The graphic above breaks down the average patient experience at the Union County Health Department nursing clinic. Director of Nursing Krista Finch said the goal time for each patient is 60 minutes, while the health department currently comes close at about 65 minutes. However, she noted that the interaction with a clinician, listed in the chart as 25 minutes, can vary widely as some patients spend closer to 45 minutes directly interacting with them.
(Graphic submitted)
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The Union County Health Department is pursuing a special status that will help the agency fill in the gaps for community members who do not have a primary care provider.
“We still see that there are some patients falling through the cracks and we want to help those people,” said UCHD Director of Nursing Krista Finch.
The local health department is working to become a Federally Qualified Health Center (FQHC) look-alike.
FQHCs serve medically underserved areas and populations and provide primary care services regardless of a patient’s ability to pay.
The Union County Health Department already operates on a sliding fee scale based on ability to pay, as FQHCs are required to do. UCHD does not turn away anyone based on inability to pay.
A look-alike meets all the requirements to become an FQHC but does not receive program funding.
Instead, there are a number of benefits the health department would receive by becoming a look-alike.
Finch said look-alikes receive enhanced reimbursement from public insurers like Medicaid and Medicare. The majority of UCHD patients currently attending the clinic rely on these insurances.
Look-alikes can also participate in federal programs to receive drug discounts and free vaccines for children without insurance or not enough insurance.
Finch said look-alikes can also be designated as Health Professional Shortage Areas, which are allowed to apply for recruitment and retention assistance, such as student loan forgiveness, through state and federal programs.
Above all, Finch said becoming a look-alike would allow the health department to expand the primary care services it offers with a goal of “whole-person healthcare.”
Health Commissioner Jason Orcena said the area has a large population of individuals who are eligible to receive healthcare at FQHCs or look-alikes that aren’t receiving it, specifically in the northern part of the county.
While UCHD partners with Lower Lights Christian Health Center, Orcena said officials there have indicated a need for expansion as the center is “busting at the seams.”
“We can help manage that here,” he said, emphasizing that the relationship between the two agencies will continue if UCHD obtains look-alike status.
Finch added that UCHD already serves a large population of patients who have a number of health conditions but no primary care provider.
On average, the health department sees each of its patients once per year, Finch said.
She said UCHD employees work to connect patients with care for underlying health issues or social support needs even if they are beyond the scope of their specific appointment.
For instance, the top diagnosis over the past three months in the health department’s reproductive health clinic was anxiety. Depression was the fifth most diagnosed condition.
UCHD can connect patients with mental health providers, but Finch said access to timely care can be a major challenge in meeting healthcare needs.
“We see a lot patients that need a bridge,” she said.
Orcena said becoming a look-alike would require the health department to formalize relationships with mental health and dentistry providers.
Aside from referrals to other healthcare providers, Finch said UCHD will continue to provide its wide range of nursing services and programs as a look-alike.
In a presentation to the Board of Health Wednesday, Finch listed 19 services provided by the health department’s nursing clinic. They range from immunizations to insurance enrollment assistance to home visits for newborns and mobility-restricted adults to providing cribs for children.
Finch said the health department schedules, on average, 24 appointments per day between two nurses and one clinician.
She added that 26% of patients are able to make a same-day appointment, with 36% scheduled between one and four days after calling and 31% between five and 10 days.
Orcena said some of the recent changes to the reproductive health clinic have moved UCHD closer to look-alike status, but there are still operational changes that will need to be made.
He said preparing and applying to become a look-alike is a complex process.
The health department budgeted to hire a consultant, Cathy Corcella Consulting, LLC, to prepare the application and guide UCHD through the process.
Orcena said Corcella served as the consultant for several FQHCs in Ohio and was recommended by the Medina County Health Department.
The board approved a contract with Corcella for up to $75,000 to pursue a look-alike designation.
Orcena said the process will to become a look-alike will likely take between 18 and 24 months. He said UCHD officials hope to apply by the end of the year.
“I think it’s great,” said Board member Tiffany Wood. “If there’s such a need… build it.”