Wolf Visits Community Health Center

Congressman Frank R. Wolf (R-VA-10) had a busy day on the healthcare front yesterday--visiting facilities in Winchester and Loudoun and finishing up the day in Ashburn with a public forum on the increasing incidence of Lyme Disease in Loudoun.

In the afternoon, Wolf visited the Loudoun Community Health Center on the third floor of the Leesburg campus of Inova Loudoun Hospital-in the former obstetrics ward of the old hospital.

Chief Operating Officer Stephanie Kenyon invited Wolf to come to the center for a personal tour as the center celebrated its new status as a Federally Qualified Health Center Look Alike, which it was granted two weeks ago. The federal recognition provides a number of financial benefits to the organization, including higher reimbursements, according to Inova Loudoun Hospital and LCHC board member Mark Stavish.

It does not qualify the center to receive the large $600,000 grant for full designation, but Kenyon said the organization has also applied for the full status and expects to hear next week whether the application was successful.

The Look Alike status is hard to earn, Kenyon told Wolf, noting that it is very competitive, with 240 applications received from across the country. The center received positive feedback, she said, noting she and Stavish are hopeful they will get good news next week.

While there are many similarities between the LCHC and the Loudoun Free Clinic, which also operates on the downtown Leesburg hospital campus, the main differences lie in fees charged and age of patients served.

LCHC uses a sliding fee based on income and family size, while the LFC does not charge any fees, using only voluntary patient donations.

The community health clinic accepts all patients, whether insured or not, while the free clinic accepts only those living with an income at 200 percent or below the federal poverty level, who must be uninsured and residents of Loudoun.

But the biggest difference in those the two centers serve is the age of those accepted. The LCHC accepts all ages, including children and the elderly, while the free clinic serves only ages 18 to 64.

During its 15 months of existence, Kenyon said the center has served 2,300 patients. Fifty percent are Hispanic and 30 percent involve baby care, making the community health clinic the only place in the county that can serve low-income children.

With no doctors in the community accepting new Medicare or Medicaid patients, "We're the only ones," Stavish said, noting that the center gets a lot of referrals from doctors--so much so the center has a waiting list of between six and eight weeks. The free clinic also sends its more complicated cases to the center, Kenyon said.

Kenyon said critical patients are worked in on an emergency basis and the center works closely with Inova Loudoun Hospital, which has contributed about $1.3 million to the facility, including $500,000 start up, according to Stavish.

Stavish pointed out that on a dollar ratio, the same service would cost five times more if it had to be treated in the hospital emergency room.

"Inova has a huge vested interest, so patients don't end up in the ER or, worse, in the ICU," he told Wolf.

Transportation is a problem and the center is working with Virginia Regional Transit to provide a bus stop on Market Street, Kenyon said, noting, "a lot of patients can't get here." She also is working with the county on a fund to provide taxi service where essential.

Because of the high number of Hispanic patients, the staff members all speak Spanish in different degrees, and some also can speak Farsi when treating Iranian patients.

Wolf focused on the center's board make up, which he found unusual and speculated might be strengthened with more business representation. Community health centers, in a practice dating back to President Johnson's administration in the 1960s, must have a board majority of patients to reflect the healthcare needs of the community. No more than 10 percent of the board can make money from the health industry, Kenyon said. Fifty-one percent of the board members are patients.

That provision clearly startled Wolf, who asked if it wouldn't be better to have more people on the board with experience of running things, including industry movers and shakers.

While Stavish acknowledged "51 percent is maybe too high," he pointed out that the center has an advisory board, which has no vote, but does possess the kind of expertise and community outreach to which Wolf was referring.

One new initiative, Stavish said, is working with the Loudoun Chamber of Commerce to have businesses provide prepaid cards to their staff to enable them to attend the center. Patients would swipe their $500 cards, and each visit would be deducted from the total. Anything left over would be gifted by the employer to the center. If the endeavor comes off successfully, it would be first such initiative in the county.

After a tour of the facility, during which Wolf enjoyed swapped tales of growing up in South Philly with fellow Pennsylvanian and physician Thomas McGorry, who happened to be on duty yesterday afternoon, Wolf told Kenyon and Stavish he was impressed by what the center was doing and would endeavor to help as much as possible.