Then There's This: Power to the People's
Community clinic gains new status – and a bundle of funds
From a humble church basement on the Drag to a bustling 14,000-square-foot facility on I-35, People's Community Clinic has come a long way from its hippie beginnings in 1970 as the People's Free Clinic.
Last week, the local institution marked a crowning moment in its history of serving medically underserved and uninsured patients. People's CEO Regina Rogoff checked her email after her morning exercise and learned the clinic had obtained a new status as a "federally qualified health center."
The long-sought-after designation carries with it a $650,000 federal grant and enhanced reimbursement of costly pharmaceuticals, among other benefits. It also allows People's to expand its medical services (including access to dental care) and increase its 9,000-patient caseload by about 25%. That could translate to fewer people going to hospital emergency rooms for non-emergency illnesses.
"It's nice to get good news," said Rogoff, referring to the effects of ruthless budget-slashing that took place in the 2011 legislative session. "Last year we lost half a million dollars – $526,000, to be exact – and this year we're looking to gain $650,000 in funding from the new access point – so we're ahead of the game."
The financial turnaround is just reward for a clinic that was among the state's wounded as a direct result of lawmaker hysteria over women's health care. The prospects don't appear to be much brighter for the 2013 Legislature, but with People's FQHC status, along with funding from Central Health – Travis County's health care district – and St. David's HealthCare, the clinic now stands on higher ground.
With the Supreme Court expected to rule today (June 28) on the Affordable Care Act, People's and other FQHCs could see a greater number of patients on Medicaid, if that portion of the law is upheld. "But whatever the court does, the need will still be there," Rogoff said. "If the law stands, there'll be more people who will have Medicaid coverage and who will be in need of a place to get care. And if the law is reversed, we will still be here for the uninsured."
Patients on Board
Even before last year's budget cuts, People's had already started mapping out its future as a primary care provider to a growing population of people in need. The board decided in 2010 to pursue the federal designation in order to ensure its independence and financial health and viability. To do that, it first needed to completely restructure its board to reflect a 51% representation of the community it serves. By October 2010 the transformation was complete. "We went from a board of 24 members to a 15-person board," Rogoff said. "Eight of them are patients and seven of them were holdovers from the other board."
Simply speaking, it meant that people like Cathy Cranston went from being a patient one day to a board member the next. Cranston, a personal care attendant who works for people with disabilities and elderly individuals, is typical of many patients at People's – she's among Austin's "working poor" who are both uninsured and ineligible for Medicaid.
The FQHC status, Cranston says, "means that we're going to be able to serve more people ... there's such a great need for health care for people that fall between the gaps." She first walked through People's doors as a patient three or four years ago and still relies on the clinic as her primary care provider. "It was just a life saver for me because I was dealing with blood pressure issues at the time," she says.
As part of its application process, the board also solicited letters of support from community members and organizations and received more than 100 letters in response. (For various reasons, Central Health and its affiliated network of clinics, CommUnityCare, assumed a neutral stance after People's declined to join under their FQHC umbrella, deciding to maintain its autonomy and seek its own federal designation.)
People's submitted its FQHC application in 2010. Then it waited. "There was a first round of awards that we did not make," Rogoff said. "There were, I think, 800 applications in the first go-round, and 67 were initially funded." People's name wasn't on the list of 67, but it learned then that its application was still alive. "We'd been hearing rumors that there would be money released back in March ... then in May ... then I'd kind of given up actually projecting when we would hear because everybody would roll their eyes." Finally, on June 20, Rogoff got the confirmation she'd been waiting for.
The federal grant is good for two years, and it's renewable, so People's expects to maintain its federal status from here on out. "You do of course have to deliver what you've committed to deliver, but we have no real concerns about that," Rogoff said. "We've been walking the walk for a while – since 1970."
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