For 30 years, RiverStone Health Clinic has been a soldier in the War on Poverty.
Since 1984, patients have visited the South Side medical clinic more than 1.1 million times.
Thirteen percent of all residents in Yellowstone County depend on the clinic for access to health care. It has provided more than $40 million in charity care over the last three decades.
And its influence can be felt throughout Montana, said John Felton, RiverStone president and CEO.
More than 70 percent of medical students who have graduated from the Montana Family Medical Residency program, housed at RiverStone Health Clinic, practice in Montana.
At last count, more than 20 of them are in the Billings area.
“So there’s a pretty good chance people receiving care from family medicine doctors, we’ve impacted them and they don’t even know it,” Felton said.
RiverStone Health Clinic, at 123 S. 27th St., is celebrating 30 years of service with an anniversary open house on Thursday, from 3 to 6 p.m. It will include a health fair, and Billings Mayor Tom Hanel will speak at 4 p.m.
The celebration comes during the annual National Community Health Center week, Aug. 10-16. Health centers in the United States go back to 1965, their creation part of President Lyndon Johnson’s War on Poverty.
“An urban health center in Boston and a rural center in Mississippi were the first two,” Felton said. “Today, there are a total of over 1,200 health care organizations in over 9,000 sites serving 23 million patients.”
It’s one of the few federal programs that enjoys broad bipartisan support, he said. Two of the biggest expansions in the health care programs came under Presidents George Bush and Barack Obama.
“People recognize it as a program that works,” Felton said. “That’s why we’re still here (nearly) 50 years later and other programs have struggled.”
Along with its main campus, RiverStone Health has primary care clinics in Worden, Joliet and Bridger. The clinic employs more than 100 physicians, nurses, nurse practitioners, physician assistants, social workers, case managers and community health workers.
RiverStone Health serves a broad spectrum, from pregnant women and children to the elderly in hospice care, either at home or in the Horizon Hospice Home. The bulk of patients range in age from 25 to 55 or 60, Felton said.
“We take anyone who comes to us for service, whether they have Medicare, Medicaid, private insurance, no insurance — it doesn’t matter,” he said. “We serve everybody.”
Most patients are low income, working and have families. Anyone whose household income is under 200 percent of the federal poverty guidelines gets a sliding-fee discount, based on his or her income.
Funding comes from a combination of federal grants and patient fees. But part of what makes RiverStone successful, Felton said is that it’s “a well-run business that happens to have grants for low-income people.”
“But you have to run your business like anybody else,” he said.
The clinic also offers Healthcare for the Homeless, reaching out through the Montana Rescue Mission, St. Vincent de Paul the HUB and at RiverStone Health Clinic.
“Outreach also happens in alleys, in doorways, under the Rims — wherever people experience homelessness,” Felton said. “That’s where the service is happening.”
RiverStone Health has evolved from its humble beginnings. Originally, the Deering Community Health Center occupied a 3,000-square-foot building, now the south clinic.
In 1995, the clinic building expanded, adding 28,500 square feet, both to enlarge the clinic and to consolidate other Yellowstone City-County Health Department programs. Clients could get all their care in one spot.
The big change that drove the $2.5 million expansion, Felton said, was the addition of the three-year Montana Family Medicine Residency.
At the time, some local physicians thought it would be a good idea to establish a rural family medicine training program in Billings, since none existed in the state.
“They figured we should do collaboration with the health center and the two hospitals,” Felton said. “And since the residency mission is to serve the underserved population, they brought it here.”
To train physicians at the clinic required not just the expansion of space, but also of services. That meant offering the full scope of family medicine, including prenatal care and obstetrics.
The physician training program, which started with six residents in each year, expanded to eight, for a total of 24 at any one time.
“We’ve increased year by year the number of patients that get served and the number of visits that are made,” Felton said.
By 1998, the department operated as an independent health district governed by a board of directors. In 2008, the Yellowstone City-County Health Department changed its name to RiverStone Health.
Felton called the revision not just a change in moniker but “a model of providing health care and services.”
“It’s part of bringing all the services together for people we serve under one umbrella,” Felton said.
In 2010, a second, 43,000-square-foot $10 million building project allowed RiverStone Health to further consolidate its services on the South Side campus. In 2011, RiverStone Health used close to $1 million in stimulus money to boost the size of its dental clinic.
It doubled the dental chairs from five to 10 and added a digital X-ray machine to replace an ancient one. About 80 percent of dental patients are self-pay.
Felton points to a couple of important recognitions RiverStone Health Clinic has received. The Montana Family Medicine Residency was one of the original 11 programs in the country to receive the designation as a Teaching Health Center.
RiverStone Health Clinic and its three outpatient clinics have each been recognized by the National Committee for Quality Assurance as a patient-centered medical home. PCMH, has to do with a team approach to primary care, Felton said.
What the recognition means, he said, is “beyond us saying ‘trust us, we provide high quality care,’ this says we have four sites providing a high quality of patient care.”
Felton talks about RiverStone Health Clinic’s legacy, as not just growing in size, but in the values that underpin the care it provides. Its leaders are engaged in organizations regionally and nationally to continue to improve the quality of community health care nationwide.
Locally, in excess of 350 health care students, including medical, dental and pharmacy students, come through RiverStone each year.
“I think that’s part of the legacy that has grown here, of being an organization that believes that a rising tide lifts all ships,” he said. “That’s very important to us.”
As for the future, RiverStone hopes to keep moving toward a system of primary care and prevention. It’s working with School District 2 to develop a school-based clinic.
It sponsors a gardeners market, to make low-cost fresh produce available to people. And though RiverStone still has plenty of sick people to take care of, it’s slowly shifting its emphasis on keeping people at every stage of life healthy.
“We believe we need to keep people well and really make investments in the community that have long-term impacts,” he said. “That’s how you start to impact the health of a community.”