FHC Sees Healthy Growth

Orangeburg's Family Health Centers is finding new ways to take services into its communities. That's helping its bottom line, too, its chief executive officer says.

"We developed a sound financial system. We have many revenue streams today. When I came on, we only had two sources," FHC CEO Leon Brunson Sr. said in a recent interview. Those sources were grants under Section 330 of the Public Health Service Act and patient fees.

"That's not enough to sustain a federally qualified health center. You have to have more revenue streams. Pharmacy is a big revenue stream. You have to look at other funding sources to really make a difference," he said.

Brunson will celebrate his sixth anniversary as the health center's top officer on Dec. 31. He said he is proud of the center's progress.

Orangeburg's Family Health Centers Inc. has grown its operating budget by more than 100 percent from $10 million to $21 million and is steadily expanding access to care to its most vulnerable service population.

The FHC has its main Orangeburg site on Magnolia Street in Orangeburg, along with six satellites sites in Denmark, Vance, Holly Hill, Norway, St. Matthews and St. George.

Three new, full-time pharmacies have been opened at the sites in Norway, Denmark and St. Matthews with the help of an expanded service grant from the U.S. Department of Health and Human Services.

The agency also received a clean audit for the last fiscal year.

"We received no recommendations in our audit. This is the first time Family Health Centers has ever received a clean audit. By virtue of that, it opened the doors for many funding opportunities for us," Brunson said. He also touted the leadership of FHC Chief Financial Officer Shasonda Amos.

FHC Board Chairman Dr. Sam Alston said he is very pleased with FHC's fiscal soundness. He hopes to enhance health care delivery with a particular focus on children, women, veterans and migrant workers.

"They're all welcome to any of our clinics. We're getting the board to focus more on those areas. With a clean financial audit, we have no financial problems with our bookkeeping procedures, and I want to shout out loud that anyone who visits any of our clinics receives affordable, professional health care," Alston said.

FHC was accredited by the Joint Commission in 2002, verifying it is in compliance with nationally recognized standards. It will undergo its third reaffirmation process in the spring.

The FHC was the first primary care medical home in the state to be accredited by the Joint Commission.

Brunson said FHC has successfully grown in its ability to deliver comprehensive and high-quality preventive and primary health care to patients regardless of their ability to pay.

FHC served 21,549 patients last year. The center employs 246, including 184 direct employees.

"This year alone, we generated $9.6 million in federal dollars, the highest that's ever been generated at Family Health Centers," Brunson said.

Earlier this year, the agency received a $1 million grant from the U.S. Department of Health and Human Services to build a new, free-standing facility in Denmark.

Construction will start in early January on the facility, which will include three full-time providers, a pharmacy and behavioral health, care coordination and nutrition services, Brunson said.

FHC also received a $1 million grant from the Centers for Medicare and Medicaid Services to help get more eligible children enrolled in Medicaid and the Children's Health Insurance Program.

The Centers for Medicare and Medicaid Services has also included the FHC in a cardiovascular disease risk reduction study model designed to reduce stroke and heart attack risk in Medicare patients 65 and older.

"Another outstanding thing we have going on is telehealth," which connects patients at FHC sites with specialists at the Medical University of South Carolina via telecommunications technology, Brunson said.

The agency also participates in the South Carolina Health Information Exchange program, which gives health care providers real-time access to a patient's medical history - with their consent.

The FHC has also created a new logo and will be replacing the roofs at each of its locations with green metal roofing to coordinate with its new brand. New LED signs including message boards are also being placed in front of all FHC locations.

"They will advertise what is going on inside like, for example, flu shots. It identifies it as a Family Health Center facility, which is part of our branding package," Brunson said.

The center also has two new dental and optometry mobile units which will be traveling across The T&D Region to provide free vision and dental exams, along with teeth cleaning, for uninsured individuals beginning Dec. 12.

"We realize that patients do not have transportation to come to us, so we want to take the service to patients. We also want to reach out into the communities where there are uninsured individuals. Hopefully we can sign them up for Medicaid or affordable care by the time they get their eyes checked and have a cleaning," Brunson said.

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"We funded the optometry unit from our operating funds, and we received a $525,000 grant from (U.S. Department of) Health and Human Services for our dental unit. We're going to continue this forever. It's part of our scope, and we're going to keep it," he said.

The FHC is also among the non-U.S. Department of Veterans Affairs providers who are authorized to provide care to eligible veterans who live more than 40 miles from a VA medical facility, or would have to wait more than 30 days from the date of an appointment.

Veterans can receive the same care that they would receive at the Dorn VA Medical Center in Columbia for any service FHC provides, Brunson said.

"The VA would have to give prior approval to them coming to us. The veterans would not be charged, but the VA would reimburse us for providing that service. We would bill the VA at our Medicare rate," he said.

Brenda Williams, vice president of strategy and compliance at the Regional Medical Center, said the RMC and its physician practices have also provided health care to veterans under the Veterans Access, Choice and Accountability Act since 2014.

"In 2015, we offered a colonoscopy program specifically for our veteran population in conjunction with the VA hospital," Williams said.

Brunson said he is concerned about the future of health care, particularly since there has been discussion of repealing the Affordable Care Act. There has been also discussion about giving states more control over Medicaid, with that control coming in the form of block grants.

"We don't know how severe it's going to be, but I don't think they'll be able to repeal the Affordable Care Act because there are too many good parts to it. … But they are going to do something, and we are afraid of what is going to happen," Brunson said.

Hospitals and community health care centers across the country are equally concerned about block grant proposals.

"They put all the Medicaid and Medicare money into that block grant. That doesn't mean we'll get a share, or that the money is going to be distributed in the state of South Carolina correctly," Brunson said.

In the meantime, the FHC is planning on constructing a training facility beginning next year for its employees to stay ahead of ever-changing technology developments in health care.

"It will keep our employees updated in the latest technology in their areas, too, so we will not grow obsolete when it comes to patient care. The medical field changes so fast, so you've got to have something to train the employees. You can't send them all across the country and hope to retain them," he said.

"We feel that if we train our people, they will stay with us."