BIG HORN COUNTY — Nearly half the population of this county, which is dominated by Indian reservations, is medically underserved, uninsured or underinsured and doesn't have access to primary health care services.
That is due mostly to a serious and growing deficiency in the availability of primary medical, dental, and behavioral health care in this county of 13,000 people, according to the CEO of a newly created health care corporation.
Bighorn Valley Health Center, a private, nonprofit health care corporation, aims to bridge the gap when it completes a $3 million health center in 2012. The organization originally planned to purchase and renovate an existing building in Hardin to house the health center but organizers are revisiting that option.
The corporation, operated entirely by community volunteers, this month submitted a 168-page application to become a Federally Qualified Health Center. The biggest benefit to becoming an FQHC is access to grant funding. For new starts, up to $650,000 can be requested. The process is highly competitive. Only 350 grants are awarded to 1,100 applicants. Another significant benefit is enhanced Medicare and Medicaid reimbursement. Word on whether Bighorn Valley Health Center receives the designation won't come until summer 2011.
Community Health Centers are specifically designed to provide care to underserved populations where the rates of uninsured and underinsured are high.
Even with the high-quality health care options available in Hardin, specifically Hardin Clinic and Big Horn Memorial Hospital, many residents are not receiving the effective and holistic primary care they need locally, said CEO Dr. David Mark. Many seek care outside the community and many others either delay or avoid regular preventive care, he said.
For several reasons, the problem has become worse during the past five years. And with the number of primary-care providers dwindling nationwide every year, the shortage of primary-care doctors is only expected to worsen. A community health center will act as a safety net, Mark said.
The health center aims to complement, not compete with, existing medical facilities to bolster the capacity to deliver high-quality and locally responsive primary care.
“We want to make sure the new kid on the block isn't disruptive,” Mark said.
Bighorn Valley Health Center plans to provide services to everyone, regardless of the individual's ability to pay. Services will be available on a sliding-scale fee scale based on income.
BVHC recently requested $392,000 from the Montana Coal Board of architectural services and land acquisition. The request was denied.
The Indian Health Services dental clinic at Crow Agency has historically been able to meet only about 50 percent of the dental need in its target population, according to Mark. Recent clinical observations during WIC screening exams through the Big Horn County Health Department also showed a “dramatic need” for additional pediatric dental services. The Special Supplemental Nutrition Program for Women, Infants and Children, known as WIC, is a federal assistance program of the Food and Nutrition Service of the U.S. Department of Agriculture for health care and nutrition of low-income pregnant women, breastfeeding women, and infants and children under age five.
The Centers for Medicare and Medicaid Services has determined that deficiencies in primary care access and outcome have results in “numerous instances of patients being placed in harm,” demonstrating that this deficiency represents a significant threat to public health the community, according to the organization's application to the Coal Board.
“We have found a lot of working poor who are not accessing primary care,” Mark said in an interview with The Billings Gazette.
Most of Big Horn County's area comprises Indian reservations: The Crow Indian Reservation covers 64.2 percent of its area, while the Northern Cheyenne Indian Reservation covers another 6.37 percent.
Also included in the overall target population are employees or retirees from three coal development facilities: Westmoreland Resources Inc., Decker Coal Co., and Spring Creek Coal Co.
Contact Cindy Uken at firstname.lastname@example.org or 657-1287.