By Tim Leeds/Havre Daily News/tleeds@havredailynews.com
Hill County could get funding to start a health clinic for low-income and uninsured people by next fall if residents work together on it.
"It depends on how much your community wants it," Mary Beth Frideres of Montana Primary Care Association Inc. told about 50 people at a meeting in Havre Tuesday.
People seem to want it. When Frideres asked for a show of hands of those who support it, everyone in the room raised their hands.
The meeting was held so Frideres could make a presentation and answer questions about community health centers. Frideres works with communities applying for federal grants to open the centers.
Cindy Smith, director of nursing at the Hill County Health Department, said the Hill County Health Consortium has been working on opening a center for about a year and a half. It unsuccessfully applied for a grant last year and is looking for help from the Montana Primary Care Association to increase its chances this year.
Frideres said the health centers provide primary care, mental health and dental care, and drug abuse treatment. The amount charged to the patient depends on income.
Treatment can be provided at the center or through contracts with providers in the community, she said.
The centers are required to use a sliding fee scale. A person who makes 180 percent to 200 percent of the federal poverty level pays 80 percent of the fee, and a person whose income is at or below the federal poverty level pays nothing.
The centers cannot refuse service to anyone. A person who makes more than 200 percent of the poverty level also would be served, but would be charged the full price for the services.
Frideres said that when communities start looking at opening a center, sometimes medical practitioners and existing facilities resist the effort because they are concerned it will compete with them. After a center is open for a while, that opposition generally stops, she said.
The centers don't compete directly with other facilities, she said. Instead, they supplement and complement existing services.
"What happens over time is they start talking about the benefits and looking at it as a whole," she said.
For example, the community clinic in Helena treated 3,000 patients in its first year. In the same year, the emergeny rooms of local hospitals lost 3,000 patients - 3,000 nonpaying patients, she said.
The number of centers is growing, with the full backing of President Bush and bipartisan support in Congress, Frideres said.
Chinook opened a community health center three years ago, and Chester is applying for a grant. Rocky Boy's Indian Reservation is looking into taking the first step needed to apply for the grants used to fund the centers.
The first thing Hill County would need to do is get a federal declaration of having a medically underserved population or medically underserved area, Frideres said. That is what Rocky Boy is working on now, she added.
"If we can get you that, then all heck breaks loose," she said.
The federal government looks at how many medical practitioners serve an area, how difficult it is to reach doctors and other problems people have getting medical service, she said.
The number of doctors in Havre will make it difficult to get that designation, she added.
"You have a lot of docs," Frideres said.
She said Montana Primary Care Association is now looking at the possibility of having North Havre designated a medically underserved area, and that shows promise, she said.
The census tract being looked at also includes rural areas stretching around the west and southwestern edge of Havre, and includes about 4,000 people, Smith said today.
Once an area receives a designation, it can apply for a federal grant to open a center, with a maximum of $650,000. No local matching funds are required.
The grant is given every year as long as the health center meets the federal guidelines for providing services.
The next application date is May 23, and it might be difficult to have an application ready by that time, Frideres said.
"If you could pull off an application by May 23, that would be best. That would be difficult but it could be done," she said.
If Hill County applies for a grant on May 23, it would know by Sept. 15 whether it is receiving funding, Frideres said.
Frideres said the centers typically provide about 15 good-paying jobs.
Smith said the Hill County Health Consortium has already done much of the groundwork in preparing an application, including planning some of the services that would be provided and getting memorandums of agreement from organizations and medical practitioners in the community.
She said the center could be located in the Hill County Courthouse Annex. The consortium is open to suggestions about other locations.
Smith said the next meeting about the health center will be Jan. 21 at the Holiday Village Shopping Center Community Room starting at 2 p.m. Representatives of Montana Primary Care Association have been invited to the meeting, she said.
