Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: FRIDAY, January 24, 1992 TAG: 9201240171
SECTION: VIRGINIA PAGE: A1 EDITION: METRO
SOURCE: CHARLES HITE MEDICAL WRITER
DATELINE: LENGTH: Medium
COMMUNITY HEALTH CENTER ANSWER IN RICHMOND
It's hard for people to understand, Evelyn Graves admits.Why should the federal government help subsidize a medical clinic in the middle of downtown Richmond, a city seemingly overloaded with hospitals and doctors?
"We're going to locate within spittin' distance of the Medical College of Virginia," Graves says. "There was some shock when I went around the community trying to get support. People would say, `Why, MCV is right across the road? How can we be medically underserved?' "
It took some time, but Graves finally succeeded in convincing people in her community of this basic point: The availability of medical care doesn't necessarily mean access to medical care.
That issue will be part of a discussion next week in the office of Roanoke Health Director Donald Stern, who will host a meeting to drum up support for a community health center in Northwest Roanoke. He's hoping to find neighborhood leaders like Graves who will take on the task of organizing a grass-roots board to oversee a clinic.
Graves is president of the board of directors of the Richmond East End Health and Safety Council, a community group that first organized over the issue of lead contamination. It didn't take long for the group to recognize that access to basic health care was a problem for many residents in east Richmond.
The area had a high poverty rate, a high infant mortality rate, a high teen pregnancy rate, a large population of elderly, and relatively few physicians.
Graves, who had helped organize a community health clinic in Connecticut, knew these factors meant there was a good chance the east end of Richmond could qualify for one. In early 1990 she began talking up the idea with community leaders and local service agencies.
The east end council recently won approval for a $572,00 federal grant to help start a community health center. Graves expects the funds to be released this summer and the center to open soon thereafter.
The center will be staffed by three physicians, several nurses and other support staff, Graves says.
Attending the meeting in Stern's office next week will be community leaders, Carilion Health System officials and Bruce Behringer, executive director of the Virginia Primary Care Association.
The association is made up of representatives of the 27 community health centers throughout Virginia. Behringer, who advised community leaders working on the Richmond center, says more federal funds are being made available for community health centers. He believes that bodes well for groups in urban areas.
The Richmond facility is only the second urban center in Virginia. Newport News has had one since 1978.
But this year nearly $50 million was made available to fund 11 new centers, Behringer says. That's 10 times the amount allocated the previous year. And six of the 11 centers will be in urban settings, he notes.
"I don't have any doubts that a good argument could be made for the development of a community health center in Roanoke," Behringer says.
Seven years ago, Carilion health officials asked that several census tracts in Northwest Roanoke be declared a federal health manpower shortage area, a designation that has requirements similar to those for a community health center.
The manpower shortage designation would have allowed Dr. Anthony Remson to work off federal loans he received to attend medical school. Carilion officials had recruited Remson to open a practice in the former Burrell Hospital, an adult home that Carilion took over in 1980.
"I thought we had a strong case. It was an isolated neighborhood, predominantly black and poor with virtually no doctors," says Dale Byington, a Carilion health planner who coordinated the application for a health manpower shortage designation. "I thought we met all the criteria."
Byington says federal officials rejected the designation largely by arguing that patients in the area had adequate access to doctors in other parts of town.
Stern says a community health center does more for a community than enhance its access to physicians. A center also educates the community about its health problems and what patients can do to improve their health.
"We'll be concentrating on our high infant mortality rate, our high teen pregnancy rate and treatment of chronic diseases," says Graves, president of the Richmond community center.
Community health centers are not walk-in clinics. Patients must have appointments. The centers accept Medicaid and Medicare patients and give discounts based on family income.