers. She works 20 hours a week now, but is expected to be working full-time in the next four to six weeks.

All of the recent changes are part of Heartland’s larger mission to provide an integrated medical home for patients — regardless of income or insurance.

It has applied to become a Federally Qualified Health Center. If approved, it would bring hundreds of thousands of dollars in federal funding to provide care. Stewart anticipates to learn whether it is accepted by Aug. 1.

At right, patient Don Hall, Lawrence, visits with AmeriCorps member Brittany Love, Conway Springs, center, and Kathleen Litton, advanced registered nurse practitioner, Friday, Oct. 1, 2010, at Heartland Medical Clinic. Heartland received a $117,000 grant to partner with the Corporation for National and Community Service to provide nine AmeriCorps members with training in the health care field. At left is Jack Campbell, a Kansas University student and volunteer at the clinic. by Mike Yoder

Jenny Davidson, Lawrence, goes over a diabetic patient's questions about medication Thursday, Sept. 30, 2010, at the Heartland Medical Clinic, 1 Riverfront Plaza, Suite 100. Davidson and Megan Foster, pictured in the background, serve as co-coordinators of the Diabetes Care and Prevention program at the clinic. by Nick Krug

Heartland Community Health Center will be providing diabetes screenings next week as part of National Diabetes Alert Day.

The screenings will be on a walk-in basis and available to anyone:

• from 9 a.m. to 4 p.m. Wednesday, March 23.

• at the center, located on the east end of the Riverfront Mall, near Seventh and New York streets.

• For $5, the screening includes a diabetes risk assessment, hypertension assessment and hemoglobin test.

The center also will be handing out free diabetes care and prevention education materials. Each participant will have the opportunity to schedule free nutrition and exercise counseling.

“Diabetes is a serious disease, particularly when left undiagnosed or untreated. The good news is, once you know you are at risk for type 2 diabetes, you can take immediate action to lower your risk by making and maintaining healthy lifestyle changes.”

— Allison Veeder, nurse practitioner

More than 164,000 people in Kansas have diabetes, including 8,100 in Douglas County.

It is estimated that one-third of people with diabetes do not know they have the disease. That means more than 38,000 Douglas County residents might currently be at risk for complications resulting from untreated diabetes.

Risk factors for diabetes include:

• family history of diabetes.

• being overweight.

• physical inactivity.

• being older than 45.

If left undiagnosed or untreated, diabetes can lead to serious health problems such as heart disease, blindness, kidney disease, stroke, amputation and even death. With early diagnosis and treatment, people with diabetes can delay or prevent the development of these health problems.

For more information about the event, contact Ali Edwards, outreach coordinator, at 841-7297 or by e-mail at ali@leocenter.org.

Jon Stewart, executive director of the Leo Center, left, gives a tour of the center to Prathiba Wheeler, a consultant with Heritage Treasures LLC, center, and Raymond Mabion, pastor of Bethlehem Christian Assembly and administrator of Bethlehem Home Health Care in Kansas City, Mo., Tuesday, June 23, 2009. The visitors were hoping to model a clinic in Kansas City after the Leo Center. by Mike Yoder

Heartland Community Health Center will talk about is plans to become the first Federally Qualified Health Center in Douglas County during an open house.

The event will be from noon to 3 p.m. Sunday, March 13, at the center, which is located on the east end of the Riverfront Mall in downtown Lawrence.

“With the FQHC designation, HCHC will be positioned to provide affordable, quality health care to the approximately 14,000 men, women and children in Lawrence who are currently paying out of pocket or going without.”

— CEO Jon Stewart

As an FQHC clinic, Heartland — formerly called The Leo Center — will be able to expand services and operating hours and hire additional staff and providers.

It has been working in partnership with Lawrence Memorial Hospital, Bert Nash Community Mental Health Center, Douglas County Dental Clinic and local health care, religious and opinion leaders to develop holistic health care in Douglas County. Studies have shown that an integrated, holistic health care model has the potential to save hospitals and the health care industry billions of dollars.

The center recently hired two employees:

• Allison Veeder, advanced registered nurse practitioner. She previously served 15 years at Lawrence Memorial Hospital, most recently as a charge nurse in the emergency department.

• Karin Denes-Collar, a licensed specialist clinical social worker. She is a staff member at Bert Nash and will provide behavioral health screenings and brief therapies to our patients alongside our primary care providers.

Ashley Yost, medical assistant at the Leo Center, left, and clinical assistant Marissa Wuller, center, work at the clinic Wednesday, Jan. 12, 2011. The center has applied to become a Federally Qualified Health Center. If it gets the designation, the center will receive more federal funding and resources that will enable it to offer more services, including mental health and dental. by Mike Yoder

The Leo Center, a safety net clinic, has applied for a federal designation that would bring hundreds of thousands of dollars in federal funding to the Lawrence community.

In return, it would be able to provide more care, including dental and mental health services, to low-income residents.

Leo center director Jon Stewart recently submitted an application to the Health Resources and Services Administration to become a Federally Qualified Health Center, or FQHC.

If approved, The Leo Center’s annual budget would go from about $350,000 to $1.3 million, and its patient visits would increase from about 2,500 to 10,000.

It also would receive cost-based reimbursement for Medicaid and Medicare. Instead of receiving about $29 for a typical family doctor visit, it would get about $119.

“Not too many practices can even can cover costs at standard medicaid reimbursements,” Stewart said. “The idea is that you use those funds to provide comprehensive services to each patient and defray the costs of the uninsured.”

