Ellen Thompson
Havre Daily News
ethompson@havredailynews.com
Hill County's stalled application for a federally funded community health center is getting a big push from U.S. Sen. Max Baucus, D-Mont.
Baucus is holding up several political appointments to the U.S. Department of Health and Human Services as leverage to advance applications for health centers in both Havre and Kalispell, a Baucus spokesman said Wednesday.
"It's one tool Max uses frequently to get what he wants for Montana," spokesman Barrett Kaiser said. "It's a fairly drastic approach, but Max is adamantly behind this application."
Hill County has been unable to obtain a designation as a medically underserved area, a requirement to be considered for a federally funded clinic for low-income residents. Flathead County has the required designation but has not received funding after several years of applying, Kaiser said.
"They really have been trying to be good advocates," Hill County nurse Cindy Smith said of Baucus' office.
Baucus is the highest-ranking Democrat on the Senate Finance Committee, which confirms appointments to HHS, Kaiser said. HHS oversees the U.S. Health Resources and Services Administration, which designates areas as medically underserved and funds clinics in those areas.
Baucus has stalled the confirmation process for appointees Alex Azar as deputy secretary of HHS, Suzanne DeFrancis as assistant secretary for public affairs, and Charles E. Johnson as assistant secretary for budget, technology and finance, Kaiser said. Baucus' intention is that Hill County's application be given "a fair shake," he added.
In the meantime, Hill County is trying a last-ditch effort to receive the designation. The county narrowly missed the mark two years in a row. The final avenue for receiving the federal designation is an application submitted with a letter from the governor, Smith said.
Worsening health statistics in Hill County are a reason why the county needs a health center grant, said John Schroeck, director of primary care for the Montana Department of Health and Human Services. He said the governor will submit a letter on the county's behalf within a week.
"Things are getting worse in Hill County, not better," Schroeck said today.
"We try every avenue before we try for this exceptional governor's letter," said Marge Levine of the Montana Primary Care Association, a nonprofit organization that helps local governments apply for health center grants.
"When you have small rural populations, getting those ratios (to qualify) is difficult," she said.
The data can be misleading, she said. For example, Rocky Boy's Indian Reservation has doctors at its local health clinic, but those doctors don't just serve the reservation's residents, but all enrolled members of the tribe.
Smith mentioned another way the data is skewed. Northern Montana Hospital has a staff of doctors, but in a recent year, Smith's office found that the doctors had 11,000 visits from people living in four nearby counties. Getting appointments may be difficult even with the number of doctors in Hill County, she said.
"We want to have the governor's letter express that," Smith said.
The county has some other negative statistics that might help it get the designation. Though a relatively low infant-mortality rate worked against the county's application this year, that doesn't reflect other problems in the county, Smith said.
Among some statistics the governor's letter might highlight is the county's high teen pregnancy rate, she said. In Hill County, 58.8 teens in every 1,000 give birth, compared with 36.2 teens per 1,000 statewide. Hill County also has a higher cancer incidence rate and a higher heart disease death rate compared with the state's rates. In Hill County, 502.5 people in 100,000 are diagnosed with cancer annually, compared with 474.3 in the state. In Hill County, 257.4 people in 100,000 die of heart disease annually, compared with 221.2 in the state.
The medically underserved designation would get Hill County in the door. Then it would have to apply to HRSA for a grant to fund a health clinic. Levine said Hill County's trouble receiving that designation would not affect its application. The next opportunity to apply for a grant is in December, she said.
If the county succeeds in getting a clinic, it would probably operate on a sliding-fee scale serving uninsured and low-income people.
