Members of the Salem Area Chamber of Commerce met for a luncheon at the SBU campus in Salem on Sept. 12 to hear Four Rivers Community Health Center CEO Stuart Gipson, who presented on the services the center offers, and the ways in which they plan to expand.
Four Rivers is a non-profit, federally qualified health center, of which there are only 29 in the state, according to Gipson. Four Rivers has locations in Rolla, St. Robert, and Salem, and plans to open a clinic they call “Four Rivers Families” soon in Rolla.
“We run a nonprofit business that focuses on low-income patients for primary care, medical, primary dental care, and a little bit of behavioral health. We don't get a ton of behavioral health, but those are kind of the three areas we focus on,” said Gipson.
Gipson said the center can offer all outpatient primary care services. Physicians, medication-assisted treatment for substance abuse, family medicine practitioners, PA’s, and dental services including oral surgery, can all be accessed through the center, said Gipson.
“Our focus is on uninsured and Medicaid patients primarily. I mean, we certainly see commercial patients as well. And we want to be open to everybody. We want to have that access. We feel like we have, and we know we have, great providers and great people over there. We want to make that accessible for everybody, especially on the medical side,” said Gipson, who added that he thinks Four Rivers might be one of the only dental providers in the county that primarily accepts Medicaid.
Many individuals in Dent County rely on Medicaid for their medical needs, many of whom are children. Access to medical care that accepts Medicaid can be crucial, and that’s a role that Four Rivers wants to fill.
Said Gipson, “Just the stats of that, about 50% of kids in our counties are on Medicaid. […] Medicaid is for low-income patients, so mostly a lot of kids, a lot of pregnant women, and until about a year and a half ago, that was basically it. Missouri expanded Medicaid about a year and a half ago to adults that are below 138% of poverty, which is about, I think, $30,000 a year for a family of four. That's kind of the population that we focus on, is that population on the dental side, because we know there’s not access for those patients anywhere else, or very, very few places.”
Gipson said the center now has nine general dentists and three pediatric dentists, as well as an oral surgeon, across all of their locations. Gipson said he was glad the center had been able to expand their dental offerings at the Salem clinic. He said only about 45% of kids in Dent County who are on Medicaid have had a dental appointment in the last 12 months.
“Most kids that are on Medicaid are not seeing the dentist, and one, that's because of access, there's not anywhere for them to go. So, we're trying to solve for that problem, with having more providers,” said Gipson.
The second problem Gipson identified is education. Four Rivers seeks to address both issues with their “Smile-Mobile” which travels to area schools giving dental care to kids.
“The other sad fact that we see it's almost 18-20% of the kids we do see here in the clinic, they have to have a major surgery for dental treatment,” said Gipson. “Six or seven kids a day are put to sleep, put under the anesthesia, and we do a full mouth rehab on those kiddos. It's really sad. And it's really preventable. If we can get them into the dentist early, if we can get them having better habits and those types of things. So that's one of my big focuses, is how can we help support parents? How can we help support kiddos, to make sure that they're getting the dental treatment they need early? […] I'd say dental treatment is probably, if not the most common, one of the most common surgeries that kids have in our community.”
Another aspect of the services that the center provides that Gipson says is somewhat unique is the use of community health workers, who help patients with aspects that are less directly related to healthcare, but still impact a patient’s health. Areas in which community health workers might help include food, housing, transportation to appointments, and connecting patients with other community resources. According to Gipson, Four Rivers employs around 10 community health workers.
“I think we have some really great services in our communities. But a lot of times, it's just connecting the dots so that people know where to go and who to talk to, to get those services taken care of. And so, I think that's kind of unique, is we're not just going to treat the patient that's in front of us with a medical condition, we're going to look at the broader scope of what's going on in their life and try and affect that as a whole. So that's one of the things I love about health centers,” said Gipson.
As mentioned, many of the patients seen at the clinic or assisted by community health workers are low-income. Income is often a significant barrier to medical care for low-income patients. Four Rivers, as a Federally Qualified Health Center, seeks to ease this burden on uninsured patients by utilizing a sliding pay scale and helping with Medicaid applications.
“There's a lot fewer uninsured patients than there were two years ago, but they're still out there, people that don't have insurance. We're able to offer them a sliding fee discount for the services that we offer. So, the lowest level I think, is $25 for an office visit,” said Gipson. “We can help coordinate medications for them, we have a pharmacist on staff that comes down to Salem and also in Rolla; they can help coordinate medication costs and help them navigate the medication system that goes along with that to make sure that if we see them, they can also get the medication prescribed to them as well.”
Members of the Salem area business community, several of whom work for community-oriented organizations, had several questions for Gipson about the services mentioned as he wrapped up his presentation. Gipson said Four Rivers strives for innovation in the services they deliver.
"We want to hear from you guys, we want to know what you feel like is missing in our communities. We try and invest in those things as best we can,” said Gipson. “Obviously, we're the health center, we're not a hospital, we're not doing inpatient services, so some of that's limited. But we try and be innovative and creative with some of the ideas that we bring forward and ways we can deliver services.”
Four Rivers Community Health Center’s Salem location is on the corner of MacArthur Ave and Franklin St. and can be contacted by calling (573) 453-9138.
