CHAMPAIGN — When David Cobbs was a teenager, Frances Nelson Health Center wasn't just his neighborhood clinic. It was the only place he and his low-income family could go to see a doctor.
Decades later, Cobbs said he was able to turn to Frances Nelson once again for dental care when he became unemployed and uninsured.
And while this longtime health center has been mostly closed to new adult medical patients in recent years, Cobbs said he's hopeful its recent ownership change will mean more openings for him and others in community.
"That's one of the things the new ownership is addressing, to make things work more smoothly and efficiently," said Cobbs, one of the 17 board members of Promise Healthcare, the new not-for-profit local community organization that took over the operation of Frances Nelson's medical clinic and dental center Nov. 1.
Promise Healthcare is also the new parent organization of SmileHealthy, a Champaign County dental program for needy patients.
Frances Nelson — a Federally Qualified Health Center with sliding-scale fees based on its patients' incomes — started as an independent clinic in 1968 on Champaign's Carver Drive and had been operating as a satellite of the Community Health Improvement Center of Decatur for the past 11 years.
The health center moved to a new, larger building at 819 Bloomington Road, C, in 2006, and the dental clinic was added last year. The move allowed Frances Nelson to serve more patients at first, but a dwindling staff and financial issues in more recent years left it struggling to keep up with the demand for primary medical care.
The United Way of Champaign County gathered community representatives last year to explore solutions, and they concluded getting Frances Nelson back under local leadership was the best option.
Cobbs, 55, is one of nine Frances Nelson patients appointed to the Promise Healthcare board that was created in August.
A computer programmer who is between jobs, he left Champaign-Urbana when he went to college and returned to live in the local community in 2006, he said. But he remains uninsured and had to turn to a hospital emergency room when he needed medical care, he adds.
"I don't even have primary care right now," he said.
Fellow board member Marya Burke of Urbana says she and the rest of the board live in the community and they're invested in the health and well-being of the people Frances Nelson serves.
Plus, she said, "having people who are local makes it all that much easier to take advantage of the resources that we have here in the community."
Burke has also been a patient "off and on" at Frances Nelson for the past 15 years, she said.
"I've always felt good about the people I've worked with there, but I've always known there was always more need than was able to be met, so that's a big focus of what Promise Healthcare is," she said.
Detaching Frances Nelson from its former parent organization in Decatur required Promise Healthcare to pay CHIC for its investment in Frances Nelson and approval from several federal agencies.
Kevin Yonce, a CHIC board member, said it wasn't a simple procedure.
"I think it had benefits for both sides," he said.
Financial terms of the deal are being kept confidential as part of the agreement, according to Promise Healthcare Executive Director Nancy Greenwalt.
However, she said, Promise Healthcare was started with no loans or debt.
As part of the agreement, Frances Nelson will also continue to have financial ties to CHIC, receiving its federal grant money through that organization for the next few years, until Frances Nelson's next opportunity to apply for a grant as a Federally Qualified Health Center grant on its own rolls around, Greenwalt said.
A transition board that stepped down when the permanent board was appointed talked about the possibility of adding satellite locations for Frances Nelson and possibly even a name change for the health center, but neither of those ideas are on the table now, said Promise Healthcare Board President Dr. Scott Anderson, a Champaign dentist.
The main priority is finding ways to serve more patients in its current location, which has plenty of space, Anderson said.
And that means serving more than just low-income patients covered under the state's Medicaid program, he said.
Frances Nelson needs to find ways to serve more uninsured patients who can afford to pay little for their care.
"If providing the service was profitable and easy, there would be lots of businesses lining up providing these services," Anderson said. "But it's neither profitable nor easy."
Anderson is more than familiar with the need to serve more low-income patients and the challenges providing it.
He has worked with SmileHealthy, as both a board member and volunteer dentist, and he's also volunteered as a dentist for Frances Nelson's dental clinic.
Anderson was also one of the dentists who said yes when Champaign County Health Care Consumers asked local dentists to treat a couple of low-income patients a month at reduced rates, he said, but that program didn't solve the problem of creating more affordable dental services for the poor because there weren't enough participating dentists.
Greenwalt says Frances Nelson is currently accepting new mental health and new dental patients, but still lacks openings for new adult patients seeking medical appointments.
With just three part-time and three full-time health care providers on staff, the health center can only work in new patients if they're children, she said.
"There's just no way we can meet everybody's needs to get in right now," she adds.
Some immediate changes to expand access that were made right after Promise Healthcare took over, Greenwalt said:
— Some Fridays and Saturdays were added to the dental center's hours.
— Medical copayments were cut to $10 for the neediest patients with incomes at or below 100 percent of the federal poverty level.
— The medical clinic opened on the day after Thanksgiving and will also be open for some appointments on Christmas Eve and New Year's Eve.
Opening on those three days when the health center was formerly closed "should be a real blessing to our patients," Greenwalt said.
All employees who were working at the time of the transition of ownership kept their jobs, she said.
"I think change is difficult, but the staff has been great," Greenwalt said. "We've made a few changes, but everybody has been really excited. They really care about this place, and they care about the patients and the chance to do better."
Greenwalt said opening up Frances Nelson to more patients will continue to be a challenge until more medical providers can be recruited.
One solution would be recruiting more volunteer doctors willing to commit to a regular schedule, for example, seeing Frances Nelson's patients one day a month, she said.
Greenwalt said she and the board also want to collaborate with other service providers in the community to make sure they're using resources for low-income patients as effectively as possible.
Anderson says there are medical providers out there who have a heart for working with low-income folks.
"We have to identify more of them," he added.
Frances Nelson has had a lot of community support in recent years and it's going to need more if it's going to be the model health center the community needs, Anderson said.
Some examples, he said: Jimmy John Liataud gave $50,000 for Frances Nelson's new dental clinic. Carle has been a big supporter. The United Way of Champaign County led both the campaign to relocate and expand Frances Nelson and to add its new dental clinic. And the move to bring Frances Nelson back under local leadership wouldn't have happened without the United Way's help, Anderson said.
Carle invested $1 million in Frances Nelson's new building, provided free rent for three years and gives the health center ongoing support, said Lynne Barnes, a Promise Healthcare board member and a Carle executive.
"We'll need broad community support and it's going to take time," Anderson said. "I'm hoping a year from now, we're going to be a lot better."