A required 25 percent local match of $60,975 brings the total to $304,875, payable over three years through the the Primary Care Support Grant Program.
“I’ve got to tell you, I am really excited, and I am excited for the people in Park and Big Horn counties,” said Bill Baker of Powell, who has spearheaded the effort to create a community health center here.
A news release from the Wyoming Primary care Association announcing the grant said, “Community Health Centers ... provide care to people who have difficulty accessing health care because of distance or inability to pay for needed care.”
The application was submitted in May by the five-member Powell Health Care Coalition, comprised of Baker, his wife Sharon, dentist Larry Akin, David Whittle and Powell Tribune Publisher Dave Bonner.
Baker said he was elated to learn that the entire amount the coalition applied for was funded.
“In mid-July, they asked everybody in consideration of a grant to cut back (the amount they requested), and we did,” he said. “We cut back 30 percent, and that was all restored.”
In a letter Baker received via email Thursday, Keri Wagner, a program specialist with the Wyoming Office of Rural Health, wrote, “Powell Health Care Coalition shall receive up to $243,900 ... Although it was suggested the purchase of dental equipment could be removed from the grant request, the Office of Rural Health has chosen to include it in the award. Park County is a Low-Income Dental Health Profession Shortage Area and dental services through the Community Health Center would be extremely beneficial to the low-income population.”
The Primary Care Support Grant Program was funded by the Wyoming Legislature in 2011 to help organizations begin work to apply for federal community health center funding or to become a new rural health clinic.
Jan Cartwright, director of health policy for the Wyoming Primary Care Association, said Park County Health Coalition’s grant application came closest to the intent of the original legislation that established the grant program.
The grant “will be a great beginning to allow them to apply in the future for a federal community health center,” Cartwright said.
As Baker has explained, the center would provide medical, dental and mental health services to Park and northern Big Horn Counties. It would provide free care for people with incomes under the federal poverty level, and care on a sliding scale for people with household incomes up to 200 percent of the poverty level.
However, the center would provide care for patients of any income level and would bill Medicare, Medicaid and health insurance companies for its services. The model for the center that’s been discussed involves integration of Powell Valley Healthcare into the community health center, Baker said.
The Powell Valley Healthcare Board voted in May to support the grant application.
After learning of the grant award Thursday, Bill Patten, chief executive officer for Powell Valley Healthcare said in an email, “Very exciting! I have not had a chance to chat with Bill and Sharon yet to see what the plans are for the next steps. I do know, however, that we are looking at a lot of work and probably not a lot of time to get it done. I plan to do all I can to work with this group to help with ‘the heavy lifting’ that moving this project forward is going to require.”
During last week’s meeting of the PVHC board, Patten said the proposed public model for the center is innovative and based on cooperation with Powell Valley Healthcare, but there is very little information yet about how it would be structured to eliminate competition with existing local medical services.
Baker said one of the first items on the list of things to do now that the grant is approved will be taking up discussions with Powell Valley Healthcare administrators and medical providers about the community health center proposal.
“It’s going to be very important for the medical staff there, the providers, to decide what it’s going to look like,” he said. “If it isn’t going to work right for them, it’s going to be difficult to get it to work for anybody.”
Patten provided an update for members of the Powell Valley Healthcare Board on Aug. 26, before the grant was approved.
Powell Hospital Trustee Renee Humphries said she had heard little from doctors in Powell regarding their feelings about the community health center proposal.
Patten said he believes that is because medical staffers still are waiting to hear what services the center would provide and how it would be structured.
“There’s so much lack of clarity about the scope of services,” he said. “If we’re talking duplication or competition, clearly they would not be in support. But right now, there is such a lack of scope and definition ... how can I say what it would look like?”
Dr. Bob Tracy agreed, saying he’s not convinced that mechanisms exist to form the proposed center in the way it has been framed in discussions.
Trustee Jim Beukelman said, “In reality, the uncertainty of the project is such that no one is willing to come forward to make a statement.”
Money from the state grant also will help pay for a needs assessment that would determine whether this area would meet the demographic eligibility requirements for establishing a community health center in a medically underserved area.
While Powell would qualify as underserved for dental and mental health services, Powell and the immediate surrounding area would not qualify as medically underserved. To meet that requirement, the center’s service area would have to include northern Big Horn County.
Putting that needs assessment together and expanding the Powell Health Care Coalition board will be some of the first items on the list of things to do now, Baker said.
Patten told the PVHC board he provided information needed for the grant application as requests came in. He said some questions focused on issues surrounding the medically underserved population designation.
“It is my understanding that Lovell has no interest in having a CHC,” Patten told the board. “If they don’t want one there, one could easily ask, ‘Why would they want one here?’
“I am very candid with Bill (Baker) about my concerns and issues,” Patten continued. “But if ... we can find a way to serve the underserved, we should.”
Patten has stressed that any effort to establish a community health center should involve North Big Horn Hospital in Lovell.
Baker said Thursday, “I think we really need to extend an olive branch to the people of Big Horn County. ... We do not want to be predatory in any way, shape or form. If there is any way we can (create a community health center) through some sort of collaboration with North Big Horn Hospital, we want to do that.”
Baker said the coalition has had two conversations with North Big Horn Hospital Chief Executive Officer Rick Schroeder.
“We have invited him to join us in our board meetings, much as Bill Patten has,” he said. “Bill Patten, I believe, has already talked to him about areas that we may be able to collaborate in.”
Those conversations took place in May, Baker said.
“We haven’t had a significant board meeting since then,” he said. “We have been waiting for the grant to settle.”
Baker said he expected to get back in touch with Schroeder this week.
He said coalition members also plan to talk to Rep. Elaine Harvey, R-Lovell, who co-chairs the Wyoming Legislature’s Joint Labor, Health and Social Services Interim Committee.
“Since we have the grant, we really are going to get together and talk with the people in Big Horn County,” he said. “We haven’t had anything to talk about until today.”
Schroeder couldn’t be reached for comment before press time last week.
Park County Health Coalition’s grant was one of four approved Thursday by the Wyoming Office of Rural Health through the Wyoming Primary Care Support Program.
The other three are:
• $203,388 to North Big Horn Hospital District’s Rural Health Clinic in Lovell for a mobile van for regional outreach to Senior Centers and for occupational health.
• $226,500 to Evanston Community Health Center to upgrade facility to be ADA compliant and to open an X-ray department;
• $326,212 to the Cheyenne Health and Wellness Center, a community health center in Cheyenne, for one-time costs to construct new dental and mental health suites and to provide more space for the pharmacy and State Donated Pharmacy Program.
Baker said he doesn’t view the grants for the community health center in Powell and the grant for a van for regional outreach in Lovell as competing grants.
“Nor do I believe North Big Horn Hospital District sees them as competing,” he said. “I see them as a real opportunity for collaboration. I fully expect we will have a conversation with NBHH District about this sometime in the near future.”