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Community Health: Centers Filling the Gap Missed by Medicaid

Virginia is one of 19 states that have not expanded Medicaid under the Affordable Care Act.  So community clinics here are expanding their mission and changing their image as they strive to fill the gap. 

There’s a misperception that what used to be called Free Health Clinics still serve only adults who can’t afford to pay… that people fortunate enough to have health insurance, should never patronize.  But in fact, the opposite is true.

“Now we see everyone. We see children, adults, the uninsured, homeless and the insured individual.”

Michelle Brauns is Executive Director of the Community Health Centers with offices in Montgomery and Giles counties.  A year and a half ago, they became Federally Qualified Health Centers or FQHCs. Before the change, 100% of patients here were not covered by health insurance.

Brauns say, “Today about 75% of them are. So 25 % of our patients have Medicaid, Medicare, the Anthems and Optimas of the world. 

Before the transition, this place was supported mostly by donors and volunteers.  Now the federal government covers a third of the budget and care for insured patients helps offsets costs for those without it, the same concept used in all insurance vehicles, but the health center still has to come up with the rest.  And Brauns is still working to spread the word that in other ways, not much has changed here.

“I met with a couple yesterday, who’d been supporting us for a while and asked me on the phone this week, ‘Tell us about this change you’ve made because we’re not quite sure we understand it.’ And I invited them in to have a tour and I said let me show you what we’re doing and let me assure you that our mission is the same.  We take in everyone.  We don’t turn anyone away and your donations are still needed.

Jackie Jackson says “Really, other than the screening process it’s not different than any other doctors office. You make your appointment you pay your co-pay the doctors and nurses are wonderful, or the therapists or even the dental because I have seen them all.”

Jackson, and her husband moved to the New River Valley 2 years ago from the Tidewater region. Both of them worked most of their lives, but never had health insurance. They were pretty healthy and it seemed like an unnecessary expense. Her husband is covered by Medicare,  but when she applied for coverage under the Affordable Care Act she was told:

The center in Christiansburg.

 “The bad news is there’s not a plan you can afford with what you make.  The good news is, you earn so little, you’re in such a low bracket, they can’t’ penalize you for not having health insurance..”

She did a bit more research and found the Community Health Center in Christiansburg

“It’s a bit embarrassing saying you need help or you don’t have health insurance or you haven’t seen a doctor in ‘X ‘years. It was actually one of the doctors here that the stress of taking care of my husband was taking its toll on me and he even stopped one of our exams one day and said we have a behavioral therapist on staff.  I’d like to bring her in because I think you need her today more than you need me.”

And here at the Community health center, that therapist is just down the hall.

“When they come to the same building that they see their physician in they feel more comfortable seeing someone for mental health issues.”

Stephen Cazzazza is a first 1st year doctoral student at Radford University.  Part of his training is a grant-supported position where he sees patients and works with them, one on one.

“The integrated care is a great opportunity to kind of reduce some of the stigma that rural areas have around mental health.”

It’s things like that that this former ‘Free Clinic’ is counting on to transform its reputation to match its name, Community Health Center.

Robbie Harris is based in Blacksburg, covering the New River Valley and southwestern Virginia.
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