Bluegrass Community Health Center (BCHC) is a full-service medical clinic, complete with doctors and nurses and a nurse practitioner. They have two clinics in Lexington, one at 1306 Versailles Road, the other at 151 N. Eagle Creek Drive. Just another medical facility for which we are grateful when we’re under the weather, right?
Well, not quite. About 72% of their 8,000 patients are uninsured. BCHC accepts Medicare and Medicaid and many kinds of commercial insurance, but if you are uninsured, BCHC considers you for a reduction in your bill depending on income. As of 2013, the poverty level in the 48 contiguous states for a household of one person is $11,490. BCHC discounts the bill on a sliding scale until the patient reaches 200% of the poverty level, $22,890 for one person. At that point, the patient pays the entire bill. A Federally Qualified Health Center, BCHC is supported through grant funding from the US Department of Health and Human Services. “This federal money helps fill the gap between paying patients and the large number of uninsured patients,” says Susan Fister, Ph.D., RN, Executive Director of the clinic. Fister is also a nursing professor at Eastern Kentucky University (EKU).
BCHC began as a migrant health center. Fister wrote a grant which was funded, and the clinic opened in 2001. Taking care of farm workers “was our niche for a few years,” Fister says. She points out that farm workers are from many places, not just of Hispanic backgrounds. She adds, “What became unique in the community is BCHC’s commitment to the underinsured and underserved, including the homeless.” The clinic remains under the sponsorship of EKU and all employees at BCHC are University employees. They serve mostly an eight-county area including Fayette (Lexington), and the counties clockwise around it: Scott, Bourbon, Clark, Madison, Garrard, Jessamine, and Woodford.
The clinic’s focus has broadened since opening. In addition to welcoming the uninsured, BCHC serves three special populations: farm workers, the homeless, and refugees who wind up in the Lexington area. Fister makes it clear that physicians can refer to BCHC just as to any other medical facility. “We have no specialty,” she says. “We do family practice.” They also have on staff a substance abuse counselor and a licensed clinical social worker who works with those battling depression or facing family crisis.
BCHC does all of the refugee health screenings for the central Kentucky area. Of the more than 50,000 persons allowed into the United States each year with refugee status, fleeing war or persecution, between 250 and 300 end up in Lexington. According to the Center for Disease Control (CDC) website guidelines for immigrant refugee health, people entering the United States as refugees must have a health screening that covers 14 areas. It includes such things as HIV, intestinal parasites, lead, mental health, malaria, other sexually transmitted diseases, tuberculosis and viral hepatitis, among other things. Fister says that if any of these people need treatment, they are cared for at BCHC, or referred to a local specialist for appropriate medical attention. In no case are they returned to the country of origin if they flunk a health test.
According to Fister, Iraq, Nepal, and Congo are the three most common countries of origin for refugees coming to central Kentucky. “They have nothing to do with immigrants who are on a list who want to enter this country for other reasons than fleeing dangerous or unpleasant circumstances in the country of origin,” she says. Because they come from many places, BCHC must provide multilingual staff to provide language support for the refugee patients. BCHC contracts with a local interpreting company to supplement their own linguistic staff.
The homeless are not forgotten. BCHC treats their medical issues, and also has close ties with Lexington organizations like the Salvation Army, the Catholic Action Center, and others who extend help to the homeless.
BCHC is one of about 70 licensed members of the Kentucky Primary Care Association based in Frankfort. The KPCA website defines it as “a not-for-profit 501(c)(3) charitable organization charged with promoting the mutual interests of our members, with a mission to promote access to comprehensive, community-oriented primary health care services for the underserved.” One advantage to having the KPCA affiliation, Fister says, is that they advise members on Medicare changes. They are currently adapting from Toyota “lean management training” adjusted for health care centers. This means “making sure that everything that is done has value, and not ever doing things that do not have a value and cause waste.”
BCHC is also proud of being recognized by the National Committee for Quality Assurance (NCQA) as a “patient-centered medical home.” Fister says that “home” means that they make sure the patient is the “main decider” about health care with decisions made jointly with the patient.
For more information on the Bluegrass Community Health Center, please call 859-259-0717 or visit their website at http://bchc.eku.edu. The clinic welcomes donations, which are tax-deductible.
by Martha Evans Sparks, Staff Writer, KY Doc Magazine