MANSFIELD – Over the past 15 years, Third Street Family Health Services’ medical services operations have more than quadrupled – growing faster than any other healthcare organization in Richland County.
But it is not clear whether the expansion of services on Third Street will continue, as the nonprofit anticipates the changes that could result as a new Republican administration in Washington dismantles Obamacare and rulings are being taken as to whether to continue to expand Medicaid eligibility.
Third Street, founded in 1994, began as a part-time clinic at 600 W. Third St., with doctors, nurses and receptionists volunteering their time in the evenings, said current CEO Jared Pollick.
MedCentral General Hospital (now OhioHealth) launched the clinic.
Over the years, hospitals have regularly struggled with the inappropriate use of emergency rooms by patients going there because they did not have a primary care doctor or could not find a place of treatment. open on weekends, Pollick said. “It may take a few weeks to get an appointment. So they just went to the emergency room, ”he said.
Within a year or two, the agency, originally named Third Street Community Clinic, had its own independent, nonprofit board of directors.
The agency’s budget grew from $ 1.8 million in 2002 to $ 12.9 million last year, with the fastest increases occurring after 2009.
The number of patients has increased from 13,400 in 2012 to 18,000 last year, said COO Nicole A. Williams.
By the end of this year, the agency predicts, more than 21,400 patients will have made nearly 86,300 visits for medical, dental or behavioral care.
Third Street has worked hard to strengthen the medical safety net, finding a primary care practitioner “for people who don’t have one, to spot medical problems early,” Pollick said.
“We are saving about 25% of the system per Medicaid patient by preventing extraordinary use and more effectively managing their chronic conditions,” he said. If an amputation is needed for unmanaged diabetes, it costs a lot more than if that patient had “been taken care of from the start, put in place with a nutritionist and everything,” he said.
Third Street acquired “look-alike” status to become a federally accredited health center about 15 years ago. Over the next two years, he received grants as a community health center, for programs that found support on both sides of the political spectrum.
“President (George W.) Bush doubled (this) program during his tenure, and then President Obama did it again with the Affordable Care Act,” Pollick said.
Williams said Third Street’s eligibility for the Health Center Consolidation Act (Section 330) reimbursement allows it to offer services on a sliding scale – and allows access to grants for up-front costs in order to expand programs.
Third Street initially focused on primary care, but now also offers several more specialized types of care.
“We have had the opportunity to hire some really great staff. It kind of spurred our growth, when opportunities arose, ”Pollick said.
More than half of Third Street’s nonprofit board members rely on the agency for their health care, the CEO said. “It means we have an active patient base telling us what we need to do to maintain a high level of quality. “
Opening of eight satellite offices
Although the clinic started at 600 W. Third St, it opened eight new satellite sites between 2010 and 2016, including three last year.
First came Third Street OB / GYN, 770 Balgreen Drive; then Mansfield Family Health, 741 Scholl Road, Suite A; Hawkins Medical Center, 2131 Park Avenue West, Suite 200, Ontario; Third Street Pediatrics, at 270 Sterkel Boulevard, Suite A; and Shelby OB / GYN, 199 W. Main St., Shelby.
Last year Tyger Care began operating at Mansfield Senior High School, 124 N. Linden Road, providing medical and dental care to students.
Shelby Health and Wellness, 31 E. Main St., Shelby, which provides medical and dental services, opened in January 2016. “We have improved the look of an older downtown building. It’s beautiful, ”said Williams.
Five Points Primary Care opened late last year near downtown Mansfield at 200 Park Avenue West.
Third Street owns its original clinic building and Shelby Health and Wellness premises, but rents space for all other sites.
Third Street, which employed 83 people in 2008, now has 160 in its workforce.
Improve patient access
The number of patients continues to increase “because we are not reluctant to open a new office,” said Williams. “We can do it because we manage our funds. “
Although Third Street has gained a reputation for problems with patient wait lists which have already reached 2,000 to 3,000 people, this disappeared “almost immediately” when Pollick took over as CEO six years ago, Williams said. . Now, “if you are a brand new patient and want to be seen immediately, we can take you into one of our offices,” she said.
Bureaucratic issues have been resolved, Pollick said. “We had a very cumbersome registration process for new patients. We were creating an internal bottleneck. We have broken down the barriers. “
“Everyone is welcome – it doesn’t matter if you are on Medicaid, it doesn’t matter if you don’t have insurance or private insurance, we’ll take you,” the CEO said. “If you have private insurance that we’ve never heard of before, well, we’ll get accredited and take it.”
“People think you come here, you see ‘anybody’,” Williams said. But Third Street is trying to establish patients with the same primary care provider. “It should work like any other practice,” she said.
Third Street officials say their agency has worked closely with other medical entities, including OhioHealth, the Area Agency on Aging, the Community Health Access Project (CHAP) and Catalyst Life Services.
OhioHealth “employs a lot of specialists,” Pollick said. “This is the place where our OB / GYN does the deliveries and our podiatrist does the surgeries. OhioHealth Mansfield and Shelby did not see us as competitors in the primary care arena. They saw us as someone they can work well with and stick together with, and form a better and more cohesive solution to health issues, ”he said.
Beginning last July, Third Street worked with CHAP to hire four community health workers who previously worked for CHAP, when that agency began to focus solely on providing funds to reduce child mortality in the area. “We were one of the groups that said, ‘Yeah, we’d be interested in doing that,’ Pollick said.
Third Street has worked with the Richland County Mental Health Board on addiction issues, employing doctors to provide drug-assisted treatment, including suboxone.
“We first collaborated,” Pollick said. “As a result, we were able to stretch our dollars. “
No collaboration has taken place at this point with Avita Health System, which will open its new hospital in Ontario on Monday, Third Street officials said.
“We asked them for things like letters of support for our Shelby Wellness and our OB in Shelby, and they weren’t very open to it at the time,” Pollick said. “OhioHealth was there. They were ready, willing and able to support us. We never want to twist anyone’s arm to do anything.”
Concern for the future
Third Street officials are concerned that major changes in federal health care policy following the November election could affect its ability to maintain the current level of services.
“The health system as a whole needs a lot of parts to function as it does. We are concerned that the status quo will change, ”Pollick said. “If they don’t fund us (at the same level), we’ll have to go back to our original size – and that means more patients than we can see.”
“If the Medicaid expansion were revoked, we would go from a relatively manageable 13-15% uninsurance rate to 33-35%,” he added.
“Patients leaving the system would be a problem – because we don’t know where they would go. A lot of people would be in a very bad situation,” Pollick said.