Tim Ray, who consults with clinics seeking designations as federally qualified health centers, addresses members of the Northwest Colorado Visiting Nurse Association Wednesday afternoon at the VNA. The VNA is seeking the designation as a federally-qualified health center to better provide health care to persons with low income or those who are underinsured or uninsured.

Photo by Jerry Raehal

Tim Ray, who consults with clinics seeking designations as federally qualified health centers, addresses members of the Northwest Colorado Visiting Nurse Association Wednesday afternoon at the VNA. The VNA is seeking the designation as a federally-qualified health center to better provide health care to persons with low income or those who are underinsured or uninsured.

Primary care of concern

VNA seeks federal designation to provide community health care

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— The need for more and better health care in Moffat County continues to be a pressing issue among area health care providers and staff.

The Northwest Colorado Visiting Nurse Association Board of Directors voted Wednesday for certain adjustments recommended to it by the Bureau of Primary Health Care that will help the VNA become a federally-qualified health center. That designation allows the VNA to draw more federal, state and private grant money.

New monies would help the VNA provide primary health care to underserved, underinsured or noninsured residents of Moffat and Routt counties.

Primary care is care given by family doctors, internists, pediatricians and obstetrician gynecologists. It is generally recognized as the first line of access points for patients.

The VNA applied for the designation once and was turned down, though consultants have said it is common for entities to apply three times before being accepted, said John Merrill, Board of Directors president.

"We take their suggestions very constructively," Merrill said.

As far as adjustments went, the VNA changed its health care clinic's name to the Northwest Colorado Community Health Center, which was a direct suggestion from the Bureau of Primary Care, Merrill said.

The board also voted to elect Maria Martin to the board, which was suggested to represent the Hispanic population in the Yampa Valley. Martin works for Comunidad Integrada as a program coordinator.

It is a requirement for qualified health care clinics to have 51 percent of their boards made up of people who receive most of their primary care from the clinic, as well. The board found that it already met that requirement, having more than 51 percent in that regard, Merrill said.

Currently, the VNA Northwest Colorado Community Health Center, which serves patients regardless of their ability to pay, is open in the mornings on Wednesdays and Fridays.

Liz Shugart began four weeks ago as a full-time nurse practitioner for the program. Her main priority will be to work with the Community Health Center and develop the program.

It opens for Monday mornings on Sept. 10, said Suzi Mariano, VNA public information coordinator. Shugart is the Community Health Center's only provider, and is still adjusting and learning the best ways to serve the community, Mariano added.

"We are working towards the goal of becoming a complete clinic," she said. "We have a lot of systems to put in place. Liz is working with (local physicians) to understand the community and the people she's seeing."

The consultant

and the speech

Tim Ray, who is consulting with the VNA during its effort to change its designation, gave a presentation after the board meeting.

He has worked in community health since he was a young man, he said, and gave his impression of where health care is nationally and how community health centers can serve their public.

"My heart has always been with rural primary-care issues," Ray said. "In a recent U.S. census the number of Americans that are uninsured continues to rise, but for some strange reason, the lack of health care doesn't keep them from getting sick."

The uninsured "simply go without primary care," Ray said.

In most cases, they end up at the emergency room, which is one of the most expensive and least effective medical resources in terms of primary care. Patients are not guaranteed to see the same doctor each time and do not generally receive continued medical checkups, Ray added.

Community health centers "provide folks with a medical home," Ray said. "It's where people can go when they have questions about their health and get continuity from their doctor."

Ray told the VNA audience a community health center is more than primary medical care, it is a true community resource, and should look to provide whatever services the community needs but for which it does not have access.

"You try to meet the unmet needs out there by integrating services," Ray said. "It is a natural evolution of how we impact, in a positive way, the general health of the residents of Northwest Colorado. Enriching the community is a large part of what a community health center is supposed to be about."

The application process for clinics being designated federally qualified health centers is extremely sensitive to congressional input, Ray said. He encourages the audience to contact their Colorado representatives and senators and tell them about what need there is in the community.

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