Tim Leeds Havre Daily News tleeds@havredailynews.com
The Bullhook Clinic community health center found out last month it once again has money to operate, with one major change in its operations already made and some more on the way. One of the changes takes place Aug. 1 after seven years as the Hill County director of nursing, Cindy Smith is leaving that position to become executive director of the Bullhook Community Health Center Inc., a change she says is “bittersweet.” “It’s very hard to give up public health. I love public health and there’s so much to be done,” Smith said this morning. The clinic, which offers reduced-fee services to people who can demonstrate low income levels, opened in 2005 as part of the Hill County Health Department. After losing the second year of its grant due to federal budget cuts, its staff found out at the end of June the federal government awarded it more than $560,000 for operations this year. The clinic is eligible for $650,000 for each of the next two years under the federal Community Health Center grant program. To increase its chances to get the grant, the clinic left the Hill County Health Department and will now operate as a private nonprofit business. Smith also is looking for new facilities to house the community health center, which will be moving out of the Hill County Courthouse Annex once a new location is secured. She said the health center is negotiating with Northern Montana Medical Group to lease the old home health care building east of Northern Montana Hospital’s parking lot. She said she would be presenting the lease proposal to the community health center’s board at its meeting this morning. “The faster we can get something in place the faster we get it remodeled,” Smith said. “ Now there’s lots of work to be done, but that’s part of the challenge.” Smith said part of the work has involved transferring The operation of the health center, including billing and payroll and benefits, from the county’s operations to a stand-alone nonprofit operation. Pam Burke, health information officer for the County Health Department, said the health center has filed for nonprofit status with the federal Internal Revenue Department. Hill County Commissioner Mike Wendland said the commission is reviewing the job description for director of nursing for the health department, and that once the review is done the commission will advertise the position. “We have to get on it pretty quick,” he said. The Bullhook Community Health Center offers services of a family nurse practitioner and a care manager to its patients and coordinates its services with health providers in the community and with the County Health Department and the Women, Infants and Children and Family Planning programs. It offers reduced fees on a sliding scale to patients with qualifying income levels and can help with vouchers for services outside of the clinic. Smith said Bullhook will be advertising soon for positions at the health center. She said she plans to have a doctor on staff, and wants to eventually offer dental care and mental health care as part of the health center’s services. Until the health center has all of its operations up and running, it can continue to help its patients with vouchers to help pay for services from other providers, Smith said. Once fully staffed, Bullhook will have about 15-17 employees, Burke said. Burke said the Community Health Center grant came at just the right time the clinic was almost to the point of having to turn people away and helping them find other health-care providers. The grant it received helps solidify the clinic’s position, she said. “It will be nice to be able to say, Here we are and here is what we do. Come on in.’” she said. Burke said the clinic found out in 2006 that the federal government was again offering grants to operate community health centers and applied in December. It found out last month that it was receiving a pro-rated grant of $566,667 this year, and can receive $650,000 for each of the next two years if it can show it is meeting its goals in providing health services and what its future plans include “Just showing we deserve (the funding,)” Burke said. After that, the clinic can continue to apply for grants. Burke said those future grants would be on a competitive basis, but only in Hill County. If any other community health centers were to open in the county, they would compete with Bullhook Community Health Center for the grant. The Bullhook Clinic left the County Health Department and became a freestanding health center to increase its chances to get funding, Burke said. The clinic originally received a Healthy Community Access Program grant from the federal government to start the clinic, Burke said. Most of that grant had to be used for getting the program running and planning for and applying for its future funding, leaving only 15 percent to pay for actual services provided. The second year of the grant, the funding was cut in the federal budgeting process, leaving the Hill County clinic in a dire situation along with about 30 other community clinics across the country, Burke said. The clinic received an extension to continue operations through money earned by the clinic and savings it could find. She said about half the clinic’s staff was fired due to the budget cut, wages were reduced and job duties were increased to allow the clinic to continue to provide services. When the clinic found out last fall about the Community Health Center grants available, the staff decided to apply as a free-standing nonprofit business instead of as a part of the county government, Burke said. The federal government was awarding 10 grants to clinics operating as part of a governmental entity, and 100 grants to free-standing clinics, she said. The plan to move the health center had nothing to do with its change of status, Burke said. The county courthouse annex in its present form does not have enough space to hold all of the programs in it now. She said the clinic’s original plan was to expand its location in the annex, which houses the WIC and Family Planning programs as well as the clinic and the health department. After an engineer looked at the basement and started giving estimates as to the cost of remodeling and upgrading the basement to meet code, the price became too high, she said. While the Bullhook staff would like to remain with the other programs in the annex, that is not looking feasible, Burke said. The decision to move the health center was made to help everyone. “So the county won’t be hurt or constrained by our presence,” she said. “ Obviously, we need to do what is best for all the agencies.”
