FHCSO celebrates 20 years

What is a Federally Qualified Health Clinic (FQHC) or Community Health Center (CHC)? Prior to the early 2000s, most people in Johnston and Marshall Counties did not know.

The Family Health Center of Southern Oklahoma (FHCSO) Inc. is a CHC with its board consisting of concerned community members who realize there are many citizens in Johnston County and the surrounding area with unmet healthcare needs due to financial restraints. These 15 board members represent the citizens to the clinic in its operations and long-term planning.

Initial planning for the CHC began in May 2001. Many rural communities have resisted CHCs, due to the fear of losing existing physicians and pharmacies to one. In Tishomingo, people believed that both could work together.

Through a series of meetings, groups of citizens began planning the Family Health Center of Southern Oklahoma. A governing board for the proposed clinic was developed, and negotiations began with Mercy Health of Tishomingo to take over the existing Mercy clinic.

Leading up to the birth of the CHC, the Mercy Health System had taken over Bell Clinic and renamed it Mercy HealthCenterofTishomingo.

Mercy Health Center provided the community with access to healthcare and supported Johnston Memorial Hospital, which was also struggling due to declining revenue from reduced Medicare/Medicaid reimbursement rates and managed healthcare.

Mercy Health Center did not offer a sliding fee scale (income-based care) or the 340b prescription program. These programs are vital to providing primary care to area citizens.

After discussions with the Oklahoma Primary Care Association, the local group believed a grant for a CHC was the answer and a perfect fit for Johnston County.

Members of the group met with representatives from the Oklahoma Primary Care Association and the Office of Primary Care, and visited the Mary Mahoney Memorial HealthCenter,anFQHC located in Oklahoma City.

Executive Director Tina Davis said the board began meeting long before they opened.

“In 2004, we opened for business on Jan. 5, but the board started meeting in 2002,” Davis recalled. “I was asked by the administrator of the hospital if I would write a grant for a FQHC.”

At the time, Davis was a respiratory therapist for JohnstonMemorialHospital, and also worked in administration. She had written a few grants for the hospital for trees and equipment. Norma Howardwasadministratorof Johnston Memorial Hospital at that time.

Davis had limited grant writing experience; however, it was decided that in order to save the costs associated with hiring a grant writer whospecializedinCHCfunding that she should write the grant. A grant to open a CHC is extensive. Along with the grant, the organization had to form a not-for-profit corporation to operate the clinic.

“I was writing (the grant) mostly after hours and that consumed my evenings and weekends for most of two years,” Davis said.

Asking for guidance from local professionals along the way, Davis was able to successfully complete the grant that established the Family Health Center of Southern Oklahoma. The original grant was for $800,000.

Grant writers typically are paid five percent of the grant value for their grant writing, if approved. Davis, by writing the grant on a voluntary basis, saved the FHCSO $40,000.

With minimal guidance, Davis also successfully completed the extensive Internal Revenue Service 501-C application to incorporate as a not-for-profit. Local attorney Laura Corbin set up the corporation. The organization establishing the CHC needed funds to get started. To help raise these funds, the first activity of the community members involved was to have a bake sale, which raised approximately $200.

From this humble beginning in Tishomingo, the Family Health Center of Southern Oklahoma - led by its local board of control and Davis as administrator - has grown into clinics in Tishomingo, Atoka, Kingston and Coalgate.

FHCSOcurrentlyemploys 143 individuals, including physicians, nurses and other professionals, who have a large economic impact on Johnston County and the surrounding area. Without MercyHealthSystemhaving the existing Mercy Health Center in Tishomingo in place and willing to work with the newly formed CHC, it would have been a much longer and more expensive process to go from granting of funds to operation, according to Davis.

Mercy agreed to lease the 5,390 sq. ft. building located between Johnston Memorial Hospital and the Johnston County Health Department to the newly formed clinic, which included leasing all existing medical equipment in the building and donated all the medical supplies to the new health clinic as an 'inkind' contribution, with an estimated value of $10,000.

“It really worked out well, because Mercy already had their operation going,” Davis said. “We literally got a letter in November saying, ‘you’re funded’ and we opened up in January 2004.”

FHCSO opened on Jan. 5, 2004, with two physicians and a total of 12 well-trained employees already in place from Mercy Health Center.

