Problems plague Frances Nelson

Problems plague Frances Nelson

CHAMPAIGN — Even before a local community organization tried to buy Frances Nelson Health Center, the small clinic had been plagued with problems, The News-Gazette has learned.

The staff has dwindled since the beginning of the year, and a local consumer hot line has been receiving complaints for more than a year that established patients are having trouble getting in for care and new patients rarely get in at all.

Now, Promise Healthcare, the not-for-profit organization hoping to purchase Frances Nelson from the Decatur organization that has run it for 11 years, says the deal is off.

Mark Ballard, head of the Promise Healthcare board, says Decatur's Community Health Improvement Center rejected the local group's offer.

So Promise Healthcare will pursue its goal of expanding access to health care in Champaign County by opening a clinic of its own, he said.

"For now, our offer remains in effect, and we hope that CHIC will reconsider accepting it before we get too far along the path of opening a new clinic," he said in a written statement.

Ballard declined to say how far apart the two organizations were in reaching a deal, but he did say the local organization's offer was based on fair market value of Frances Nelson's assets.

"We didn't feel we could pay more than fair market value, because that would not be a good use of community assets," he said.

Barbara Dunn, CEO of Community Health Improvement Center, said she believed negotiations were still ongoing, and she was unaware that the Champaign County group would explore options to start a clinic of its own.

"I can't even comment on that," she said.

Financial stress

Frances Nelson Health Center was relocated to a larger building and it's staff was increased six years ago with the help of a community fundraising effort, so it could accommodate more needy patients.

Dunn acknowledges the clinic is now under financial stress.

"We've had to make some tough decisions, and we're very much hoping that we'll reach an agreement with the community group," she said Tuesday afternoon.

She declined to discuss financial details about the health center, and Ballard said that information hasn't been shared with the local community group.

Reports to Champaign County Health Care Consumers' patient hot line indicate Frances Nelson has largely stopped taking new patients for more than a year, and even existing patients have been encountering problems getting care, hot line coordinator Crissy Turino said.

"There's been a lot of different problems," she said.

For example, Turino says, Frances Nelson patients who can't make their $10 copayments upfront are being turned away for service instead of being allowed to see a health care provider and billed.

A recorded message warns patients to bring their copayment or their appointments may be rescheduled.

Many patients have also complained they can't get in for medication checks, "almost to the point that they're running out medications, things like that," Turino said.

Some people have been forced to go to hospital emergency rooms for prescription refills, she added.

Lawrence Stewart, 45, of Urbana said he's called Frances Nelson for appointments on about the seventh day of the month two or three times, and been told the clinic is booked through the end of the month.

He's been also unable to make his $10 copayment and called churches asking for help, he said, but was turned down because he isn't a member.

Turino said Frances Nelson is intended to be the local safety net health care facility for people who can't get care elsewhere, and it's a problem when they can't get in.

"It's really important for my clients to be able to rely on their health facility to get the care they need, and they definitely have had a difficult time for the last year or more," she said.

Dunn said Frances Nelson has been focusing on serving people "in a timely manner," but has slowed down taking new patients.

Local layoffs

There have been layoffs both at the Decatur clinic and at Frances Nelson since the beginning of the year, she said, and two health care providers at Frances Nelson resigned.

Dunn declined to say how many staff members were laid off at Frances Nelson or which providers resigned, but said the providers were "mid-levels," a term typically used to describe advance practice nurses and physician assistants.

The mid-level provider situation at Frances Nelson is "critical," Dunn said, and if a mid-level provider would be willing to work at Frances Nelson under a temporary arrangement with CHIC with the understanding he or she would need to arrange a new contract with the Promise Healthcare group, Dunn said, "we would hire someone."

Salaries and benefits are still being paid regularly at Frances Nelson, Dunn said, but it would be "unfair" to say Frances Nelson is doing OK financially, Dunn said.

The dental clinic at Frances Nelson, operated under contract by SmileHealthy, a dental health organization based in Champaign County, is still operating and accepting new patients with about a six-week wait, said SmileHealthy's Executive Director Nancy Greenwalt.

Dunn blamed at least some of the financial difficulties at Frances Nelson on settlements of an antitrust lawsuit filed by Illinois Attorney General Lisa Madigan against the former Carle Clinic, now Carle Physician Group, and Christie Clinic, which had accused the two clinics of conspiring to turn away new Medicaid patients.

Settlements with Carle in 2008 and Christie in 2009 involved ramping up the number of Medicaid patients at both clinics — a move Dunn contends had a financial impact on Frances Nelson, which was depending on the payments from Medicaid payments to cover the cost of treating uninsured patients.

As a federally qualified health center, Frances Nelson gets a higher reimbursement for the care of Medicaid patients than private physicians receive.

Claudia Lennhoff, executive director of Champaign County Health Care Consumers and a member of the Promise Healthcare board, contends Medicaid patients were already having trouble getting into Frances Nelson when Attorney General Lisa Madigan stepped in. And, she adds, Champaign County continues to have many more Medicaid patients than Frances Nelson could ever serve now.

Total Medicaid enrollment in Champaign County has grown from 23,649 adults and children in 2006 to 33,237 persons last year, according to the Illinois Department of Healthcare and Family Services.

New clinic

Ballard said Promise Healthcare intends to make SmileHealthy the operator of the new local community health center, though SmileHealthy will also continue to operate the dental clinic at Frances Nelson under contract for a time.

