Ellen Thompson
Havre Daily News
ethompson@havredailynews.com
People don't have enough access to medical services in Hill County, the federal government decided Thursday. That was great news to the Hill County Health Department, which needed to hear it before beginning an application for a federally funded health center.
The U.S. Health Resources and Services Administration designated Hill County a medically underserved area Thursday through a special application process after denying it that designation four times over two years. Hill County will apply for a community health center grant as soon as possible, in late August or September, Hill County Nurse Cindy Smith said Thursday.
"This was our last chance," said Jennifer Brandon, a grant writer at the Health Department.
Hill County was approved after submitting a special application through Gov. Brian Schweitzer's office, HRSA spokesman David Bowman said today. Areas are occassionally approved under that application process, he said.
"It's a provision in the law ... that is a recognition of the fact that exceptional circumstances aren't always captured in the criteria," Bowman said.
U.S. Sen. Max Baucus, D-Mont., has been pressuring HRSA to designate Hill County as medically underserved, as well as to give Kalispell a community health center grant. Baucus has held up three political appointments to the U.S. Department of Health and Human Services, which oversees HRSA, to give Havre and Kalispell "a fair shake," spokesman Barett Kaiser said last week.
"That's not the reason" for the designation, Bowman said today. "They were awarded the governor's exception."
Kalispell was not awarded the grant and will be reapplying in late summer, Wendy Doely, an employee with the Flathead City-County Health Department, said today.
Factors described in special applications for a medically underserved area designation can include, for instance, the closure of a factory, a demographic change, or a change in health status in the area, Bowman said.
In its special application, Hill County described a trend of declining health as well as a lack of services not reflected in the county data, Smith said.
The county pointed to a heart disease death rate and a cancer rate that exceed those of the state and a high teen birth rate. The letter also said that in a recent year, 11,000 visits to Northern Montana Hospital were made by people living in four nearby counties, not by Hill County residents.
The county has sought the designation so it can apply to HRSA for a lucrative grant that could vastly expand medical services available to poor and uninsured area residents. Centers can receive up to $650,000 a year from HRSA, said Mary Beth Frideres, associate director with the Montana Primary Care Association, which helps counties apply for the grants.
Frideres will be helping Hill County with its application.
The application is extremely competitive, Frideres said. Montana has 11 centers funded by HRSA, including one in Chinook. But no health centers in Montana have been added to the list of recipients in two years.
Frideres said Kalispell, Hamilton and Lewistown will also be applying for health center grants this year. All three have been turned down in the past, she said.
Smith knows it will be a tough competition, but she already has her wish list for the center. It includes: "mental health, dental health and more access to primary care before and after (regular business) hours."
Smith's office will begin to work on the application for a community health center grant as soon as possible, she said.
"The real trick is to tell the Havre story in a compelling way," Frideres said. "You have people that work that perhaps can't pay for health insurance, perhaps can't afford to pay for their doctor bill, and all that impacts access to primary care."
Frideres said community members can help by contacting Smith's office and preparing letters in support of Hill County's application.
"When I came up there and talked to the Havre people about a community health center, I was really blown away by how much interest there was in the community," she said.
Frideres was in Havre in January, when the Health Department was considering applying again for a medically underserved area designation after failing to receive it last year.
Hill County's difficulties in getting the required designation won't affect its application, Frideres said. She said she will advise the county to ask for the maximum funding.
Smith said the county will highlight some of the same issues described in the special application submitted through the governor's office, including a relatively high teen birth rate and a heart disease death rate and cancer rate that exceed those in the state as a whole.
Community health centers work well in Montana, Frideres said, because people in Montana want to pay for services. Most health centers operate on a sliding fee scale, she said.
"The sliding scale is really helpful because it's based on your income," she said. "If that's affordable, people pay it."
