The Fayette County Community Action Agency established Community Medical Services to provide quality, affordable health care to all local residents.
The Fayette County Community Action Agency (FCCAA) developed Community Medical Services (CMS) offering comprehensive health care for the entire family. CMS is a Federally Qualified Health Center (FQHC) operating under a separate corporation as an affiliate of FCCAA.
CMS offers complete medical and dental services including:
- Treatment of chronic conditions
- Regular examinations
- Many types of blood tests
- Dental services
CMS staffing includes a Medical Director, a Physician, a Dentist, an Office Manager, and a variety of other support positions as shown on the CMS Organization Chart. A Chief Executive Officer/Chief Financial Officer position has also been established to handle overall management of CMS.
Medicaid and Medicare patients are welcome at CMS, as well as all types of insurance and managed care plans. A sliding fee schedule is available for persons with no health insurance depending on family size and income.
About a two-year planning process should be anticipated for agencies interested in replicating CMS. This includes about 1-1½ years for planning and another year to recruit a physician.
The steps taken by FCCAA to develop CMS are detailed in the HHS Self-Sufficiency Bulletin Providing Primary Health Care for All Generations: Developing a Community Health Center as a Part of the Community Action Movement. Two factors involved were:
- Designation as a Health Professional Shortage Area (HPSA)
- Becoming a Federally Qualified Health Center (FQHC) Look-Alike
FCCAA participated in the J1 Visa Program involving recruitment of foreign physicians. The dentist previously had a private practice, but preferred being an employee to focus on dental treatment without associated administrative demands. Additional physicians volunteer their services to CMS.
The initial start-up costs for CMS were funded through:
PA Department of Health – 1997 Primary Care Challenge Grant to launch medical services ($125,000)
FCCAA Capital Investment ($500,000)
PA Department of Health – 2001 Primary Challenge Grant to launch dental services ($125,000)
Private foundations ($150,000)
Private and equipment donations ($150,000)
The University of Pittsburgh Medical Center and private physicians donated furniture and equipment. Annual operations bring in about $966,000 in revenue to cover approximately $903,000 of expenses. CMS covers malpractice insurance at a cost of approximately $10,000 per physician and $2,000 per volunteer physician.
FCCAA and CMS have also established the Fayette County Nurse-Family Partnership (NFP) as part of a national evidence-based, nurse home visiting program that improves the health, well-being and self-sufficiency of low-income, first-time parents and their children. NFP is a nurse home visiting program for pregnant women, which continues until the child is two years old. The Comprehensive Health Investment Project (CHIP) of Virginia offers another program model of this type.
As a private licensed school, FCCAA is able to provide a variety of training opportunities through CMS. These include Nurse Assistant, Dental Assistant, Phlebotomy, and Medical Billing.
CMS conducted the Fayette County Health Needs Assessment in 2002 that is being used to develop or intensify community health programs in the county. Future plans for CMS include the addition of (a) an eye-care clinic, (b) a pharmaceutical program with a sliding scale and (c) a mental health component.
FCCAA reports the following outcomes for CMS:
This past year, Community Medical Services patient roster exceeded 3,300 area residents. Since its opening in September of 2001, Community Dental Services has more than 1,400 patients on its roster.
More than 80% of the patients at Community Medical Services are Medicare (915) or Medicaid (1504) recipients and/or sliding fee scale (413) participants.
553 of the patients' incomes are 100% below the federal poverty level.
532 patients at Community Dental Services do not have dental insurance. 789 are Medicaid recipients. 152 patients benefit from the sliding fee scale.
James Stark, Executive Director