The new local community clinic would be a federally qualified health center, pending approval of an application by the U.S. Health Resources and Services Administration, he said.

Ballard also said private donors would be sought to help cover the cost of opening the new clinic, and it would be located in Champaign-Urbana.

"We will offer a full range of serves at our new clinic, including dental," he said.

Ballard said he was disappointed a deal with the Decatur organization wasn't reached.

"We thought this would be a win-win for everyone," he said. "They'd get a significant infusion of cash. We would have brought Frances Nelson back into local control to expand access to care in our local community."

Turino encourages anyone running into problems accessing health care at Frances Nelson or elsewhere to contact the Champaign County Health Care Consumers patient hot line at 352-6533.

Comments

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Ellen wrote on June 27, 2012 at 11:06 am

Slowed down taking new patients? I have asked numerous times in the past three years for my daughter who is unemployed and uninsured. I have been told each time that they are not taking new patients at all. 

Bulldogmojo wrote on June 27, 2012 at 11:06 am

I have adequate health care (for now) but when I didn't years ago I used frances Nelson several times and it made all the difference which is why I have money deducted from my paychecks to donate to Frances Nelson every two weeks. This story makes me more than a little worried about the clinic's patients, if all that is standing between them and access to treatment is $10. I guess I will have to go down there with an envelope of $10 bills so they can draw from it when someone is in a pinch. You never know what the future holds especially in Illinois so don't be afraid to give back when you can I guess.

rsp wrote on June 27, 2012 at 12:06 pm

Take it to Health Care Consumers. When someone calls for help because they can't get in the money can help them directly. They won't just hand the client the money. Give the money to Frances Nelson for that purpose and it will get lost in the shuffle. People will still be told to bring their $10 down because what you dropped off may get spent on anything. 

ashrprice wrote on June 27, 2012 at 1:06 pm

"He's been also unable to make his $10 copayment and called churches asking for help, he said, but was turned down because he isn't a member."

 

Why am I not even remotely surprised? How very Christian of the churches in this area.

rsp wrote on June 27, 2012 at 8:06 pm

You would be surprised at how many people who call churches every month asking for "help". With the economy down giving is down and their expenses are up as well. They want to help and they want to know they are really helping and not contributing to the problem. If it's not helping and they have wasted the money they can't help someone else. 

just me wrote on June 27, 2012 at 9:06 pm

I went into Frances Nelson three years ago and filled a paper to get my husband established there.  I was told it may take a couple months to get a call and we are still waiting.  If you go by there you will see many people going in with babies. If you are going  there for medical care you obviously can't afford these babies you keep having.  If these people got birth control instead of more babies maybe Frances Nelson could see more sick patients.

common_sense_isn't wrote on June 29, 2012 at 9:06 am

Last I checked you weren't the baby police.  If your husband needed care so badly, people with young children probably needed it too.  Did you consider that many people go there with their babies not because they continue to have too many children but because that might be the only place in the area that they can afford to have well baby visits, immunizations, check ups, etc?  That's like sitting outside the homeless shelter saying that only homeless people go there.  If you sit outside a clinic that provides healthcare to low income parents, not surprisingly, you will see many low income parents going in and out with their kids.  Suggesting that someone is any less worthy of having children because they happen to be low income is pretentious and quite frankly, offensive.

cbrads334 wrote on June 28, 2012 at 8:06 am
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I commend the person who wants to help others by donating money for those who cannot afford a co-payment.  I would also suggest that he does what the person who replied to his comment said.  Don't just blindly give your money away.  Make it so it can only be used for the purpose you wish it to be used.

Secondly, in regards to comments #6 and #7:  how magnaminous of you, stereotyping Hispanics.  I'm sure you're aware of how the economic situation has been these past couple of years.  Yet you begrudge someone wanting to take care of their child's health?  I imagine you'd criticize these women if they didn't take their kids to the clinic, as well, calling them neglectful mothers. 

Also, if you do not support giving birth control options to the poor, this is the result.  Think what would happen if abortion became illegal.  It really isn't any of your business whether others opt to have a child, or not--  it's the individual's right to choose their own option.

concernedforcommunity wrote on June 29, 2012 at 11:06 am

It is sad that there is a group of people that want to make access to affordable healthcare better and they are being stalled due to not offering enough money.  If the adminstrators of the clinic in Decatur truly cared for the underserved population shouldn't they take the offer and go with it?  Maybe this new organization needs to consider opening a clinic in Decatur as well if this is how the CHIC clinic and Frances Nelson Clinic are being ran. 


Turning people away because they cannot pay their co-pay goes against everything they vowed to uphold as a Federally Qualified Health Center. It is truly sad that this allowed to go on.  I hope that they can reach an agreement, with the new Medicaid cuts coming there may be more adults in need of services.


Before deciding to begin the effort to establish a Federally Qualified Health Center, you must understand the federal requirements associated with obtaining health center status (http://bphc.hrsa.gov/policiesregulations/policies/index.html). These standards relate to health center governance, quality of care, services provided, and management and financial systems. Specifically, a health center must:


. Be a public or private not-for-profit organization.6


. Provide comprehensive, culturally competent, primary care (directly and/or by contract), and assure that their patients can access the care regardless of ability to pay, including:


Reference: http://www.nachc.com/client/documents/Starting%20a%20FQHC%20Manual-September%202011.pdf