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.
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.
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.
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.