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PMH sets sights on federally funded clinic

Pioneer Memorial Hospital recently began to address a problem occurring between the local Hispanic population and the existing healthcare system _ a problem of both language and culture _ making it difficult for non-English speaking people to obtain medical care in this community.
   Since that time the hospital, through a grant from the Oregon Community Foundation instituted a multicultural outreach program and hired an interpreter to help fill in the gaps. Through these expanded services an additional and somewhat unexpected segment of the population, suffering equally from lack of medical care, was also discovered.
   Sharry Fassett, multicultural liaison spearheading the outreach efforts, recently outlined the process leading up to one possible solution.
   "About a year ago we identified that there was definitely a need for helping the Hispanics in this community from a health care standpoint. Not only did they not have access because of money, but they didn't have access because of language." In fact, she says, Hispanics come from an entirely different medical system and consequently have entirely different expectations when it comes to medical treatment.
   The place where cultural differences are most often apparent is the emergency room which frequently serves as the introductory point for families with health problems. "The reason they opt to go to the emergency department is because that way they don't have to make an appointment. If you speak Spanish and need to see a doctor, there is no receptionist in the city that can take that call for you," she explained.
   Reportedly, there is currently no statewide effective 800 number where a non-English speaking person can go for answers or assistance.
   The problem with having non-emergency health care situations taken care of in the emergency room, is that it has a consequence of being particularly costly. And, if the patient has no insurance or resources to pay for the services, the hospital ends up paying the bill.
   Eager to educate this under served segment of the population on appropriate avenues for seeking healthcare, PMH began to offer various outreach services to meet the needs of non-English speaking members of the community, which in turn revealed yet another population of people with similar problems.
   "We began to realize that there was a whole other group of people in the community that wasn't accessing health-care," Fassett said. "We started seeing people that are not getting health care, some with extreme medical problems. They frequently live in remote locations, and they have no insurance. Some of them have been laid off work and have very limited or no resources at all. Or, maybe they work part-time and make a little too much money to be covered by the Oregon Health Plan ... they simply don't have enough money to pay for treatment. Or, folks on Medicare who find they have to pay for medications they can't possibly afford. The dilemma became what do you do with these people stuck in-between the system?"
   To explore possible solutions to the situation and to meet grant requirements, a series of public forums was hosted by PMH. Together with the Department of Anthropology they undertook the task of interviewing members of the community to determine the full scope of the problem.
   That assessment was concluded in August. Among its many findings is a section which states that the most frequently utilized health care resource for the low-income, uninsured residents in the community is the public health department. Although a valuable resource they are not equipped to meet all, or even most of, the basic needs of their low income clients.
   Hospital staff began looking for options to meet the health care needs of this growing population of people with no medical coverage in Prineville. "We started looking at a rural health clinic and just found out there wasn't enough dollars in grant funds to meet the costs for that sort of clinic," Fassett said.
   It has since been determined that a better option would be a federally qualified health care center. "As a federally funded clinic, not only can we purchase drugs at a federal price for patients who can't afford them," she explained. "... we can also provide care on a sliding scale based on income."
   A federally funded clinic has a broad appeal for hospital administration as well. Under a federally qualified clinic, services can be contracted out or shared with existing entities. Meaning, that services already provided through PMH including laboratory, X-ray and pharmacy can be utilized by the new clinic and paid for with federal dollars, which in turn will help support the existing infrastructure of PMH.
   The next phase of the process to obtain federal funding involves gaining a designation from the Oregon Health Department as pertaining to a medically underserved area. Such a designation has already been approved at the State level and is currently pending federal approval.
   Fassett added that one stumbling block to the process involves a hefty grant packet which needs to be completed in order to finalize the process.
   In order to accomplish this aspect of the process they hope to hire a professional grant writer through a grant from the Oregon Primary Care Association. Hospital administration anticipates that the whole process will conclude sometime next summer.
   According to Fassett, the city granted the hospital property on the corner of main and Loper which, due to its extreme uphill terrain presumably would require preparation before it would be suitable for building.
   Though, Fassett says, the location is ideal for a `safety-net clinic' due to the proximity close to the hospital and exiting clinic. However, it may be some time before construction of such a building could get underway, providing of course that the hospital is successful in gaining funding for the project.
   In the meantime, the group is looking at the possibility of utilizing the recently vacated clinic located next to Price Slasher grocery store on Main Street. "Even if we have to start in a little clinic and do the best we can with meager funding, I'd like to see it happen," she said.
   "We are going to have a meeting on Fri., Oct. 26 where we are asking anyone who hasn't had a chance to offer input or ideas to come forward with that information," Fassett said. County and city officials along with consultants from Portland will be on hand as well. Anybody who has an interest in this project is encouraged to come to that meeting.
   The meeting will be held at the hospital's Ochoco Conference room starting at 10 a.m. Anyone interested in hearing more about the project, or who would like to offer opinions is encouraged to attend. Call Fassett at 447-6254, ext. 376 for more information.