Guilford County’s Evans-Blount Community Health Center at 2031 Martin Luther King Jr. Dr. in Greensboro – which opened seven years ago largely to provide health care to low-income residents in that area – is expanding its services into behavioral health care and it may expand in another way as well: Guilford County health officials are exploring opening a similar clinic in High Point.
Guilford County Health Director Merle Green said that a new clinic in High Point modeled after Evans-Blount is on the department’s to-do list, but she added that there’s a lot of work to be done before that happens.
“I think it will be doable,” Green said of establishing a clinic in High Point similar to the one in Greensboro, which charges patient’s using a sliding scale based on their ability to pay.
Under Guilford County’s arrangement with the clinic, no money changes hands between the county and the provider – Carter’s Circle of Care. Instead, the county essentially subsidizes the clinic by paying rent and providing other forms of support, which encourages a provider to offer services in an area that otherwise likely would have been overlooked. Before the opening of the Evans-Blount clinic, there was constant talk of a need for a healthcare provider in the 27406 zip code where the clinic is located – the largest zip code in Guilford County and one known for being economically distressed and having no healthcare providers operating within its borders.
“The model is to have a sophisticated enough partner to handle the medical end and the county is responsible for the physical facility, which makes for a great partnership,” Green said.
The Evans-Blount clinic is now expanding from physical health services – such as exams, immunizations, medical tests and treatment for bodily ailments – and adding many more services including those related to mental health and behavioral health. New programs will provide substance abuse treatment, medication management and specialized veteran-care treatment such as those for head trauma and post traumatic stress disorder (PTSD). Veterans’ concerns and opiate addiction have been in the forefront in Guilford County in recent years and the demand for those types of services has been high.
Ron Carter, the co-owner and chief operating officer of Carter’s Circle of Care, said those sorts of enhanced treatments and add-ons will get people in the door and in the habit of using the clinic.
“Hopefully, they will make Evans-Blount their medical home,” Carter said.
He said that some other services such as the treatment of pregnant women with drug problems is also being added to the mix.
“We’re seeing some pregnant women who are addicted and know they need help,” he said.
The clinic is also offering perks such as free delivery of medications through an agreement with Friendly Pharmacy.
The clinic, which is open Monday through Friday, has a medical doctor present about two days per week and has a full-time nurse practitioner. The clinic is now expanding the doctor’s time there to four days a week and hiring an additional nurse practitioner.
Evans-Blount sees an average of 413 patients a month, many of whom are uninsured or underinsured. About 40 percent of the clinic’s revenue comes from Medicaid, and 37 percent is from self-paying patients who pay based on income, while 13 percent of the revenue is from Medicare and 10 percent from commercial insurance.
The new programs and expansion come with new community outreach, Carter said. He said he and staff are making every effort to let the dozen or so churches in the area know about the services available at the clinic.
“We’re going to try a different approach and we’re going to be showing up at the churches,” he said. “We’ve tried to mail and we’ve tried to call – but those things haven’t seemed to help.”
Guilford County Commissioner Carlvena Foster is one of those pushing strongly for a similar clinic in High Point.
“We have the free clinic but the free clinic does not reach everyone who needs help,” Foster said recently.
She said that seeing what’s been happening in Greensboro with Evans-Blount has convinced her of the need for this type of clinic in High Point.
Over the years, county commissioners and citizens from High Point have often complained that their city is frequently overlooked by Guilford County when it comes to services. More than one High Point commissioner has said that that city is treated as “the county’s red-headed stepchild.”
Green said the key to a new High Point clinic is finding the right provider.
“We don’t have one right now – but we are getting closer,” she said.
She also said that, ideally, grant money would take care of some of the cost of a second clinic, as it did in the case of Evans-Blount in 2009, when a state grant of $150,000 helped pay start-up costs.
“We are continuing to look at grants and other funding opportunities and ways to bring a model such as Evans-Blount to High Point,” Green said, adding that setting up a new clinic should be easier after the learning experience of the first.
“We’ve worked out the kinks over the last six years,” Green said.
She said the medical provider running the facility gets revenue from insurance or from patients who are paying their own bills, which offers the provider a steady revenue stream. From time to time, she added, some grant money and “infrequent donations” also help cover the cost of operation.
Green wrote in an email, “Expenses are divided whereby the county paid for the initial medical equipment and building renovations, and now the county covers the ongoing monthly rent; other building costs such as dumpster services and janitorial services; and the monthly utilities. The contractor, on the other hand, pays the costs for staff; medical malpractice insurance; laboratory tests that are sent to outside labs; day to day clinic supplies; technology usage; etc.”
The clinic receives about $45,000 per month in revenue, for an annual income of approximately $540,000 a year. The total annual cost for maintaining the clinic –including salaries – is roughly $680,000.
Carter said in the end engaging patients is a major goal and added that many who use the clinic likely would not have gotten treatment elsewhere. He said one example is an uninsured truck driver with unmanaged diabetes and high blood pressure. Carter said the man stated, “I’m not going to be able to afford this” but the clinic convinced him to seek help and now his blood pressure and diabetes are under control.
“Every month he’s there to get his pill bottled filled,” Carter said. “He wants to know if he has the right amount.”
Guilford County Commissioner Ray Trapp said that he came to a community event at the clinic and the parking lot was packed. Trapp said the clinic has become more than a mere medical provider for the community. He said that at the event he attended, people were excited about a turkey give-away, Zumba classes, healthy cooking classes, smoking cessation programs and other offerings.
In 2009, the health department budgeted about $400,000 for the clinic’s first year of expenses and the county kicked in a one-time payment of $250,000.
“Over time, the need for county dollars has been reduced to the current budget of only $143,000. This is great!” she wrote. She said the county and clinic staff are “running a very tight ship.”
The clinic is named after two prominent black area doctors – George Harrison Evans and Alvin Vincent Blount Jr. – who practiced medicine in the Greensboro area in the early to mid 1900s. Evans, the first black doctor to practice at Greensboro Hospital (now Moses Cone) delivered more than 3,000 babies for local residents. Blount served with distinction in a MASH unit in the Korean War before embarking on a prominent career in Guilford County.