HARDIN – Fueled with a $604,000 federal grant, a new community health center has opened here, expecting to chart an estimated 4,800 visits annually.
The Bighorn Valley Health Center, housed in 1,450 square feet of a remodeled office building, is a private, nonprofit health care corporation. It is designed to “fill a gap in health care services,” said Dr. David Mark, interim CEO, who has long led the charge for the center.
But leaders of the long-established Hardin Clinic, which St. Vincent Healthcare purchased in July 1997, say existing clinics in the county are sufficient to serve the population. The clinic serves about 19,000 patients annually.
Community health centers are specifically designed areas with high populations of under-insured residents. The health centers provide access to health care for millions of people who have been locked out of the "traditional" health care system.
RiverStone Health Clinic in Billings is a community health center.
Bighorn Valley Health Center will work to meet the primary-care needs of low-income individuals and families living in Big Horn County, including many of the area’s Medicaid recipients and uninsured. Its primary clientele is expected to be residents in the county whose income is less than 200 percent of the federal poverty level. That would be a single person whose annual salary is less than $22,341 or a family of four earning less than $46,101. Fifty-four percent of the county’s population falls into this category, Mark said.
No one will be denied service, regardless of the patients’ ability to pay. Though appointments are encouraged, walk-in patients are accepted. The co-pay is $10.
Nearly half of the 13,000 residents of Big Horn County, which is dominated by two Indian reservations, is medically under-served and doesn’t have access to primary health care services, said Mark, who once worked for Indian Health Service.
The Indian Health Services dental clinic at Crow Agency has historically been able to meet only about 50 percent of the dental need, Mark said. There also is a need for more pediatric dental services.
Even with existing health care options available in Hardin, many residents are not receiving the effective and holistic primary care they need, Mark said. Many seek care outside the community, and many others delay or avoid regular preventive care.
Bighorn Valley Health Center is designed to complement existing health care facilities in the county, including St. Vincent Physician Network-Hardin Clinic, Big Horn Memorial Hospital and Indian Health Service, Mark said.
He is, however, savvy enough to know that not everyone sees it that way.
“Our desire is not to compete,” he said. “We want to work together. We hope to make it a positive disruption, but inevitably there is a reshuffling of the feathers.”
Montana now boasts 17 community health centersm with one out of every 10 Montanans now relying on a community health center for primary care, according to Bob Marsalli, CEO of the Montana Primary Care Association.
“For the residents of Big Horn County it means some really good-paying professional jobs,” Marsalli said. “It also means access to affordable primary care. When a person’s health improves, the health of a community improves. They go to school. They return to work or find work. Health and prosperity go hand-in-hand.”
The clinic is staffed with 12 people, including two part-time volunteer physicians, one nurse practitioner, one physician’s assistant, two RNs, two nursing assistants, a certified public accountant and three front office personnel.
Bighorn Valley Health Center’s emphasis is on prevention, Mark said. Its goal is to help patients manage the most prevalent diseases or disease factors facing low-income communities, such as diabetes, hypertension, substance abuse and HIV/AIDS.
As of 2009, there were more than 1,200 community-based health centers operating in the United States, the District of Columbia, Puerto Rico, Guam, and the U.S. Virgin Islands. Collectively, these centers serve more than 20 million patients, 7.8 million of whom are uninsured.
A George Washington University report from 2009 showed that the average patient receiving care at a health center had total annual medical expenditures of $1,093 lower than an average patient who did not use health centers.
Still, leaders of the St. Vincent Physician Network-Hardin Clinic aren’t convinced of the need.
“The community health center has alluded to the fact that there is a gap in health care services but has created a facility within blocks of a very established primary-care facility,” said John Kinna, executive director of the St. Vincent Physician Network.
“If there is any gap in service within Big Horn County, it is due to the vastness of the county. There are very remote areas within this county that do struggle with access to care in the physical geographical sense.”
Big Horn County, the sixth-largest county in Montana, spans 5,023 square miles.
St. Vincent Physician Network-Hardin Clinic employs five full-time physicians and one physician’s assistant and offers complete family care, including prenatal, newborn care, wellness and acute care along with obstetrics and routine outpatient surgeries, which are performed at Big Horn County Memorial Hospital. The Hardin Clinic has also provided the medical staff for the hospital throughout the years.
Hardin Clinic, since its establishment, has been open to provide care to all people of the community and surrounding areas regardless of ability to pay, Kinna said. Its affiliation with St. Vincent Healthcare allows it to offer an excellent financial assistance program for patients with limited or no resources.
The Indian Health Service has a facility in Crow Agency along with satellite clinics in Lodge Grass and Pryor. There is also an Indian Health Care facility in Lame Deer and a community health center in Ashland.
“These clinics along with the Hardin Clinic are substantial enough to care for a county population of 13,000,” Kinna said.