Owensville Primary Care: A New (Old) Model for Community Health Care
Owensville Primary Care (OPC) is quite literally a lifesaver for many people in Southern Anne Arundel County. The three doctors, one nurse practitioner and two-dozen plus nurses and staff help patients without regard for their ability to pay. It’s always been that way. Back when the clinic was founded in 1974, volunteer doctors from Howard University came to help a rural, largely African American tenant farming clientele.
That original idea transformed into the South County Family Health Care Corporation. That was when the current building was constructed and opened in July of 1976. The original initiative was part of creating community health centers, OPC’s current executive director Sylvia Fielder Jennings said.
It was a community-based approach to health care.
Then, as now, patient fees were based on a sliding scale. Some may pay as little $10 to see a doctor. And not just any doctor. Experienced doctors with deep ties to the community and a nearly familial relationship with patients.
For example, Dr. Wayne Bierbaum, medical director for the facility, has been with OPC for a quarter century. He’s also an accomplished nature photographer and member of the Muddy Creek Artist Guild.
He knows his patients and their families, as do the other docs on staff. Dr. Leslie Brooks has been there for 22 years. Nancy Bryant, the nurse practitioner, has been there a decade. Jennings said that any eventual retirement will be a blow to patients.
“When one of them retires, there will be a great deal of grief. They are almost more than patients,” Jennings said.
Staff members spoke on Tuesday at a luncheon in-service about patients who wanted anything but the maze of modern medicine.
They told the story of a man with a chainsaw injury who came in the front door, quite wounded. His care was beyond what they could handle. He didn’t want to hear that he had to go to the emergency room, but patiently sat in the waiting area with staff until the ambulance arrived to take him there.
Another time a man was waiting out front when staff arrived to open for the day. He was having a heart attack. He drove himself, hoping that somehow OPC physicians might be able to avoid giving him unpleasant news about having to visit the hospital. Again, they waited with him for the ambulance to arrive, which eventually led to open heart surgery. He’s recovered fully.
Jennings said that they serve about 3,400 individuals, leading to about 12,000 patient encounters a year. They care for everyone from infants to the elderly.
As a non-profit, they’ve got some unmet needs, a wish list. Jennings said that they have a budget with monies coming from insurance, federal government programs like Medicare and Medicaid and volunteer donations. In all, it takes $1.8 million to keep things afloat.
“It’s not easy, but we operate within the money. It’s tight, mind you. It’s tight,” Jennings said. When it comes time to reconcile the year’s expenses she said, “I hang on by my fingernails.”
Coming up June 27, they’ll have a fundraiser at Calypso Bay where 10 percent of the days proceeds will go to help cover the costs of covering uninsured patients. They also do one at the Greene Turtle. In years’ past they held a silent auction alongside their November free flu shot clinic, although they didn’t hold it in 2012.
Their clients mostly come to them through person-to-person referrals. Jennings said that they keep an updated website for the center. They used to send a newsletter to all postal patrons in South County, but that got to be too pricey.
What’s It Like to Be a Patient?
Mavis Daly has been a patient since she moved to south county full-time in 1987. She primarily sees Dr. Brooks.
“I like the warmth, the greeting when you walk in, the feeling like you are among friends,” she said. “Everyone is kind to me. They make my visit as easy as possible.”
Daly said that she feels like Dr. Brooks is irreplaceable.
“She’s a superb personality and doctor. She’s warm,” Daly said.
She said that the staff and nurses at OPC are also good to her.
“It seems to fit the South County personality,” she said of the center.
Another standout according to Daly is Billy Aisquith, the office manager who, “always makes a point of seeing me and giving me a hug. If there is confusion on appointments, she oversees it.”
Davis also appreciates the auxiliary staff. There is a podiatrist, and a Quest Labs phlebotomist on site.
“It’s such a help and nice that I don’t need to go somewhere else,” she said.
Daly also had high praise for Jennings whom she said was “responsible” for finding the current home for the Shady Side Museum property and house.
“When Sylvia was with Del. Virginia Clagett, she called us about the museum property. They had to sell it to a non-profit. We [Shady Side Rural Heritage Society members] weren’t a museum, just people driving around with things in peoples’ trunks. Sylvia was the one who arranged for the sale. She helped us to purchase it for $90,000 for that waterfront property. It is sort of ironic that she was most responsible for getting that property,” Daly said.
As with most good things in South County, it comes down to who you know. Or maybe who Sylvia Jennings knows.
“Sylvia pretty much knows everyone,” Daly said, praising her leadership of OPC.
How Do They Do It?
Serving a rural population, especially as the only health center in the area, the facility has had its share of ups and downs. In 1981, the original mission bankrupted. Their status was de-funded by the feds and all of the staff, aside from one doctor, one nurse and an office manager, were let go. Those three kept things afloat. Eventually, it grew again.
In 1997, they joined into a partnership with other community health centers in the state. They are also a part owner of Priority Partners, a partnership made up of eight federal qualified community health centers and the Johns Hopkins Health Systems. Those relationships have helped them to organize themselves and look to the future.
Jennings said that the partnerships have helped the tiny center to be able to do things they otherwise would never have had the wherewithal to do. For example, they implemented a patient management system that helps them to operate more efficiently. They also converted their medical records to electronic records, a multimillion dollar project that they implemented gradually over an 18 to 24 month period about four years ago.
Jennings has every expectation that electronic records will improve health outcomes for patients. It doesn’t eliminate the paperwork, and actually slows things down because the doctor has to input everything, but will carry medical care into the future.
In 2004, Jennings applied to become a Health Center Program look-alike program under a U.S. Department of Health and Human Services program that helps to provide quality medical care to under-served communities and vulnerable populations. These look-alikes don’t get grants from the federal government, but rather receive cost-based reimbursement for Medicaid services.
Jennings said that they had to prove their numbers and demographics, but that it has helped not to be a grantee.
In terms of what the Affordable Care Act will mean for the center, Jennings isn’t sure. She isn’t sure that anyone knows, really— from the doctors to the state exchange navigators all the way up the chain to the HHS secretary. Jennings guesses things will go sort of the way they did when the state of Maryland brought in Medicare patient MCOs in 1997.
“That was an interesting situation. We had assignments from Edgewood… they thought it was close to Edgewater. It took a while to sort out,” she said.
They do know that widening the Medicaid circle to 137 percent of federal poverty designation will bring in 100,000 people in the state of Maryland into the program. How many of those are in South County is a big question. Jennings said they’ll have to see how it all plays out. There are meetings and webinars and other mechanisms to help them get up to speed on the federal law changes that are set to begin to be put in place as early as October 1 of this year.
Jennings has plans to hire another doctor, and is interviewing for the position now.
As for their patients, Jennings said the mission will continue. They take any qualified health insurance plan.
“We take any company that wants to sign up. We don’t refuse any insurance,” Jennings said, adding that it isn’t the insured that make the budget tight. It’s the uninsured. “They’re the people costing you money.”
As new people come under the mantle of some kind of coverage, Jennings said they expect to see a caseload increase. Typically when people get insurance or coverage after a long gap, they have to play catch-up with their health care needs. Then things level-off to about 3.5 visits a year.
Jennings also said that the center tries to meet needs where they see them. A lot of seniors don’t have Part D prescription coverage, so she has a free prescription drug program for seniors who can’t afford their medications.
“When you see something, you have to do something about it,” she said.
The center also has mental health and counseling services as well as a podiatrist on site.
Owensville Primary Care is located at 134 Owensville Road in West River. For more information, call 410-867-4700 or visit OwensvillePC.com.