Health & Medicine

July 16, 2012

The Effort expands its clinics to prepare for federal health care changes

Well before President Barack Obama's health care overhaul comes of age in 2014, the region's largest health clinic operator is mapping out an expanded network to serve thousands of soon-to-be-insured, low-income patients.

Well before President Barack Obama's health care overhaul comes of age in 2014, the region's largest health clinic operator is mapping out an expanded network to serve thousands of soon-to-be-insured, low-income patients.

The nonprofit health firm, The Effort, is nearly doubling its capacity by adding three new full-scope health clinics – paid for with a $2.8 million investment from Dignity Health, the operator of Mercy Hospitals in Sacramento.

The venture is part of California preparations for full enactment of the Affordable Care Act, which has designated such clinics as the backbone of its vision to expand access to care, local health care experts say.

In Sacramento County, with its dearth of county-run clinics, the nonprofit network is giving hope to the dream of accommodating a flood of newly insured, low-income people by 2014.

The collaboration will give a much-needed boost to the county, with its safety net that many describe as beyond frayed. Budget cuts and priorities placing law enforcement over health care led to the shutdown of five county-run clinics, leaving just one open for the entire county.

"I like to say Sacramento County is uniquely bad," said Jonathan Porteus, chief executive officer of The Effort. "If you have a paltry safety net, you end up with a community that is struggling."

The health care act's expansion of coverage to an estimated 167,000 of Sacramento County's low-income residents is expected to produce a tsunami of new patients with pent-up demand.

"This area has such a massive need," Porteus said. "What a heartache it is."

Fortunately, as Sacramento County was busy slashing services, The Effort was positioning itself at the vanguard of the health care overhaul movement, Porteus said. From nine different funding streams, The Effort rounded up much-needed dollars – most notably, the multimillion-dollar, three-year grant from Dignity Health.

But even before securing the $2.8 million investment, The Effort made sure it won full recognition as what's called a Federally Qualified Health Center.

"The federal government is relying on Federally Qualified Health Centers like The Effort to help with health reform," said Rosemary Younts, director of community benefits for Dignity Health. "And The Effort is the most mature FQHC in our region."

Currently, The Effort operates full-scale health clinics in North Highlands, Oak Park and Roseville and on J Street in Sacramento, as well as a number of satellite centers. It also has a well-regarded residential treatment center.

On a recent afternoon, Porteus gave a tour of the clean, modern North Highlands facility, pointing out a bank of new dental chairs for children, doctors' workstations (grouped together in one room to encourage communication), behavioral health rooms (equipped with white noise to ensure privacy), playrooms and sleek computers in examining rooms.

While showing the facility, Porteus admitted taking a dislike to the term "safety net."

"To me a safety net is something with holes in it that you jump into," he said. "A net with holes in it is insufficient. I'd rather say we provide a safety blanket."

The new money from Dignity Health will help The Effort build three new clinics in Rancho Cordova, Folsom and Carmichael. This will expand the number of people The Effort sees in its network from 20,000 to about 35,000.

"Our reason for collaborating with The Effort is they already have a strategy in place," Younts said. "We're accelerating that strategy by a number of years."

To earn its FQHC status, The Effort has had to meet high standards, converting to electronic medical records for increased efficiency and, notably, providing a medical home for patients – or a setting in which primary care is coordinated and not fragmented.

The Effort's offerings include primary care, prenatal care, preventive care, children's dental services, pediatric behavioral health care, midwifery, parenting education and even 24-hour suicide and parent-crisis lines.

With federal status comes added financial support. The Effort's $650,000 annual grant from the federal government was doubled. And FQHCs receive higher reimbursement rates and can bill MediCal, California's version of Medicaid, and Medicare at enhanced rates.

Meanwhile, Mercy Hospitals will close three smaller community clinics they operate in two-room modular units in Folsom, Rancho Cordova and North Highlands. The Effort will take those over as temporary facilities until its three new full-scale clinics are built by next year.

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