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A Bullhook Clinic spokeswoman said workers are having a hard time dealing with the clinic’s “dire” situation while still assuring residents that they can continue treatment at the facility with confidence. “We’re still here still serving. Don’t think that we’re not here for you,” spokewoman Pam Burke said. The clinic will cut half its staff at the end of August In December, the clinic lost its second year of funding from a $1.7 million Healthy Communities Access Planning grant as a result of an appropriations act adopted by Congress. The clinic has received $980,000 for its first year. As a result of the rescinded funds, the staff of the clinic will be cut in half from 12 employees to six. The proposed cuts after the end of the first funding year on August 31 include: two outreach specialists, a care manager, the data analyst, the operations manager and the fiscal officer. Cindy Smith, executive director of Bullhook Clinic and director of nursing for the Hill County Health Department, said clinic employees are “trying to do our best to make things business as usual for our patients.” Smith said the clinic can stay afloat for another year.
“The worst-case scenario is to go another year and be done. It will be tight. Plus, we have to think how long can you keep taking on more work and continuing doing your original job,” she said today. The various duties of the eliminated jobs will be absorbed by the remaining staff. “For us left behind, we are saying How are we going to do all this,’” Burke said. The data analyst helps facilitate and access information electronically; the fiscal officer is in charge of internal accounting and taking care of bills and paperwork; and the two outreach specialists help with community education and connections among providers and clients. Two care managers at the facility help patients fill out paperwork, receive free and discounted prescription medications and sign up for the sliding-scale fee program. The operations manager oversees the day-to-day functions of the clinic. Smith said she anticipates many late nights at the clinic and working weekends. She said the decisions were made based on the answers of a survey conducted by the clinic, the help of a technical assistant and the assessment of services that can generate more funds. The results of the survey listed medical services and pharmacy assistance as the most important services the clinic provides. Judy King, a member of the Bullhook Clinic board, said she believes funding will come through somehow and wants the public to continue receiving treatment at the facility.
“I just hope the funding comes soonEnough that no one will be laid off. I really admire those being laid off. They are giving 110 percent. Nobody is jumping ship yet,” King said. If funding is found after the positions are cut, those laid off will get the first offer for the job, Burke said. The clinic will remain open its regular hours but won’t be able to expand as its workers had anticipated. Its hours are Monday and Wednesday 7 a.m. to 7 p.m. and Thursday 8 a.m. to 5 p.m. The largest percentage of clients seen by the clinic are uninsured or underinsured patients The clinic, which is located in the Hill County Courthouse Annex building on Fourth Avenue, sees all categories of patients not only those without insurance but those with Medicare, with Medicaid, and with insurance. Services offered include primary care, health and wellness exams, sports physicals, and assistance with management of chronic illnesses like diabetes and high blood pressure. Vouchers for dental work also are available through the clinic. Within the first four months, or 43 clinical days, the nurse practitioner had seen 277 patients. Of those clients, nearly half accessed the sliding-fee scale, which offers lower fees based on income and household size. Burke said the clinic needs help because of the sliding fees, which is an important part of the clinic’s mission. “We are here to help the people who are low-income and underinsured how can we charge a large amount of money for the services?” she said.
The vouchers have totaled $18,974 to date. Care management has 190 clients enrolled and will need to put a cap on the number of patients it sees due to the elimination of one of the care manager positions. “We’ve built up relationships with our clients. Another person came in just yesterday with a great success story,” Smith said. “They are small stories but they are big to (the clients).” She said many of the patients have not been to a doctor in years and need the guidance and support of a caregiver like the clinic’s family nurse practioner Connie White. The employees have been exploring various funding options including grants. Bullhook Clinic is has received a six-month extension on the original grant, which does not bring any more funding but allows the clinic’s workers to restructure the use of the dollars they do have. Burke said the clinic has received verbal support from the state’s congressional delegation but no one has a solution to the problem. She said she encourages the community to write letters of support for the clinic to local and state government officials. The clinic began receiving funding from the Health Resources and Services Administration grant in September and opened its doors on Dec. 19. Cutbacks will not affect the other departments and programs housed in the clinic building including Family Planning, the Hill County Health Department and WIC.