The new $6 million Family Health Centers facility going up on East Broadway is a testimonial to the medicine of the future.
And by that, I do not mean state-of-the-art medical technology. I mean a sensible, efficient, compassionate and ultimately cost-effective program for improving the nation’s health rather than just trying to salvage or reverse health gone bad.
The center is moving a block west, from its existing facility at Broadway and the CSX overpass to the old American Standard Building, most recently the Louisville Antique Mall, a five-story, 1920s Art Deco building.
Architect Steve Wiser of JRA Architects has spearheaded the effort to modernize and upgrade the building while losing none of its historic character. It’s currently mostly scaffolding and sawdust, but Wiser and Bill Wagner, executive director of Family Health Centers Inc., can peer through the dust and see the end results — bigger, more comfortable examination rooms; brighter, more colorful, patient-friendly consultation offices; more expansive room for staff.
Until the new facility is completed later in the year, the center still squeezes into its current space, which is simply inadequate to serve a growing patient population.
Wagner says the facility, covering pretty much all of eastern Jefferson County, handles about 5,000 patients, a huge stress on just 8,000 square feet of offices, reception areas, waiting rooms, exam rooms, consultation rooms, treatment rooms and a lab, plus all the space necessary to keep binders and folders full of patient records on stuffed-to-the-gills metal shelving.
“Our appointment schedule is already completely full for tomorrow,” says Dr. Elaine Woerner, the center’s staff family physician, on a recent weekday mid-afternoon, squeezing into a small, crowded exam room that for now doubles as her office.
In the new facility — four floors and 40,000 square feet — Wagner estimates they’ll eventually be able to handle 15,000 patients a year. More exam rooms, more staff (both medical and support), more radiology capabilities, a reception area on each floor, dedicated areas for pediatrics and neonatal services, and an electronic record-keeping system that will free up all that storage space.
And they’ll need every bit of it. As a result of the success of the Affordable Care Act and Kentucky Kynect, “there will now be more than 80,000 insured patients in Jefferson County that weren’t insured before,” says Wagner.
Much of that burden falls on the two federally funded not-for-profit health providers in Louisville — Family Health Centers and Park DuValle Community Health Center — that operate 10 locations in the area between them.
“How do we treat them all? We can no longer afford to send them all to the hospitals,” Wagner says.
But don’t expect him to be critical of the controversial ACA. For one thing, he says, it will lead to better care and a healthier population — especially among the patient group Family Health Centers tends to treat: underinsured and uninsured, the type of patient who has tended to use the hospital emergency room system for primary medical care.
“The whole new emphasis is switching to preventive medicine and primary care, which is way more cost-effective than emergency medicine,” Wagner says. “Cheaper to treat, and also better outcomes.”
And as much as the ACA will spawn a whole new population of insured patients (many of them with existing health issues) to add to the responsibility of health-care providers, this new facility would not be possible without the ACA. It is being built with Obamacare money.
“It’s a little-known fact that the Act made about $11 billion available in a trust fund for federally funded community health centers like ours,” Wagner says. “Part of that is a certain amount of grant money for capital expenditures. It’s on a competitive bid basis, but we applied and were approved. So this is a really big deal!”
Not only will the new facility provide the elbow room to spread out, accommodate more patients more comfortably and add staff, it also will allow the Family Health Centers to offer a true “medical home, team-based” approach, a family care provider in all aspects of that term.
“People need to feel they have somebody they know, somebody who cares and takes a personal interest in every aspect of their health and life,” Wagner says.
And it’s not just some liberal, soft-headed notion. Comfort and trust lead to compliance and to returning for follow-up visits, all of which lower the cost of medical care. An office checkup twice a year, to catch something in its early stages, is far less expensive than months of radiation treatment.
To that end, the new facility will have full-time translators on site, and contract for additional interpreters, speaking about 42 languages, including several African dialects, for Louisville’s growing immigrant population. That will be part of a focus on patients’ cultural backgrounds as well as medical needs.
“A lot of patients don’t know what a prescription is or why they have to go to a pharmacy,” says assistant director Bart Irwin. “Just buying Tylenol in the drugstore can be daunting. Have you ever noticed how many different Tylenol bottles there are on the shelves?”
The new facility will include dental care and a pharmacy on premises, and space for radiology and a dental clinic. The in-house pharmacy will make sure patients, many of them with chronic illnesses, fill their prescriptions and stay on their meds. Federally funded community health centers can purchase drugs at steep discounts and pass those savings on to patients.
Providing more than physical medical care, the new center also will have the staff and expertise to address social issues, financial issues, behavioral health, psycho-social issues, professional anxiety, all the stresses that impact a person’s health. “Currently, when we have troubled or disturbed patients, we have to send them across town to a mental health facility,” says Wagner.
For that reason, the design of the new space involved more than just dividing up the rooms and deciding where the HVAC would go. “We chose JRA Architects because of Steve Wiser’s experience in health-care facilities,” says Wagner. “But also because they have interior design capabilities. We wanted to find a way to make this as inviting and non-antiseptic as possible.”
Ashley Meeks, JRA’s director of interior design, was charged with choosing colors, patterns, surfaces and materials, selecting artwork and commissioning a local photographer, all with the intention of livening up the space, making it bright and colorful, warm and comfortable, and also relevant to the urban neighborhood.
While the intent is to serve the vast community of newly insureds, Family Health Centers also will continue serving everybody who comes in the door, regardless of insurance coverage or ability to pay. Wagner says there will still be tens of thousands of people in Jefferson County without insurance.
Without insurance? But wasn’t the point of the ACA?
“A lot of them are undocumented,” Wagner explains. “But they’re still members of our community and entitled to care. We think everybody needs access to exams, screenings, immunizations. It keeps them healthier, and, actually, it costs a lot less to see them here than in the hospital.”
If they’re pregnant, they get the prenatal care they need. And their babies who are born here are U.S. citizens.
“We want to make sure they have a good start in life,” Wagner says.