One Grant County, Ind., health clinic not only serves the needs of those in the community, but people outside the county who have no other way of getting help.
Indiana Health Center is a federally qualified health center that serves both the uninsured and underinsured people of Indiana. The Marion clinic began in 1977 and is one of six IHCs in the state.
Laura Medows, practice manager of IHC Marion, says the center operates as a primary care practice to low-income families in the area as well as those who have commercial health insurance, Medicare or Medicaid. Medows says the clinic has a patient-centered model.
“We don’t just look at treating that patient in that particular instance,” Medows says. “We’re really all the time, even just during a regular visit for a sick visit, looking at all the situation around the patient saying, ‘How can we improve this person’s life from all of these different aspects?’”
Only about 20 percent of IHC’s patients don’t have any health insurance and more than 40 percent are on Medicaid and about 25 have Medicare. Medows says the center charges people on a “sliding scale” based on household income and family size. For example, a family of five who make $35,000 have a minimum payment of $45.
“Our numbers are actually pretty low when it comes to uninsured patients,” Medows says. “It’s available if people need it, but we’re really trying to encourage people to move towards the marketplace and also what’s available through the state.”
Medows says there’s a worker who specifically helps patients decide on health insurance if they don’t have it, whether it’s Medicaid or through the new Affordable Care Act, so there aren’t people living without health insurance.
IHC exists in Marion because Grant County is a medically underserved area (MUA). This means the federal government examined the area’s amount of physicans, population, poverty level and access to care. This is all determined through a Health Professional Shortage Area score, or HPSA.
The county was deemed as a MUA in 1977, and so the health center opened shortly there after.
Medows isn’t new to Marion or Grant County. She’s lived there since the age of 6 and graduated from Taylor University with a bachelor’s degree in psychology in 2003. IHC hired her in 2006 as a case manager. Even though Medows has lived here all her life, her heart for the area prompts no interest in leaving.
“What I do here makes me feel even more connected than I ever was to my community,” Medows says. “And I like my job, I like what I do, I like my patients and I love my co-workers. It’s a good job. I don’t feel like I need to leave anytime soon. … It’s a good thing to take home at the end of the day.”
After a year and a half working there, Medows says she started to learn more about the business side of the center. When an opportunity came up to work as the practice manager, she took it and has had that position since.
The clinic fluctuates on how many medical providers come per day. Medows says on Wednesdays and Thursdays, there are three providers at the clinic. Rob Dawson, family nurse practitioner and the chair of the pre-licensure programs at Indiana Wesleyan University, practices on Thursdays at IHC to keep up to date with health care apart from the university.
Dawson first came to IHC in 2004 to serve migrant camps outside the county. The camps have workers who come from surrounding areas to work in agriculture. The workers the clinic visits work at the Red Gold packing plants in Geneva and Orestes, Ind.
“It is fun to be out in the camps as people are very grateful for health care,” Dawson says. “They often don’t have access to health care, probably considered a vulnerable population.”
Medows says IHC brings a 40-foot, two-exam-room mobile RV to treat the migrant workers for three months in the fall. She added that these workers are documented, but many lack the transportation and health care to get medically treated.
IHC pairs with Cancer Services of Grant County at the migrant camps. They also provide transportation back to Marion to get free mammograms to the women of the camps. Medows says they’ve found multiple cases of early-stage breast cancer.
“When we’ve been able to find it,” Medows says, “they’ve been able to get treatment and we’ve been able to stop that before [the cancer spreads]. Otherwise, they may have never gotten that service if we weren’t out there. … Those are very special months for us because we get to do something that nobody else does.”
Dawson adds that many of the migrant farm workers suffer from uncontrollable diabetes and high blood pressure. Even though they lack constant health care, Dawson says they have always been thankful for IHC to get them treated and back to work.
“They’re very diligent in work,” Dawson says. “They want to do whatever they can to get well so they can be back at work. They don’t want to miss work.”
“That’s kind of what we try to do here. It’s not just pushing pills and ‘Take this, this’ll make you better.’ It’s more about, ‘Take this and also let’s talk about what types of things we can modify or change within your daily life to help get where you need to be health-wise.’”