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When a Texas hospital pulled the plug on the only clinic providing indigent care in Williamson County, the clinic’s nurse practitioners Melanie Truesdell, FNP, RN, and Sue Ellen Gondran, FNP, RN, stepped in and formed a nonprofit corporation to save it. Williamson County, just north of Austin, Texas, is one of the wealthiest counties in the state. But it also has a growing number of young mothers, recent immigrants, and working poor. The Round Rock Health Clinic, located in a local strip mall, was the only place that served these people in need. “When people look at Williamson County, they think that this is a very rich county,” said Truesdell. “It is, but we also have a population that needs the services we provide at this clinic. We have people in this community that make too much to qualify for Medicare, but still have no health insurance through their employers.” Recovery from the blow Although the clinic was never a moneymaker for its operator, Round Rock Hospital, the decision to close it still came as a blow. Their patients’ inability to make the one- to two-hour trips to other clinics drove Truesdell and Gondran’s decision to form their nonprofit corporation: Building a Stronger Community Tomorrow, Through the Children of Today Inc. Now that the corporation is formed, they will be able to solicit grants and donations to keep the clinic running as a nonprofit facility. “We’re not in this for a profit. We’re in this because we wanted to take care of our patients,” Truesdell said. “There was such an obvious need for primary care in the county that we decided to step forward and take that responsibility.” The Round Rock Health Clinic is staffed with two nurses, a medical assistant, an LVN, a receptionist, and a part-time file clerk. Truesdell and Gondran trimmed the clinic’s monthly operating budget from $40,000 to $25,000, and for the first couple of months they even cleaned the toilets to save the cost of a janitor. Between clinic visits and administrative work, both put in 60-hour workweeks. Money hunt Securing enough money to keep the clinic operating has been a daunting task. Fortunately, the clinic has some advantages on its side: Round Rock Hospital donated all of the clinic’s equipment and agreed to pay the rent through the end of the lease in February; Williamson County is picking up the clinic’s operating expenses until grant funding is secured; and under federal guidelines the clinic has been designated a rural health clinic (because no other clinic and few physicians in the county offer indigent care), which means it is eligible for increased federal reimbursements. Truesdell and Gondran are still in the process of declaring the clinic’s nonprofit status, which will make soliciting grants and donations easier. Although they have already registered the nonprofit status with the secretary of state and have been granted a charter, they are still waiting on the IRS to confirm their nonprofit status. Serving those in need Services at the Round Rock Health Clinic include well-child visits, well-woman examinations, and family planning. On a recent day, Truesdell and Gondran saw 43 patients in the clinic’s seven examination rooms. Truesdell handled many of the young children, some of them in foster care or from group homes. Gondran, who was trained in colposcopy services at M.D. Anderson Cancer Center in Houston, tends to specialize in prenatal care and family planning examinations. Patients with more serious problems are referred to two consulting physicians or the hospital emergency room. The payer mix is both Medicaid and fee-for-service, which has boosted the traffic through the clinic to about 600 visits per month. And after five months of negotiations, the clinic has finally earned its Medicare number, which means the staff can begin processing a backlog of Medicare and Medicaid claims. “I think we’re feeling a lot more comfortable now that we’ve gotten our Medicare number,” Gondran said. “But our ultimate goal is to find the funding for this clinic so that anyone who needs health care can use the clinic, even if they have no way to pay. That’s what we really want.” What do you
think? |
By
Kimberly
Reeves