Havre Daily News
Bullhook Clinic has lost its second year of funding from a $1.7 million grant as a result of an appropriations act adopted by Congress.
The clinic's executive director said none of its practices will immediately change as a result of the rescinded funds.
“With what we have now, we can probably go to the end of November with a full staff. We can go longer if we get creative with spending and open more hours,” Cindy Smith said Wednesday.
Pamela Burke, technical writer for Bullhook Clinic, said she is researching grants and other possible sources of funding.
“We're not going down without a fight. We're looking at all possibilities,” she said. “It's been a mad scramble around here.”
Bullhook Clinic employs a dozen people, including a clinical nurse, an operations manager, a data analyst and a nurse practitioner.
Connie White, the clinic's family nurse practitioner, said she is available for an extended workload. White said employees have discussed additional hours, but no times have been set. The clinic is open 7 a.m. to 7 p.m. Mondays and Wednesdays.
Having more hours would allow the clinic to see more patients, which would increase its income. Burke said the clinic has received $980,000 of the $1.7 million grant for its first year. The clinic began receiving funding from the Health Resources and Services Administration grant in September and opened its doors on Dec. 19.
Smith said the clinic's staff is trying to come up with a strategy and might need to make a few changes but is waiting to hear from the federal agency about their next steps.
“We will for sure keep the clinic open and have as much staff as possible for as long as we can,” she added.
In an e-mail sent in late January, a federal administrator notified the clinic about the cut and said detailed guidance will be provided by the beginning of February to those who've lost funding.
The grant stated that the clinic had to spend its first year of funding by Sept. 1, 2006, Burke said. She said she is not sure if the clinic still has to abide by the grant's guidelines and is waiting to hear from HRSA.
Bullhook Clinic is asking for the help of U.S. Sen. Conrad Burns and other state leaders. Burke has written a letter to Burns asking for aid with funding and plans on sending similar letters to U.S. Sen. Max Baucus and U.S. Rep. Denny Rehberg.
When it originally sought the grant, the clinic received help from Baucus, who held up political appointments in Washington, D.C., as leverage to get Hill County designated a medically underserved area by the Health Resources and Services Administration. The county received the designation in July after submitting a special application through Gov. Brian Schweitzer's office.
Burke said the clinic is fulfilling a very strong need in the community by enhancing and coordinating medical care in the county.
The clinic, which is located on Fourth Avenue, sees all categories of patients - those with Medicare, with Medicaid, and with and without insurance. A co-payment for services is determined on a case-by-case basis.
Smith said the clinic will not not raise its fees as a result of the lost funding.
Primary care, health and wellness exams for infants through seniors, sports physicals, and assistance with management of chronic illnesses like diabetes and high blood pressure are offered at the clinic.
Angi Disalvo, one of Bullhook Clinic's case managers, said 73 patients are enrolled in the clinic's management program and 21 cases are pending. Case managers help patients with paperwork and determine whether they are eligible for a sliding-scale fee. Of those 73, all but three are at 100 percent poverty level, Disalvo said.
“This is really the way to do it. This is run by community workers. The board is made up of clients and those who use the facility. It's based on evidence we see right here in Havre,” Burke said.
The largest percentage of clients seen by the clinic are noninsured or underinsured middle-age patients, Disalvo said. She said an equal number of male and female patients has been seen.
Disalvo said the top two needs noted by the two case managers are dental issues, for which the clinic can offer a voucher, and clients who need discounted medicines for chronic diseases like diabetes. The case managers or a pharmacy intern at the clinic contact pharmaceutical companies to get free samples for clients or discounted medicines.
Clinic workers are working on an application to become part of a federal program that would allow the clinic to receive higher payments for Medicare and Medicaid patients and an increased discount on prescriptions.
Burke said she hopes the funding cuts will be reversed or changed so the clinic can get part or all of the grant money.
“Whatever we can get is going to help. Hopefully federal funding will come through in the end,” she said.