Katy Nesbitt
The La Grande Observer

ENTERPRISE — A year after opening its doors as a community health center, Winding Waters Clinic in Enterprise continues to find new ways to connect with the public.

A few years ago, the physicians at Winding Waters faced a challenge to keep their private, sustainable and rural practice open. Nic Powers, the clinic’s chief financial officer, said the staff decided to apply for federal funding to become a federal Community Health Center program that Dave Harman, the clinic’s chairman of the board, said has been around for 40 years.

Powers said the move improved the clinic’s Medicaid and Medicare reimbursements in exchange for meeting a list of requirements including an open-door policy.

“We are required to provide care to anyone who shows up at the door,” Powers said.

By adopting the guidelines of the federal Community Health Center model, he said the clinic’s mission is focused more on the health of the entire community, not just on its patients.

Keli Christman, the practice administrator at Winding Waters. She said the funding also requires the clinic work with agencies and organizations like Wallowa County Center for Wellness and Building Healthy Families.

“They have expectations that we will work closely with community partners,” Christman said.

As part of the Community Health Center program, Nic Powers said Winding Waters staff members help teach parenting classes at Building Healthy Families. With an eye toward literacy and kindergarten readiness, the clinic gives a book at each well-child visit for kids up to five years old, Dr. Liz Powers said.

The clinic’s partnership with Center for Wellness comes in the form of The Annex, a clinic on the corner of Main and Depot streets in Enterprise offering behavioral, mental and physical health services.

“We offer a sliding fee (and) discount program all the way down to $15 per visit,” Nic Powers said.

Dr. Liz Powers said for some, traveling to the main clinic site on the Wallowa Memorial Hospital campus is a barrier.

“Being downtown creates access and a comfort zone for those seeking help through county public health,” she said.

Integrating mental and physical health has been a collaboration between Winding Waters and Center for Wellness for several years, and was previously housed in the Medical Office Building next to the Winding Waters Clinic. Dr. Liz Powers said having a clinic that treats both physical and mental illnesses can reduce the stigma of seeking mental health treatment.

“Bilateral integration of mental health and primary care look at illnesses not as affecting a body or a head,” Dr. Liz Powers said. “They get treated together.”

The original grant application for federal funding included a partnership with a county school and the establishment of a school clinic. When Winding Waters staff hosted public meetings, the proposed clinic was resoundingly opposed. Dr. Liz Powers said opening The Annex allowed Winding Waters to keep its community health center status while increasing the community’s access to health care.

Reaching out to Wallowa County’s youth is still a focus of the clinic. Dr. Liz Powers said staff is looking at the 2016 Oregon Student Wellness Survey for clues how best to meet the needs of local kids.

“In Oregon in general, there is still a need for help with home stressors, bullying and depression. Some of our kids don’t have a coat or adequate food in their homes,” Dr. Liz Powers said.

Integrating health goes beyond physical and mental health. Dr. Liz Powers said if a patient comes in for a visit and reveals they are struggling to access proper nutrition, she can help them access local food banks. If childcare is an issue, she said she can recommend options.

Within the new structure, Powers said the staff created a “care team” that has its own budget to spend on helping patients with things like temporary housing, transportation, prescriptions during gaps in health coverage and dental care.

The Annex opened early this fall and right now a building across Highway 82 from Ruby Peak is being remodeled for another clinic under the Winding Waters umbrella.

Nic Powers said Dr. Rene’ Grandi, longtime physician with the clinic, recently returned from sabbatical, during which she has spent some time studying a holistic technique called “environmental medicine.”

“She will be providing standard primary care services plus expanding her scope into areas of environmental medicine,” Nic Powers said.

The clinic will be open to the public and will also offer additional alternative medicine services such as massage therapy, acupuncture, healing touch and nutrition classes.

“We see this as another way to reach out to community members, promoting wellness, providing care in a non-traditional, or non-medical, setting, and caring for the whole person,” Nic Powers said.

Harman said the clinic’s switch over to a community health center has been a wild success.

“We know if you want healthy communities you have to invest in primary care and help people achieve their health potential,” Harman said.