Norristown Regional Health Center is Bursting at the Seams
Across the street from Montgomery County’s Human Services Center in Norristown sits a three-story, 21,000 square foot brick building that houses the Norristown Regional Health Center. The center provides high quality primary and oral health care services for children and adults, health education and other supportive services to nearly 10,000 Montgomery County patients. And that number continues to grow!
Since 2009, the North Penn Community Health Foundation has invested $184,000 to support the integrated services provided by the Norristown Regional Health Center.
DELAWARE VALLEY COMMUNITY HEALTH
The Norristown Regional Health Center (NRHC) is a satellite program of Delaware Valley Community Health (DVCH), a federally qualified, community-focused health care organization with forty-three years of experience in providing affordable and accessible primary medical, dental and behavioral health care services. DVCH manages a network of six federally qualified health centers* in southeastern Pennsylvania that collectively served over 44,000 patients in 2011 alone. Services are provided regardless of a patient’s ability to pay; 68% of DVCH’s patients are at or below the poverty level and a third are uninsured. The Norristown center is DVCH’s only health center outside Philadelphia.
HISTORY OF NORRISTOWN REGIONAL HEALTH CENTER
The NRHC opened in 1999 on Marshall Street with grant funding from the Health Resources and Services Administration (HRSA), part of the U.S. Department of Health and Human Services (HHS). With swiftly growing demand, the center outgrew its space and in 2010 DVCH purchased and renovated a building at the corner of DeKalb and East Fornance Streets. The new facility has four patient reception and registration areas (with only one waiting area at the previous property, patients had to line up outside), expanded exam areas, more clinical providers and an onsite pharmacy where patients can have their prescriptions filled before leaving the center.
The center’s patient population has continued to grow and the new space is nearly at capacity. With additional support from HRSA received earlier in 2012, DVCH plans to renovate the remaining floor to expand the number of pedaitric examination rooms and add health education space.
PATIENT POPULATION AND COMMUNITY
The NRHC served just under 10,000 patients in 2011. Although the center draws patients from as far away as Pottstown, the majority are from the Norristown area, which has a high minority population with 36% African Americans and 28% Hispanics, according to the 2010 U.S. Census figures. As the center’s largest patient population is from the Hispanic community (58% of patients), the center employs mostly bilingual staff in order to provide culturally appropriate and high quality care.
Although the center accepts most forms of insurance including Medicare and Medicaid, few patients have insurance. While 15% are covered by Medicaid and another 4% are enrolled in Medicare, a whopping 70% are uninsured. A small number of patients pay for services on a sliding fee schedule; almost none pay the full cost of services. For most, the NRHC is their only health provider.
ONGOING CHALLENGES
While the physical expansion is good news, the center has numerous ongoing challenges. A growing number of patients have chronic conditions such as diabetes, asthma and hypertension that require more frequent visits for monitoring and treatment. This reduces the overall capacity of the center and schedules are booked farther in advance, leaving patients waiting longer for an appointment.
DVCH’s reimbursement rates for Medicaid, Medicare and HHS funding have adjusted little since its founding in 1969. In the meantime, health care costs have skyrocketed. And since the center, as an FQHC, cannot turn clients away even if they are uninsured, it operates at a financial loss. Fundraising, grants – including the foundation’s support – and revenue from DVCH’s other centers currently help fill the gap. DVCH leadership is engaged in discussions with elected officials and HHS leadership to renegotiate its reimbursement rates. Unfortunately, they have made little progress so far.
ONGOING PROGRESS
In spite of its financial challenges, the NRHC continues to improve operations and recently implemented a new electronic health records system throughout all of its practices. The new system helps to further integrate primary, behavioral and oral health care by giving clinical and other support staff up-to-date information about the health needs of patients.
The NRHC is also developing innovative partnerships with other nonprofit and for-profit entities for the benefit of its patients. A relationship with Susan G. Komen and other local funders has brought a mobile mammography van to the center to screen women for breast cancer. The center is also working to expand its health education programming by collaborating with health educators at Penn State Cooperative Extension and the Montgomery County Health Department. And a nutritionist from the Einstein Healthcare Network will soon provide nutrition counseling to the center’s patients three and a half days per week.
FOUNDATION INTEREST
The North Penn, Indian Valley and Ambler communities have many uninsured and underinsured low-income and other vulnerable populations. Extensive research tells us that health insurance is a necessity for anyone seeking health services. Without insurance, most providers are unwilling to evaluate and treat patients. FQHCs serve as an important health safety net. Currently, only two FQHCs operate in in Montgomery County: the NRHC and another in Pottstown. The NRHC is the closest FQHC to the foundation’s primary service area. The foundation turned to DVCH and the NRHC to ensure that these individuals and families would have access to high quality health services within their home county.
The foundation has long championed the integration of health services in a patient-centered setting. The NRHC's integrated approach means that patients do not have to travel to multiple locations to receive a variety of health care services – patients can get routine check-ups, immunizations for their children and attend to all of the family's dental health needs within the same building. And with the launch of the electronic health records system, that care can be further coordinated and integrated as providers access and evaluate the full range of health care needs of their patients.
* Certain health centers can receive a designation as a Federally Qualified Health Center (FQHC) by the U.S. Department of Health and Human Services (HHS). To qualify, a center must meet certain criteria including providing comprehensive primary health care, operate in a medically underserved area as defined by HHS and be governed by a board comprised of a majority of community members who are patients. FQHC services are available to all and fees are adjusted based on a patient's ability to pay. FQHCs can receive reimbursement for services provided by Medicare and Medicaid, and therefore often provide care to those most in need while improving their health outcomes. All DVCH health centers are designated as FQHCs.