Chat with Health Department Director
May 14, 2008
Flint Hills Community Health Center Director Lougene Marsh will answer your questions about the health department. Submit your questions now.
Moderator: Welcome to The Emporia Gazette online chat. Our guest today is Lougene Marsh, director of the Flint Hills Community Health Center and the Lyon County Health Department. The center now offers primary medical care and dental care to residents of the Emporia area who are underinsured or uninsured. It and the health department are the community's primary resources for public health matters. The first question concerns state and federal support for the center. Be sure to refresh your screen regularly to keep track of the questions and answers as they are posted.
blulitespecial: Will you be getting any Federal or State aid to offset the recent increased costs of refugees to the Health Department? Would an increase in sales or property tax be the only source of funds? Will you pass on the costs to residents if there is no tax increase?
Lougene Marsh: Most of the refugees served by the Health Department received services in 2006 and 2007. With the recent Tyson reduction in force and the departure of most of the Somalis from our community, we are currently serving virtually no refugees. During 2006 and 2007 reimbursement was received from Kansas Department of Health and Environment for refugee health assessments. In addition, funding was received from the Tuberculosis Control program to cover some of the costs of working with refugees who had latent tuberculosis. All medications to treat tuberculosis are provided to the county health department at no cost. Fortunately, we were able to serve the refugees without requesting any additional tax support during 2006 and 2007, and with the departure of the refugees, there will also be no need for additional funding in 2008.
admireed: How are members of your Board of Directors selected? Do you have any direct connection with NRH? How much $$$ do you receive from the County Commission (lyon and other counties) not including grants that may come via the county(s)?
Lougene Marsh: The Board of Directors operates under a not-for-profit corporate structure. Members of the Board are selected by the Board itself based on nominations submitted by its nominating committee. Because the Board is the governing body for the federally-funded community health center, there are regulatory requirements around Board composition, the principal one being that the Board must be comprised of at least 51% members, who receive their medical care at the health center. I would encourage any patient (or parent of a patient) interested in serving on the FHCHC Board to contact me at 342-4864, x261. Flint Hills Community Health Center has no direct connection to Newman Regional Health (NRH) although we view NRH as an important community partner. NRH provides laboratory and radiology services for our patients and bills those services back to FHCHC for uninsured patients. NRH was instrumental in the start-up of primary care services prior to the receipt of federal funding to start a health center and NRH provided funding to Lyon County for its purchase of the current facility. For fiscal year 2008, Lyon County is providing $683,833 to FHCHC to support the county health functions. This funding represents 13% of the 2008 budget and 11% of the proposed 2009 budget. FHCHC is requesting the same amount of funding for fiscal year 2009. Other counties do not provide financial support although Coffey and Morris Counties contract with our center for child are licensing services, and our Women, Infant and Children (WIC) nutrition program services clients in Coffey and Chase counties.
pkelley: Who can use the services of the Flint Hills Community Medical Center? Is there an income or insurance limitation?
Lougene Marsh: Anyone may use the services of Flint Hills Community Health Center . There is no income or insurance limitation. All of our services are provided on a sliding fee scale basis so the cost of the service billed to the patient is determined based on the income and household size of that individual. In 2007, 48% of our patients were uninsured. The remainder had Medicaid, HealthWave, Medicare or private insurance. Our providers are all signed up with a number of private insurance carriers. We do always welcome new patients.
pmowpaint: I have a question concerning the dental clinic. I am retired, living on SS and a small pension. ie limited income. What can I expect the clinic to provide a 65+ mouth with inlays falling out and crowns about to??
Lougene Marsh: Our dental clinic provides both preventive and restorative dental services. There are some types of procedures that we do not provide, including oral surgery, and, of course, we do not provide orthodontia or any type of cosmetic dentistry. Our dental services are also available on a sliding fee scale, and the amount charged to the patient is based on income and household size. I encourage you to contact our dental clinic at 342-4864, x275, to set up an appointment.
quarterback: Who is handeling and what dental services are offered at the Health Department?
Lougene Marsh: Our current dentist is Christa Walker, who was a 2003 graduate of the University of Missouri Kansas City School of Dentistry. Dr. Walker has been at the health center since August 1, 2003, and provides comprehensive dental services, preventative, restorative and emergency. In addition to Dr. Walker our staff includes two registered dental hygienists, Pamela Hatch and Jessica Herbster. Another hygienist, Millie Bergstrom, works on a part-time basis to provide oral screening, cleaning, and dental sealants to 2nd and 6th graders in area schools.
quarterback: Does the Health Department have a hard time recruiting and retaining medical professionals for the health department? What are your biggest challenges?