Bob Thompson, as CEO of Mercy Hospital-Ardmore, was instrumental in the smooth transition from Mercy HealthCenterTishomingo to the Family Health Center of Southern Oklahoma, according to Davis. Thanks to FHCSO, Johnston County has become able to participate in National Health Service Corps (NHSC) programs and can recruit and retainprimarycareclinicians through the NHSC scholars and loan repayment programs. This has resulted in more health care providers for the community.

Initially, the CHC expected the service area to cover a 30-mile radius from Tishomingo. This included Johnston County and the bordering county of Marshall County, along with portions of Coal, Atoka, Murray, Pontotoc and Bryan counties. All seven counties had been designated as “medically underserved areas.” Now, patients travel from a much larger area - including north Texas - to receive care at the four clinics.

Congressman Brad Carson and U.S. Senator Jim Inhoff were instrumental in seeing the original funding through that would establish the clinic in Tishomingo, according to current board presidentandfoundingboard member Seigel Paul Heffington.

One of the advantages of being a patient at a CHC is the sliding scale, according to Davis. If you are uninsured, your fees for services by the clinic will be adjusted according to your income. The sliding scale can also be used, if you are insured, to reduce your costs.

“One of the biggest benefits, I think, for all patients is the 340b program,” Davis said.

When a prior attempt for the CHC grant had failed, Davis was approached by a patient leaving Johnston Memorial Hospital.

“You aren’t going to give up, are you?” the patient asked Davis.

Those words kept coming back to Davis as she worked on the grant proposal.

As part of Davis’ job, she did home visits. In one home visit, she was asked to come sit at the kitchen table, where the patient asked her which medications she and her husband could do without so they could pay their other living expenses.

This couple was retired, with Social Security and Medicare only. Experiences such as this helped Davis to remain determined to see the grant proposal through to its completion.

Patients are not having to make choices like that today because of the 340b program. The 340b pharmacy program is available to all patients at the clinic, regardless of income and insurance. Prescriptions must be ordered by a provider for the clinic to qualify.

This program pays most of the cost of all prescriptions from the clinic at a qualifying pharmacy. The Tishomingo clinic has an in-house pharmacy, and there are contract pharmacies for the other locations.

An example of the effectiveness of the 340b program is that a one-month prescription of insulin for a diabetic is $6.50. Most 340b program prescriptions have a similar cost to the patient.

“There were people who would come into my office when this first started and say ‘Man, I can go to the doctor now and not be in bankruptcy due to the sliding scale,’” Heffington said.

“This facility is like this across the board,” Heffington added. “It helps thousands of people every year.”

Davis encourages the FHCSO staff to treat each patient as if they were family. Shortly after the clinic opened, Davis said the late Dennis Toews asked her “Okay, what are you going to do?”Davissaidsheaskedhim what he meant. “This thing is going to get big,” he replied.

Toews encouraged Davis to apply for USDA money to build the new facility, and the clinic acquired five acres of land from Murray State College for a building site. With the help of Cecil Carter, thegrantfundingfromUSDA for the building was acquired. The clinic had to deed the land to Johnston County to receive the money to build the facility.

Working with the architect, Heffington and Davis were able to design a lodgestyle buildingatnoadditional cost over the original design they had been presented.

Today, FHCSO occupies a 15,000 sq. ft. building on 24th Street in Tishomingo. Davis said she credits Mercy HealthSystem,MurrayState College, Johnston County Commissioners, Johnston CountyHealthcareCoalition, Oklahoma Primary Care Association and the FHCSO board, as well as numerous community groups and citizens, for helping to make the clinic the success it is today.

Closing on its 20th year of operation, the Family Health Center of Southern Oklahoma has grown from 12 dedicated employees in Tishomingo to a staff of 143 in four towns in southeastern Oklahoma. The grant application made over 20 years ago stated: “Community members are anxious to have a comprehensive health center operated by the people for the people without regard to profit margins.” That dream became a reality for the citizens of southeastern Oklahoma.

TheFamilyHealthCenter ofSouthernOklahoma’smain office and clinic is located at 610 East 24th Street in Tishomingo. Appointments can be made by calling (580) 371-2343. Patients may visit the clinic’s website at fhcso. org.