South County health district assumes operation of Union Family Health Center

making improvements: Construction worker Anthony Smith gets ready to hang drywall in the Union Family Health Center’s new dental clinic. North Powder dentist Joel Bender will begin practice at the center this month, after completion of the remodel. The Observer/BILL RAUTENSTRAUCH

The South County Health District, formed in May after a vote within the Cove, Union and North Powder school districts, now has responsibility for the Union Family Health Center at Dearborn and Main streets in Union.

The district’s board of directors hopes to make the clinic an even better facility than it was when Oregon Health & Science University ran it. Some improvements have shown up already, but others will have to wait for funding.

The clinic has a history dating back to the mid-1990s, when Peeples and fellow Nurse Practitioner Margaurite Pike opened it in rented space in a building owned by the City of Union.

The endeavor was made possible with help from the Cove-Union-Powder Medical Association, a group of volunteers known locally as CUP and dedicated to providing medical care for local residents.

In 2000, a new building was constructed for the clinic at the corner of Main and Dearborn Streets. By then, OHSU had become the care provider, furnishing clinic equipment and supplies, and paying wages.

That arrangement came to an end this year, as OHSU withdrew its support because of financial reasons.

“Till June 30, everybody here worked for OHSU,” Peeples said.

CUP, which was formed in the 1960s and has been active ever since, mobilized forces to save the clinic from closure after OHSU said it would pull out.

Plans were drawn up for a locally-administered health caredistrict and CUP members stumped for community support. Voters within the Cove, Union and North Powder school districts gave those plans the nod in May, and the clinic never missed a day’s operation.

OHSU left behind all its equipment, and business is being conducted as it always has. Peeples, as nurse practitioner, is the primary care provider. Certified Nursing Assistant Melissa Crader and Receptionist Ralene Olsen round out the staff.

Nurse practitioners have a wide scope of practice, and typically work in rural, underserved areas. They handle routine, acute and urgent cases, can order tests, diagnose, treat diseases and prescribe medications.

Peeples figures a nurse practitioner can do about 80 percent of what a general practice physician does. And when a higher level of care is needed, help is readily available.

“We figure out where people need to go if we can’t handle it,” Peeples said, adding that local doctors visit the clinic periodically.

The daily pace at the clinic hasn’t slackened since the district took over. As in any medically underserved area, there are not enough providers to meet patient demand. Peeples said average wait time for an appointment is three weeks.

That doesn’t mean, though, that a patient in need of immediate care doesn’t get it.

“We keep some spots open for emergency care,” Peeples said.

All the services offered before remain available, and important new ones will be added soon thanks to support from CUP and private citizens.

 At present, space is being remodeled into a dental clinic that will be staffed by North Powder dentist Joel Bender.

Bender will come on board sometime this month, Peeples said. She added that a nurse practitioner from St. Luke's Idaho Cardiology Associates will also be added, visiting the clinic every three weeks.

In the future, though, the district is going to need more money than what is currently available to maintain service levels and to add services such as health screening and health education, and satellite clinics in Cove and North Powder.

Though voters did approve district formation, the issue of a tax levy to support the clinic is yet to be settled.

A levy will have to be approved by vote, and Pike, who has retired from practice but heads the district board, said the board is not yet ready to present a proposal.

“We’ve been refiguring what we need to ask for,” she said.

Another issue to be resolved is Rural Health Status from the U.S. Department of Health and Human Services. The clinic’s certification was terminated when OHSU pulled out, and the district must re-apply.

Rural Health Status carries certain benefits, the main one being better reimbursement from Medicare and the Oregon Health Plan. Pike said regaining the designation is all-important.

“There are standards we have to meet to get it,” she said. “The clinic has to be in a medically underserved area and staffed half-time by a nurse practitioner or physician’s assistant. We met the standards before and will again, but it will be Thanksgiving at least before all the paperwork is done.”

There is a silver lining in that particular cloud, however. Pike added that reimbursements will be retroactive, once rural health status kicks in again.

For all the challenges that lie ahead, the staff remains proud of the clinic and everything it has to offer.

With five patient exam rooms, a lab, a trauma care room, a soon-to-open dental clinic, a recently remodeled conference room and more, the facility is well-equipped to carry on its mission.

Finances are tight, but community support is strong, Peeples said.

“Everybody really wants to see this go,” she said.