By Clarissa Donnelly-DeRoven
In the far west of Macon County, US 441 forks and descends into downtown Franklin. Just before the crossroads, a large, beige and gray one-story building sat empty on the east side of the bustling street. But on a sunny Friday morning in July, that wasn’t the case. A pair of stray dogs roamed around the three-acre property, while dozens of visitors brought coffee, donuts, parfaits and plants.
Right now, the property doesn’t look like much: weeds emerge from cracks in the concrete outside, while inside, mysterious stains adorn the tattered white carpet, and old security cameras stick out from the ceiling. This may interest you : Public health in practice: Social cohesion for youth nutrition.
But soon – following a multi-million dollar renovation – it will become the first bilingual community health center in western North Carolina, offering the region’s low-income residents everything from dental care to domestic violence support.
“I’m glad you all see it for what it is — the dirty carpet, the weeds in the parking lot — I mean, this is where we start,” said Marianne Martinez, executive director of the public health organization Vecinos (which means “neighbor” in Spanish) which bought the building. at the organization’s fundraising event.
“In a year and a half when we get together again to crack a bottle of champagne on board, you can think back to what it was like today. And we’ll all take a nap on the exam room table.”
Expanding care to all
Since 2004 Vecinos has been the “medical home” for many of the region’s Latino agricultural workers, providing them with medical care and health education. Their outreach first started using mobile clinics. To see also : Family Health and Safety Day is coming to UH Portage Medical Center on July 30th. Later Western Carolina University donated space on its Cullowhee campus to Vecinos, where the organization operates an outpatient clinic twice a week.
Currently, between the mobile clinic and the WCU office, staff and volunteers at Vecinos provide a total of 16 clinic hours per week to the community. In an average year, they see about 700 patients. In their first year in the new hall, which will have seven permanent clinical exam rooms, the organization estimates they will serve at least 2,000 people, a reflection of the rapidly growing North Carolina Latino community and their unmet health needs.
The idea of making something like this started in earnest last year. Like other nonprofits, Vecinos creates a new strategic plan every few years and 2021 marks the start of a new planning cycle.
“With the pandemic and the emergency work we started doing with COVID outreach and all that, our board really took a step back and looked at what we were doing, and what the community continued to need. one year into the pandemic,” Martinez explained.
Over the years, Vecinos has considered expanding its patient eligibility criteria from being open only to farm laborers, to an income-based clinic — meaning, anyone who cannot afford treatment, anyone uninsured or underinsured, will be able to seek care with the organization. .
Fanny Garcia, a phlebotomist at Vecinos, says the new community health center (as the organization calls it) will make treatment much more accessible and convenient for Spanish speakers in the region.
“Blue Ridge [Health] exists, but it doesn’t always meet the needs,” Garcia said. Blue Ridge Health is another clinic for low-income people in the area, but the organization often exceeds capacity. Garcia says he hears from patients that sometimes there is a problem getting a Spanish-speaking translator or provider.
If there was a time to make this switch, the Vecinos leadership thought, now is it.
A fully-integrated model
The board and the leadership of the organization decided to move forward with the vision, but that meant they needed a much larger and more permanent space. See the article : A real health perspective.
Western North Carolina has a lower overall proportion of Latinos than the eastern half of the state. Less than 5 percent of the population in the far western regions of Graham, Swain, Haywood, Cherokee, and Clay are Latin, but that’s not the case for the Macon and Jackson regions, where about 10 percent and 8 percent of the population, respectively, are Latinos. .
In addition, nearly 40 percent of the Vecinos patient population lives in Franklin, so they know they want to find a location there. But they still don’t like the idea that people will come to them for medical treatment, and then have to go elsewhere to get the rest of their non-medical health needs — like support with immigration cases or tax filing assistance — met.
“Every time someone takes time off to get health care or other services, they’re not getting paid,” Martinez said. “That’s what we’re trying to reduce are all kinds of barriers to health care whether it’s a social determinant of health or primary and mental health care.”
For as long as this organization has existed, they have worked closely with other organizations that offer complementary services to the same patient population — El Centro Comunitario of Macon County, Blue Ridge Free Dental Clinic at the Cashier, Asheville-based Pisgah Legal Services helping with immigration cases. and started a new program to help people register for insurance coverage and file their taxes, and the Waynesville-based 30th Judicial District Domestic Violence-Sexual Assault Alliance, which helps Spanish-speaking survivors with therapy and navigation of the criminal justice system.
Martinez began to think: what if all of this was operating under one roof? He poses questions to different nonprofit leaders and workers. Soon, people from all five organizations (and more) formed a leadership committee to start working on the details.
There are models similar to this type of work. In Charlotte, the Camino Health Center provides integrated physical and mental health care in addition to food kitchens and health education classes. Behind the Buncombe County Courthouse is the Family Justice Center, and there is a similar facility in Alamance County.
In this multi-agency setting, there can be staff from domestic violence shelters, rape crisis centers, hospitals, prosecutors’ offices, and law enforcement all working together to help survivors of sexual abuse or violence navigate the criminal justice system.
What this community of organizations is trying to do is something similar.
In the end, they decided that Vecinos would buy the building, and the other four organizations would rent the space from them. There will also be additional unoccupied rooms that can be rented by other community organizations that work with this population on a flexible basis or used for events.
And there will be child care. Many times people have to cancel their appointments either because their child care failed at the last minute, or because the babysitter costs more than they make in a day.
“With dental clinics partnering with us, after two or three cancellations, they will never come back again,” Martinez said. “So if you have child care that has been canceled two or three times, you basically have, again, no dental care. So it’s very important for us to have a space where their children can come and play safely.”
How are they paying for it?
The Dogwood Health Trust, the organization formed with a portion of the profits from the sale of Mission Hospital to HCA, gave Vecinos a $1.6 million bridge loan to buy the building until they figure out their long-term financing. They eventually had to pay back, and construction costs were estimated at $3 million.
“This is a big project, and it has to be done,” Martinez said. The building is not “health care ready.” This would require a new HVAC system, water would need to be run under floors in dental clinics, and exam rooms and offices would have to be locked from publicly accessible parts of the building to ensure patient privacy.
Although counties can direct some of their pandemic relief money from the American Rescue Plan to nonprofits to support projects like this, Macon County has set all of its federal funds to go towards pay increases and bonuses for county employees, so it’s not an option.
Martinez said they were pursuing grants and loans through the US Department of Agriculture, along with money from foundations or, potentially, private loans.
“We have a lot of work to do, and that costs a lot of money,” he said. “But we have a solid fundraising plan and capital campaign. We’re not doing this alone.”
Part of the hope is that any organization that will work in this building can call on its network to help raise funds for this project.
“I don’t think that we’re going to raise five and a half million dollars over the next six months — that would be nice — but, you know, it’s going to take quite a while,” Martinez said, “And that’s okay, because it’s a long-term investment in Public.”
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