The county health department joins with a nonprofit organization to seek a federal grant that would fund a community health center. Winners are announced in September.
By JENNIFER LIBERTO
Published August 1, 2004
Hernando County health officials are scrambling to take advantage of a Bush administration initiative that aims to expand health care opportunities for the working poor through private-public partnerships.
At stake is $650,000 in federal dollars and a chance to expand health care for uninsured and underinsured Hernando residents whose incomes are as much as double the federal poverty level - or about $37,700 for a family of four.
"The main purpose of this funding is to close that gap to cover the uninsured population and reduce health disparity in our community," said Elizabeth Callaghan, administrator of the Hernando County Health Department.
Federally subsidized nonprofit clinics, called "community health centers," are the conduits for providing primary care, dental and mental health services to the working poor.
The local Health Department has spent several thousand dollars applying for the grant to fund a community health center for Hernando. The county has co-applied for the grant along with a newly established nonprofit organization, called Nature Coast Community Health Center. The federal government announces winners in September.
Florida already has more than 30 of these federally funded health centers, but the closest for Hernando County residents is in Dade City.
The county and the nonprofit group would work together to operate and oversee the center, which would be housed and staffed within the county Health Department at 300 S Main St. in Brooksville. Some of the money would pay to increase Health Department staff serving the community health center, including two additional full-time physicians.
Community health centers aim to assume more of the burden of indigent care from hospital emergency rooms. In Hernando County, county population growth, combined with the rising cost of health care insurance, has increased the number of emergency room visits among the uninsured, local hospital executives said.
In 2003, Brooksville Regional and Spring Hill Regional hospitals spent $15-million on indigent care - triple the $5-million the hospitals spent in 2000. Oak Hill Hospital spent $4.5-million on indigent care in 2003.
"It's becoming a bigger problem, because so many small businesses have quit providing health insurance, and so you have a lot of working people who don't have insurance," said Tom Barb, chief executive of Brooksville Regional and Spring Hill Regional.
Federally funded community health centers have existed for nearly 40 years, with roots in the Johnson administration, which created them to help poverty-stricken communities.
President George W. Bush has championed the private-public partnerships that create the centers and has made them a platform in his re-election campaign as a way to address a health care crisis that has left millions uninsured nationwide.
In his first year in office, Bush launched a five-year initiative to fund 1,200 new start-up centers nationwide by 2006. So far, only two new federally funded health centers have opened in Florida, although seven existing Florida community health centers have gotten federal dollars to expand. State health experts say the pressure is on the federal government to fund more start-up community health centers in Florida.
"We've spoken with (federal officials) to make sure Florida is getting a fair shake, and they're listening," said Andrew Behrman, president of the Florida Association of Community Health Centers, an advocacy and lobbying group on behalf of the state's federally funded health centers.
Local health officials say they are confident Hernando County has a good chance of getting the grant this year.
The county Health Department invested nine months and $13,000 on the application process, enlisting help from a state-subsidized nonprofit organization, the North Central Florida Health Planning Council, which researched and wrote most of the 190-page grant application.
Eventually, the Hernando County community health center budget would reach an estimated $2.2-million annually, $650,000 of which would continue to come from federal dollars over the next three years. The federally funded health centers are supposed to find other resources, through grants, private investment and patient fees charged on a sliding scale, to wean themselves from federal support.
At full capacity, the community health center is expected to serve about 9,666 people a year, including some people who have access to some health insurance. The existing clinic at the Health Department now serves 3,937 people a year but is limited to treating those whose income is no more than 120 percent of the federal poverty level (or $22,620 for a family of four). Often, the clinic must turn people away who make too much money.
The county also has another private-public partnership, Access Hernando, which serves those whose incomes are as much as 150 percent of the federal poverty level. But the county-subsidized program is smaller and focuses on offering specialized care, ranging from dermatology to cardiac tests. That program has operated on its own since 2002 and sees an average of 75 people each month, according to county records.
"There's a lot of people who don't qualify for Access Hernando who are still uninsured," said county social services director Jean Rags. "This (federal grant) would be an asset to us in that we'll have three levels of care for the indigent and underpaid."
To qualify for the grant, the county must target populations of patients who live in the county's more "medically underserved" geographic areas, such as ZIP codes 34601 in Brooksville and the northeast part of Hernando and 34614 in northwest Hernando.
If the Health Department wins the grant, the department must start providing all of the new services, including dental and mental health, within 120 days of the announcement. Hernando County could have the new center up and running by November, Callaghan said.
