First Care Clinic looks like a little storefront with a big blue awning on 13th Street, but inside there’s health care to treat the whole person, according to the clinic’s medical director, physician Christine Fisher.
The clinic at 105 W. 13th St. recently hired a couple of integrated health specialists as part of a larger program to provide whole-body health care, said Fisher.
“We will talk to the patients, and talk to them about their medical problems, and we do not only physical vital signs, but also take behavioral health vital signs,” Fisher said. “We screen for depression, for example, which is a huge deal, and a huge contributor to co-morbidities.”
Fisher made the comments last Thursday evening during the regular meeting of the Hays City Commission. Mayor Henry Schwaller IV asked Fisher and First Care CEO Bryan Brady to give the commission an update on the clinic, which in July held an open house marking its $2 million renovation.
“Our mission is to be the region’s premier medical home, dedicated to providing access to compassionate, quality care for all,” Brady told the commissioners. “We want to take everybody. We don’t care if you make $1 a year or a million dollars a year, we’re going to provide the same health care if you walk in our door.”
The clinic provides medical, dental and behavioral health, all under one roof, Brady said, with both extended evening and Saturday hours. A patient’s medical records for all three areas are maintained in a single file. Combining services under one roof isn’t typical, Brady said, but besides efficiency, it helps eliminate the stigma of accessing mental health care services.
“We’re not a walk-in clinic,” Brady said. “We kind of get labeled that sometimes, which is frustrating for our staff, and frustrating for patients, when they walk in off the street and say they want to be seen.”
First Care is also no longer a free clinic, as it was in the past. But it still serves everyone, he said.
Right now the payment model is 30% Blue Cross Blue Shield, 30% Medicare and Medicaid, and 30% uninsured. Patients below the poverty level who qualify for the sliding-fee scale can get seen for $20 a visit.
“We take everyone,” Fisher said.
The clinic’s goal is to fill gaps in medical care in the community, Brady said. But it’s also been a part of downtown Hays’s revitalization with more than $2 million in remodeling and construction of the old 25,000-square-foot Eddy Clinic building.
In 2008, the year before Brady started, the clinic saw 1,200 patients in the course of 2,500 visits, with four employees. For 2019, the clinic has a $5 million budget, and Brady estimates they will log more than 7,000 patients in the course of 18,000 visits, with 50 employees, including Fisher and four nurse practitioners with many years of hospital experience.
With integrated health specialists and a special licensed counselor, the idea is to get away from pill-and-procedure medicine, Fisher said, and instead address the behaviors that can cause other underlying health problems and help with behavior health interventions.
“Walk-in clinics are great for sprained ankles, they’re good for sinusitis, and smaller more minor medical problems,” Fisher said. “But the true value of care is typically measured by those problems that determine the morbidity and the mortality of a patient.”
Coronary issues, strokes and cancer, to name a few, she said.
“They won’t come in for those other reasons, but they will come in for the things that are bothering them,” Fisher said. “We take the opportunity to say hey, lets take a look at the things that are going to kill you.”
With the whole-body focus, First Care is addressing problems like hypertension, A1C diabetes measurements and coronary problems.
For example, the clinic’s colorectal screening rate had been between 30% to 35% the past few years, but now is at 68%, which is far above the national and state averages, Fisher said. Cervical cancer screenings are in the high 70% range, with the state and national averages around 55%, she said.
Likewise, patients are screened for clinical depression, with the hope of addressing the high suicide and drinking rates in Kansas and Ellis County, she said.
“I was there for your ribbon cutting and I was blown away,” said City Commissioner Ron Mellick. “You see the little building from the street, but once you go in there it’s phenomenal. It is second to none.”
“It’s a basic human right to have good quality care,” Fisher said. “Everyone should have access to care. That is our goal, and it should be regardless of income.”
Fisher said integrated behavioral and physical health care occur when behavioral and primary care providers work together to address the physical and behavioral health needs of their patients.
By having behavioral health specialists available in primary care settings, that improves access to care, reduces the stigma associated with receiving mental health services, is affordable, and embodies the “whole person” concept of care, she said.
“Access to care is a huge issue,” Fisher said. “If you don’t give affordable care, high quality care, or accessible care, people will let their medical problems go and then end up with a very expensive or advanced problem.”