Alternative Health Care: Community health center looks to get the word out

There's a good chance you haven't heard of the Racine Area Community Health Center.

First, it's new. The community health center opened a year ago in the Northwestern Medical Center at 2405 Northwestern Ave. as an alternative source of health care and dental care for people on Medicaid or limited insurance. It's run by the same organization that operates the 9-year-old Beloit Area Community Health Center, which has 65 employees and sees 8,000 patients a year. Racine's center staffs two doctors (general practitioners), a podiatrist, two dentists, a hygienist, bilingual support staff and day care, with plans to include mental health services, children's doctors, and more.

Community health centers are common around the country. In all, 1,100 centers in the U.S. see 17 million patients a year, which makes them the No. 1 health care provider in the country. Kenosha and Milwaukee both run community health centers, and now Racine is trying to get one going, too.

But you probably haven't heard about it. Here's the second reason: it's tough to break into the health care market. Even a clinic aimed at providing affordable health care is competing against organizations like Aurora and Wheaton-Franciscan, plus established nonprofits like the Racine County Healthcare Network. Advertising costs money and word-of-mouth travels slow.

Racine's community health center is trying to fill the gap between a provider like Wheaton-Franciscan and a provider like the Healthcare Network. It's for people with some money, but not enough to cover medical bills. Not that it's cheap. The minimum fee to see a doctor at the health care center is $50, in part because the clinic hasn't received a federal waiver to treat uninsured patients. However, the fees, which can reach $65 depending on income, are much cheaper than going to the emergency room and paying full price to see a doctor. That can range into the hundreds, even thousands, of dollars, even if you have insurance.

"Emergency rooms are the most costly way to use health care," said Richard Perry, executive director of Racine's community health center. "We're trying to keep people out of the emergency rooms."

Perry started the Beloit clinic nine years ago as the sole employee with no patients. He's not even a doctor. But he spent 20 years in the Navy working in health care, and got his first clinic going in Beloit's poorest neighborhoods.

He's hit some snags in Racine. A big one is recruiting doctors to work at the center. The Northwestern Health Center is located outside of an under-served census tract, which means the center doesn't quality for a federal program that allows new doctors to work there in exchange for relief on their student loans. But the center has still been able to hire two doctors - Dr. Mike Mangold and Dr. Alan Kanter - and a podiatrist - Michael Kokat - who are seeing about 400 patients at the moment.

The dental clinic has more patients. With most private dentists unwilling to see Medicaid patients (the reimbursement rate is low and many Medicaid patients often cancel appointments), the health center is a reliable alternative.

"We could have 10 chairs going and not be able to meet the need," said Perry during a recent tour of the center's dental clinic. The clinic has three working chairs and two full-time dentists, Jack Fisher and Heather Campbell.

The third reason you haven't heard of the community health center is because we don't realize there are alternatives to health care available. Places like the Healthcare Network and Perry's center are increasingly becoming the backbone of a national health insurance system that is leaving millions behind. While Aurora and Wheaton-Franciscan spend billions of dollars rebuilding hospitals to appeal to rich baby boomers who will soon need services, they're shutting out a growing number of people who can't afford to walk through a doctor's door.

"We're not the answer in universal health care, but we have a significant role," Perry said.

The Bush Administration agrees - sort of. The number of health care centers have doubled during his seven years in office, but the funding for the clinics remains static. That means less to go around for everyone, a common theme in our health care system.

What's frustrating to Perry is the needs are so great. Not only do people need doctors and dentists, they need counselors, day care providers, eye doctors, prevention programs, prenatal support and countless other services that are available to a select few, and withheld from people on the edge.

What's hopeful is a community health care center surrounds itself with people who understand that need. The majority of its board of directors has to be patients of the center, and the staff at the center have to represent the community they're serving. That means a lot of minority employees and bilingual employees, Perry said.

"Almost by mandate we have to mirror the population we serve," Perry said. "We are very culturally diverse."