Stewart said the center’s leaders have been working on the application for about two years. The approximately 100-page application included another 200 pages of supporting documents. Stewart anticipates to hear back from HRSA by Aug. 1.

There are more than 1,100 FQHCs nationwide, including 13 in Kansas. The closest to Lawrence are the Shawnee County Health Agency in Topeka and Swope Community Health Center in Kansas City, Kan.

The Leo Center and two other Kansas clinics applied for the status this year.

Robert Stiles, director of primary care in the Bureau of Local and Rural Health at the Kansas Department of Health and Environment, said the number of awards depends on the amount of funding available. He said about $250 million is available for this application cycle.

Stiles said HRSA anticipates making 350 awards with the average size being $650,000.

The Leo Center, which is on the east end of the Riverfront mall, offers a medical clinic, food pantry, counseling services, financial help, plus a partnering pregnancy care center. It was founded in 1999, and has grown significantly since helping five patients on opening day inside Heartland Community Church. Back then, its name was Heartland Medical Clinic. On March 1, The Leo Center is changing its name to Heartland Community Health Center.

“The original vision for us was providing health care from the heart in the Heartland,” Stewart said. “We are still doing what we were originally called to do, which is to meet needs and transform lives, and for us it’s a very specific Christian mission.”

Jon Stewart, executive director of the Leo Center, left, gives a tour of the center to Prathiba Wheeler, a consultant with Heritage Treasures LLC, center, and Raymond Mabion, pastor of Bethlehem Christian Assembly and administrator of Bethlehem Home Health Care in Kansas City, Mo., Tuesday, June 23, 2009. The visitors were hoping to model a clinic in Kansas City after the Leo Center. by Mike Yoder

Dr. Dennis Sale, left, checks the pupils of John Anderson at the Heartland Medical Clinic in the Riverfront Mall. Anderson, a diabetic who couldn't afford health insurance, lost 133 pounds in one year thanks to treatment that he received from the clinic. Sale checked up on Anderson in September 2006 at the charitable clinic, which offers low cost or free treatment and medication to the uninsured in Douglas County. by Thad Allender

The center helps people who are uninsured and those who have Medicaid, Medicare or private insurance. The fees are based on a person’s ability to pay.

Its client base and fees would not change under the new designation.

However, the Leo Center would be required to expand its services to include dental and mental health. Douglas County Dental Clinic and Bert Nash Community Mental Health Center have agreed to partner with the Leo Center.

The three nonprofit health agencies have been discussing their ideas for more than a year, and looking at other FQHCs in the region.

“There’s all kinds of grand ideas being tossed around,” Stewart said.

The goal is to provide a medical home for patients.

“If we say, ‘Go across town to another organization where they have to deal with another receptionist and they’ve never been there before — sometimes that can be a barrier,” Stewart said. “It begins to make it a little easier on the patient — to have this all handled in one day, at one time, in one place.”

Stiles, of KDHE, said research has shown that the patient-centered medical homes are not only attractive to patients, but provide better outcomes and can save costs.

“FQHCs are one model of care that we strongly support,” he said.

David Johnson, CEO of Bert Nash, said more and more communities nationwide are talking about integrating primary medical care and mental health care, and he applauds it.

“It really is going to be a big improvement,” he said. “People with serious mental illness die 25 years sooner than the general population. We’ve got to do a better job on our side in seeing that they get the primary health care that they need.”

GraceMed Health Clinic's website by kbritt

GraceMed CEO describes benefits of being a FQHC

Wichita’s GraceMed Health Clinic became a Federally Qualified Health Center in 2007.

CEO Dave Sanford said the designation has given the clinic stronger financial sustainability. It receives an annual grant, gets better reimbursement for Medicaid and Medicare costs, and the providers receive federal torte coverage. So, there’s no cost for malpractice insurance.

The grants and resources allow Sanford to better forecast revenues and identify whether the clinic can expand services or hire new workers.

“Once you have the opportunity to implement the grant and the benefits of the grant, then you can really ramp up increasing access to care,” he said.

In 2010, the clinic had 42,000 patient visits, about triple the number it was seeing five years ago. Sanford said they provide a lot of dental and primary care for low-income children on HealthWave, and dental services for seniors on Medicare.

The clinic has five locations in Wichita and they provide dental and primary care services. Referrals are made for mental health services, but Sanford said they plan to offer those as well.

“It’s almost like a three-legged stool — medical, dental, behavioral health. We feel like if we are to be a true medical home for people, we need to integrate all types of care that people can access very easily,” he said.

In return, Sanford said the federal government holds FQHCs to a much higher standard than other clinics. For example, it measures what percentage of children have been immunized and has the blood sugar levels of its diabetic patients improved.

“If it gets out of whack, we get a call from the feds saying we need to improve our performance," he said.

The Leo Center, a safety net clinic in Lawrence, has applied for the federal designation, and anticipate hearing back by August.

For the past couple of years, director Jon Stewart has been visiting various FQHCs in the region, including GraceMed.

“They’ve been real inspiring,” he said.

Logo contest! by kbritt

Logo contest

The Leo Center, a safety net clinic in Lawrence, is changing its name to Heartland Community Health Center on March 1.

It needs a new logo.

The center is having a logo contest and the deadline for submissions is Feb. 1.

For more information about the contest, go to www.heartlandhealth.org or contact Ali Edwards, outreach coordinator, at 841-7297, Ext. 212, or ali@leocenter.org.