Monday, July 30, 2012

People’s Community Clinic Now Able to Help More Patients

By Celia Neavel, MD, FSAHM 
Clinical Assistant Professor, The University of Texas Southwestern Austin Pediatrics 
Director, Center for Adolescent Health 
Director, Goals People's Community Clinic

Dr. Neavel with patient
Dr. Neavel with patient
As my family and I traveled in Germany this summer, I received the good news that my clinic — People’s Community Clinic (PCC), in Austin, Texas — was awarded federally qualified health center (FQHC) status. Ironically, at the same time, I learned German reporters were in Austin visiting PCC. Our German friends who watched the story couldn’t comprehend that basic health care is not available for many in the United States. PCC has worked to provide health care to Austin’s uninsured since opening as a small nonprofit for Austin’s uninsured in the 1970s. Attaining FQHC status will provide more needed resources and benefits to help support our mission.

PCC was organized when a group of volunteer doctors and others saw the need for patient-centered, centrally located (off the “Drag” by The University of Texas) health care for the uninsured. At that time, our patients included young adults going to college and trying to establish careers. Today, like other nonprofit medical homes, PCC struggles to provide comprehensive services to the under- and uninsured patients who have increasingly complex chronic diseases and behavioral health needs.

FQHC status, awarded to PCC by the U.S. Health Resources and Services Administration, brings with it a federal grant of $650,000. The additional funding will help us increase our services by 25 percent. Right now, the clinic serves 8,000 patients a year; that number could increase to 11,700. In addition, the new status means Medicaid will pay us higher fees for our services to Medicaid patients, while the additional funds mean we can provide discounted medications, and importantly, offer liability insurance coverage for our physicians. For years, PCC lost physicians who wanted to work in our clinic because we had to hire them as independent contractors and couldn’t offer them benefits. Most of our physicians have to work part-time someplace else, have another job, or make other arrangements for liability and health insurance.

PCC’s FQHC status comes after two years of planning by administrators, patients, and medical staff. And this was all happening during a time of electronic health record adoption! Working in a nonprofit means constant change. It also means dialogue with the greater community, ensuring the board and administration constantly hear from physicians about the challenges we and our patients face, and, I am pleased to say, it means practicing a type of medicine we believe in. I’m not sure how many of PCC’s physicians came here purposefully to serve the working poor or just liked the fact we get to spend time with our patients as part of an interdisciplinary team. We’ve come to rely on having social workers, health educators, chronic disease managers, midlevels, psychiatry back-ups, and others available in a primary care setting. Additional staff make our work more rewarding, successful, and enjoyable, despite the sometimes surreal, complex situations we face with our diverse, often disenfranchised patients. PCC’s becoming an FQHC will help support this holistic model — one bright spot amid state budget cuts and controversies in Texas health care.

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