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Community Health Center Takes Shape

Many See an Urgent Need to Care for Those Who Have Little or No Insurance

Erik Hogstrom

Dubuque Telegraph Herald

May 7, 2006

[Note: This material is copyright by the Dubuque Telegraph Herald, and is reproduced here as a matter of "fair use" for non-commercial, educational purposes only. Any other use may require the prior approval of the Dubuque Telegraph Herald.]

A Dubuque clinic opens its doors this fall to the uninsured sick child and the middle-aged woman who hasn't seen a dentist in years.

The Tri-State Community Health Center intends to serve as many as 23,000 similarly challenged residents when it debuts in September at 1789 Washington St.

"It's a community solution to a community problem," said Kevin Anderson, the center's executive director. "There is so much need that is going unmet."

Community leaders considered local unmet needs for health care when naming the center one of 10 Envision projects.

More than 1 in 4 people in Iowa younger than 65 went without health insurance for all or part of the past two years. State records also indicate nearly 60 percent of the 637,000 uninsured Iowans were without insurance for six months or longer.

"Particularly in lower-income families, sometimes they just can't afford the coverage," said John Tallent, chief executive officer at Medical Associates Clinic and a center supporter. "More and more employers offer less and less coverage."

Shrinking health insurance often keeps people from seeking care, or forces them into using stopgap measures, such as needless trips to local emergency rooms.

"It (the emergency room) is probably the most-expensive place to receive care, and people are not going to be followed up by the same doctor," said Rod Tokheim, vice president of marketing and planning at Mercy Medical Center-Dubuque.

Tallent calls the center's creation "the right thing to do."

"We think it is a badly needed resource for our community," Tallent said.

Until organizers received a pledge of $650,000 in state funding last year (and the likelihood of an identical amount this year), the center seemed an unattainable goal.

Dubuque officials had been unsuccessful in applying for federal funding several times, beginning in 2003.

"Dubuque has never given up on this," said Ann Michalski, a member of the Dubuque City Council. "Health care is one of the most important things a community can have for quality of life."

Backed by a broad coalition of health-care providers, businesses, municipal officials and residents, the center will continue attempts to secure federal funding.

The availability of federal funding will not determine whether the center remains open, Anderson said. Instead, federal funding will determine the scope of services.

"If we get federal funding, we can hire more doctors," Anderson said.

Designed at 8,200 square feet, but with room to expand, the center will initially employ a staff of 10, including a physician, a nurse practitioner/physician's assistant, a dentist and support staff.

Local and district Rotary clubs have donated $26,000 to the project - to fully equip the center's dental suite - and Rotary club members will volunteer during the construction of the center.

"I've been in three different cities with community health centers and I've never seen the broad-based support of this community health center," Anderson said. "There is ongoing community support for this center."

The health center will rely on continuing support for operations.

Typically, community health centers receive the bulk of their revenue from Medicaid and Medicare reimbursements and sliding-scale fees paid by clients.

"It's not a free clinic," Anderson said. "Most patients do have to pay something."

The community health center also differs from the free clinic model in staffing. Free clinics generally rely on volunteers, and physicians typically rotate coverage.

"The amount of services they can provide is rather limited," Anderson said.

The center will employ full-time staff, including physicians.

"It will be like any physician practice in town, the only difference is how you pay," Anderson said.

September opening set

The Tri-State Community Health Center will open in September at 1789 Washington St., the site of the former Dubuque Casket Company.

The center will provide medical care for people who receive Medicaid and Medicare coverage, underinsured and uninsured people from local communities in Iowa, Illinois and Wisconsin.