Lougene Marsh: Historically, we have not had a difficult time recruiting medical professionals although currently we have experienced some difficulty in recruiting physicians. Our recent experience with physicians has also indicated some challenges with retention. Part of the retention issue has been the demand of sharing call coverage and inpatient care with only one other physician. That coverage includes not only the patients of the physicians but also the patients of the three Advanced Registered Nurse Practitioners. There are several challenges in relation to recruiting: 1. Provision of a competitive salary when competing with private practice opportunities 2. Lifestyle choices – some new graduates do not want to return to smaller communities after training in metropolitan areas 3. Professional opportunities for the spouse of the physician or dentist 4. Shrinking number of physicians entering family practice or internal medicine specialties 5. Reluctance to come to a practice where call is shared with only one other physician. The final challenge will be addressed if Newman Regional Health decides to employ hospitalists. A benefit for recruitment of allied health professionals, such as registered nurses, licensed practical nurses and dental assistants, is the presence of ESU/Newman School of Nursing and Flint Hills Technical College
moderator: What are some of your goals for the health center?
Lougene Marsh: Our management team and Board of Directors are completing a strategic planning process and these are some of the goals to be accomplished over the next three years: 1. Expansion of the dental clinic, which is currently underway through the generosity of a grant from Jones Trust. The clinic size will be doubled, and the number of dentists will increase from 1 to 2.5. 2. Implementation of Electronic Medical Records. 3. Development and refinement of recruiting and retention strategies. 4. Gaining recognition as a Medical Home through the National Committee on Quality Assurance 5. Working with the community to reduce the adverse impacts of obesity and tobacco use.
moderator: What are the biggest challenges facing the health center? How does our health center compare with others around the state?
Lougene Marsh: Recruiting health care professionals will continue to be a challenge in the future. There are fewer physicians, dentists, and nurses being trained than are leaving the work force. Rising costs of providing medical care, including technology and meeting regulatory requirments, will continue to be a challenge. Rising cost of health insurance will continue to create more uninsured Kansans, and the challenge of providing care for more uninsured will increase the need for funding. In Kansas , the legislature has recognized the important role filled by community health centers and has committed additional funds to support health centers in the last four legislative sessions. Flint Hills Community Health Center ranks fourth in Kansas for the number of patients served by a health center. In 2007, 8,836 patients were served.
moderator: What are the biggest needs for the health center?
Lougene Marsh: Recruiting health care professionals will continue to be an ongoing challenge. Increased support for the rising costs of providing care will continue to be a need. The health center is constantly looking for grant opportunities from both governmental sources and private foundations. Recently Friends of FHCHC was formed and will utilize Emporia Community Foundation for funds that it raises. These funds will be used to meet special, one-time needs of FHCHC in the future.
emporia123: Do your services duplicate the services of Newman Regional Health? Should health services be consolidated in this community?
Lougene Marsh: The services of the health center complement but do not duplicate those of Newman Regional Health. One of the benefits of the health center is that it is consolidated with the county health department. Lyon County Health Department is actually the grantee of federal funds for the community health center. Consequently, this consolidation of health services provides considerable financial benefit with the health department operation and the community health center sharing an executive director and chief financial officer as well as other management staff, a facility, information technology, and billing and accounts payable staff.
emporia123: What progarms are run out of the Flint Hills Community Health Center?
Lougene Marsh: Flint Hills Community Health Center provides both personal health care services and public health services. The personal health care services include basic family medicine, including the services of a pediatrician and family practice providers, dental services, and behavioral health services. The public health services include immunizations, sexually transmitted infection testing and treatment, health screening services, family planning, maternal and infant services, fluoride varnish for 0-3 year olds, nutrition services through the Women, Infant and Children (WIC) program, child care licensing, and Environmental Services, including food service inspections and permitting of individual waste water systems.
Moderator: That’s all the time we have today. Thank you to Lougene Marsh for taking time to answer questions about the Flint Hills Community Health Center and thanks to our readers who submitted questions. A transcript of today’s chat will be published in Friday’s Gazette.