A recent infusion of cash from the federal government will help several community health centers in the Inland Empire expand their facilities and add staff.
Community health centers in San Bernardino and Riverside counties received approximately $9 million this month through the Affordable Care Act. Overall, $9.5 billion was allocated nationwide to expand health centers. Another $1.5 billion was designated for immediate construction projects at health centers.
The money is intended to expand services and increase the number of patients receiving services, particularly in underserved areas. With the Inland Empire still mired in the recession, community health centers in the region have played an increasingly important role for residents who have lost their jobs and insurance. Community health centers are required to serve all residents regardless of ability to pay or insurance status.
More Primary Care Needed
The San Bernardino County Public Health Department has received $4.9 million to expand the Hesperia Health Center, where the majority of patients are low income and either underinsured or uninsured.
The health center will use its grant for a 5,600 square-foot addition that will include exam rooms, procedure rooms, triage space, and areas for dental, radiology and mental health services. New conference room space will be used for educational programs to promote wellness in the community.
Meaghan Ellis, chief of Community Health Services for the Public Health Department, said the High Desert is particularly in need of expanded services due to a shortage of health care providers. There also is a need to provide services for Medi-Cal beneficiaries, who often are turned away by some primary care physicians in the area, Ellis said. Medi-Cal is California's Medicaid program.
"Historically, public health has not provided primary care," she said. "But there came a point where we decided we need to be more involved in this. It became part of our strategic plan over time."
The expansion will help the county prepare for health care reform and will provide a safety net for a pocket of patients who may not qualify for health insurance after health care reform is instituted, Ellis said. Those people include undocumented residents and people recently unemployed or uninsured after employers dropped or changed coverage.
"We're trying to open access up there," she said. "There is not enough."
The High Desert experienced a population explosion in the years before the recession, but health care providers and hospital capacity did not keep pace with that growth. In addition, High Desert medical facilities typically have not been able to provide the scope of services available in the more populous areas of the region, such as San Bernardino and Ontario.
Meanwhile, demand for health center services has continued to increase. The center serves 100 patients per week on average and is actively recruiting two full-time physicians. It has added staff, including registered nurses, medical assistants and licensed vocational nurses to meet demand, said Tammi Graham, deputy chief for Community Health Services.
Officials anticipate the Hesperia Health Center's volume will increase by about 7,000 clients over the next three years, with 2,500 new patients added in the next year and each year thereafter, Ellis said.
The center will focus on providing primary care, which is one of the areas of greatest need in the High Desert. Recruiting and retaining physicians is a tremendous challenge.
"It's not in a geographically desirable area," Ellis said. "There are not a lot of people who want to live in the desert."
There is one primary care physician per 1,618 residents in the High Desert. That ratio is three times the national average and twice the state average, Ellis said.
"You can see how underserved we are," she said.
Community Health Services also will start tracking the demand for primary care that is being placed on emergency departments at hospitals. The hope is that expanded services at the health center will reduce the pressure on local emergency departments.
Parts of Riverside Also Underserved
Southwest Riverside County is another area that experienced rapid growth in the housing boom but did not keep pace with the need for more medical services.
Neighborhood Healthcare, which operates eight health centers and clinics in San Diego County, received $3.2 million to expand and improve its only Riverside County facility.
The health center, which serves the Temecula-Murrieta area, currently leases space. But now it will be able to consolidate into a new facility and will be better equipped to provide coordinated care and the implementation of a patient-centered medical home, said Gary Rotto, director of health policy for the Council of Community Clinics. The center plans to hire 14 to 19 additional staff members, Rotto said.
"This is an economic generator," Rotto said of the federal grants. "This is increasing jobs both in the short term with construction, and in the long term with health care."
Another health center in northern Riverside County, just east of Palm Springs, received $500,000 to expand primary care services, Rotto said. Borrego Medical Health Foundation operates Centro Medico Cathedral City and with the expansion, will be able to serve up to 100 patients per day. About 30 new positions will be added, Rotto said.
In Riverside County, of those patients seeking services through centers affiliated with the Council of Community Clinics, 29% are uninsured and 33% are underinsured. The clinics in the county have witnessed a year-to-year increase of 4,000 uninsured patients, Rotto said.
The increased pressure on health centers isn't just a local trend. The National Association of Community Health Centers reports that nationally the number of health center patients has doubled since 2000.
"The number of uninsured continues to rise," Rotto said. "We are here to serve anybody in the community. We do not want there to be any barrier to health care."