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More and bigger clinics boost Treasure Valley primary care

Medical assistant Martha Madero, right, attends to patient Robin Danenberg, Nampa, at the Family Medicine Health Center in Meridian on Wednesday, Feb. 5, 2014. Danenberg said she followed Dr. Penny Beach to the new clinic because she likes way she is treated. "She's real with me," Danenberg said.
Medical assistant Martha Madero, right, attends to patient Robin Danenberg, Nampa, at the Family Medicine Health Center in Meridian on Wednesday, Feb. 5, 2014. Danenberg said she followed Dr. Penny Beach to the new clinic because she likes way she is treated. "She's real with me," Danenberg said. doswald@idahostatesman.com

Robin Danenberg and John Mayo have a few things in common. They both live in Nampa, they both have gone without health insurance for years, and they both travel to Meridian for medical care at a clinic run by the Family Medicine Residency of Idaho, or FMRI.

Danenberg and Mayo are patients of Dr. Penny Beach, who moved with several other health care providers about a year ago into a new building on Eagle Road. They previously saw patients in a cramped space with just two doctors, both of whom shared a closet-like office that doubled as a lab test area.

The new digs are spacious and bright. The clinic has added a psychologist, nurse practitioner, physician assistant, counselor, dietitian and others who are necessary to give patients total primary care.

“I think it allows more people to get what I got,” says Danenberg, referring to the new offices’ ability to accommodate more patients. “I see [Dr. Beach] for everything, from a cold to yearly exams, the whole nine.”

Danenberg was uninsured for two years but recently learned she can use Medicaid.

Mayo credits Beach with getting his cancer treated almost 10 years ago. He says the clinic did not care about his insurance coverage or his ability to pay a medical bill.

“I know if something goes wrong, I can count on her,” he says.

Though Mayo has been cancer-free since 2005, the treatment took a toll on his ability to work. He is now on disability and Medicaid.

GETTING ‘QUALIFIED’

The Meridian clinic is part of a long-term plan. With help from $650,000 in federal grant money each year, FMRI opened the larger Meridian clinic, is launching a new clinic in Kuna and is creating Idaho’s only full-time clinic on a K-12 campus.

There are dozens of federally funded safety-net health clinics around the state. The new FMRI clinics have a special “federally qualified health center” designation that gives them access to federal grants. The previous FMRI clinics were “look-alike” health centers, with underserved patients and a sliding fee scale, among other things. They received enhanced reimbursements from Medicaid and Medicare, but none of the grant funding. Now, almost half the clinics qualify for grants.

“We’re in this funny role of, we're kind of a dual organization,” says Ted Epperly, president and CEO. Four clinics now have “look-alike” status “and the whole organization is a teaching health center,” he says.

Epperly says it took months to pull together data for the grant application, which ended up being 125 to 140 pages long with letters of support from about 25 organizations, he says.

“There’s a lot going on at FMRI [to help] our community be better served, for the patients we’re caring for and the outstanding young family doctors that will serve our state,” he says.

Idaho’s clinics that are like FMRI cared for 126,000 patients in 2011, according to the National Association of Community Health Centers. About 52 percent of those patients were uninsured, 91 percent lived in rural areas, and 64 percent had incomes at or below the poverty line, the association says.

The FMRI residency program also provides training to doctors in the early stages of their careers, with the goal of keeping them in family medicine and keeping at least some of them in Idaho.

The FMRI program won “teaching health center” status in January 2011 — the first of 11 in the U.S. — that makes it eligible for a grant of about $150,000 per year, for up to six residents. That extra money helped expand the program from 11 residents to 16. The grant is scheduled to end next year, but the added residents will stay.

The new Family Medicine Health Center in Kuna is more of a reboot than a brand-new clinic. Nurse practitioner Myrna Fisher owned the clinic, but she wanted to help FMRI better serve the Kuna community, Epperly says.

FMRI also will add a family physician to the office, to help the clinic take on more patients.

The clinic officially joined FRMI on Feb. 3.

NOT JUST FOR RUNNY NOSES

Some pioneering youngsters at Meridian Elementary School will have full-time access to nurse practitioners starting this week.

The new FMRI school-based clinic is the first of its kind in the state, though a northern Idaho health center operates a mobile school clinic.

“The goal is, if we can treat them there, we can get them back to school sooner and they can get back to being educated,” says Phoebe Gray, clinic director and one of its two nurse practitioners. The other is Mary Morgan. The clinic also will have a registered nurse and a receptionist, with future additions including a social worker, a dietitian and someone to do preventive dental sealants and fluoride treatments.

The clinic will start by seeing patients who are students at the school. Then it will begin taking homeless children in the area, followed by students of nearby elementary schools and junior high schools.

It's a long time in coming. Idaho was one of two states in the U.S. without a program like it, Gray says. The other is North Dakota.

Why open the clinic in Meridian, not Boise or Nampa?

“We did a study and found that a big indicator of children [being medically underserved] is they are part of a school lunch program,” Gray says. FMRI found that Meridian has the largest proportion of kids on the free school-lunch program, so that’s where it decided to try a school-based clinic. FMRI might later branch out to places like the Boise Bench or the Twin Falls area, where there are students without stable access to primary-care providers, Gray says.

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