March/April 2015 NEOBN
By Lori Kimbel
When the citizens of Elgin see a need in their community they usually find a way to fill it. Because of this tenacity, a new emergency services building, a train depot complete with a tourist train, and a thriving opera house with live plays throughout the year have all come to fruition within the last decade. There is little doubt that the new health clinic, that they have now set their sights on, will also become a reality in the near future.
The Elgin Health District, which is comprised of a five-member board, has already secured close to an acre of land within the city limits of Elgin. They have also initiated a fundraising campaign to acquire the money needed to construct the new facility. Government leaders from the state, county and city level were all on hand Saturday, February 21, to learn about the need, give their insight as to what can be done, and find out just how they can help turn the idea into a reality.
“We do well with what we’ve got,” said Jared Rogers, treasurer of the Elgin Health District and emcee for the meeting, who also received his first stitches at six-years-old in what is still the current clinic. “We toured the facility earlier and we’ve painted a good picture of the need we have.”
According to the 2014 Areas of Unmet Health Care Needed in Rural Oregon Report from the Oregon Office of Rural Health (ORH), Elgin ranks third from the bottom out of the 104 Oregon rural health clinics in being able to meet the overall health needs of its citizens. The mission of ORH is to improve the quality and availability of primary care providers. The report takes into account infrastructure: hospital buildings and road quality; beginning and end of life: low birth weight and mortality; quality of primary care: preventable hospitalizations; and health care resources: availability of primary care providers.
It is the vision of the Elgin Health District that the new building will be able to house medical, dental, mental health services, physical therapy, and a pharmacy all under one roof. They will also add additional service providers, which will undoubtedly improve their ability to provide the health care which is needed in Elgin and the surrounding area. Currently the Elgin Clinic provides medical, dental and limited mental health services in a building that is too small for any more growth to take place.
According to Rogers, in order for the new building to be built, there will have to be community support, which will include raising roughly $600,000 in matching and in-kind donations.
Community members who gathered at the Elgin Train Depot voiced their opinions on the health care issues Elgin faces with a clinic that is too small to successfully tend to all of the medical needs of the community.
“We really need to address health care issues,” said Dianne Greif, principal of Stella Mayfield Elementary School in Elgin, who often walks kids to the clinic for their appointments. “There are kids that go without health care because their parents can’t afford to take the time off of work to take them to the clinic. This clinic would be a huge benefit to our community. The ramifications for this clinic are bigger than you can even imagine.”
“Coming from Athena, it is so important to have community involvement, it is what makes communities work,” said Senator Bill Hansell.
The current situation at the Elgin Clinic is crowded to say the least; with room for just a few chairs in the waiting room, patients often have to stand while waiting for their appointment. In one small room patients can have their blood drawn near a rotating dental x-ray machine, while sitting across from a refrigerator and stackable washer and dryer. Dr. Kim Montee, the doctor at the Elgin Clinic, has his office in what was once a closet for all of the patient files. The main examining room has the only wheelchair access into the building, so patients have to be understanding when their appointment is interrupted by someone needing to come through their exam room to get either into, or out of, the building. On the outside of the building, parking is another issue, but thankfully the church across the street allows the staff to use their parking lot, so that the few spaces around the clinic can be used for patients.
“Our staff, whether it be medical, dental, or mental health, have worked together in a positive manner during our growing pains and in doing so have managed to provide continued efficient and effective health care, even though they have outgrown our current facility,” said Elgin Health District board member, Melissa Coe. “That is what is hindering the current healthcare in our rural area.”
Medical staff at the Elgin Clinic is provided by the South County Health District and include Dr. Kim Montee, Nurse Practitioner Jamie Jo Haddock, Medical Assistant Amy Clark, referral specialist Debbie Rademacher, and medical receptionist Kanda Gresham. The dental staff includes Dr. Eli Mayes, D.D.S, Dr. Kali Gray, D.D.S., Kristi Case-Williamson, R.D.H, dental assistant Jolene Witkowski, and dental receptionists Lori Lathrop and Lezlie Reid. Shantay Mayes provides office management services from home.
“We may be third from the bottom at present, but we are on top as far as our providers go” said Rogers. “We have been extremely lucky to find providers who all share the philosophy that providing health care to rural communities, where the need is often the greatest, is far more rewarding than trying to maximize one’s income.”
There are approximately 4,000 visits that take place at the Elgin Clinic each year, half for medical and half for dental. “15,000 visits per year are possible with a new building,” said Montee. “Currently we are four months out on new medical patients and eight months out on Oregon Health Plan dental patients. With the recent health care changes there has been about a 17% increase in people who are trying to find providers. We could easily put another provider to work.”
Even though the wait-list is long, there are still a couple timeslots available at the Elgin Clinic each day for urgent care, according to Haddock.
“All of us here have a mission’s heart about our medicine; our heart is to help the community. Fortunately, this is our love,” said Montee.
Two years ago the Elgin Health District decided to remodel the Elgin Clinic so that dentistry could once again be provided in Elgin, a service that had been non-existent for more than 25 years. “I walked into the clinic and asked if they had a dentist,” said Eli Mayes. It was a perfect fit, a dental space without a dentist, and a dentist looking for dental space in Elgin. “It was one of those if you build it they will come situations. We have such an amazing, hard-working, progressive health board.”
Mayes provides service to 1,000 patients per year; half are under 18 years old and the other half are adults.
As the conversations progressed it came down not to ‘if’, but ‘when’ a new clinic can be built.
“We need to find a way to fund the physical locations so you have a place to practice,” said Hansell. “Here is an opportunity to help rural Oregon. I am willing and ready to do anything I can.”
According to Hansell there needs to be three things in place before a project can be considered for funding though the state. There needs to be an identifiable need, there needs to be community support in the region as well as the community, and there has to be matching dollars. The more matching funds a community has, the more competitive they are in the process. Hansell also talked about some of the items that may have an effect on being considered for funding during the Capital Construction Committee process, the Oregon State Kicker, that is supposed to kick in, PERS reform, and the May economic forecast for Oregon. However, if all the necessary paperwork can be provided by late May or early June Hansell was optimistic that the Elgin Health Clinic could end up on the list of projects approved by the Capital Construction Committee this year.
“We have the passion and we have the heart; we just don’t have enough of a facility,” said Montee.
“Our community needs this and the surrounding area needs it,” said Elgin Health District board member, Cheryl Coe.
As one can imagine the task of fund raising for a patient-centered medical clinic, for a five-member board, could be quite daunting, so in January the Elgin Health District obtained Westby Associates to represent them during the process from concept to completion.
According to their website, Westby Associates, Inc. is a fund development firm that has generated in excess of $160,000,000 for organizations throughout the Pacific Northwest by specializing in: strategic planning, vision casting, campaign design and direction, governmental affairs, marketing, event management, foundation and grant support, and board development. They exist to provide consultant/practitioner services to nonprofits, assisting them to think and act strategically.
“They are an intermediary of sorts between us and the political piece,” said Melissa Coe, “they know how to write the grants, they know the people to ask for federal, state and private sector monies and they are there to guide us in our endeavor. They have also helped us to write our vision statement and the development of our goals and steps to achieve them.”
“This is so typical of Elgin,” said County Commissioner, Steve McClure. “Look at the opera house, look at the fire hall, look at this train depot. I take pride in this community. You are looking at a community that has done things for themselves and it speaks a lot about a community. This clinic really needs to be done. I believe what you are doing here can be modeled in other rural areas.”