A new clinic to meet the medical, mental and social needs of WNC Latinos

In far western Macon County, US 441 branches off and descends into downtown Franklin. Just before the interchange, a huge one-story beige and gray building stands empty on the east side of the rushing road. But on a sunny Friday morning in July, that was not the case. A pair of stray dogs meandered around the property’s three acres, while dozens of visitors carried coffee, donuts, parfaits and plants.

At present, the property doesn’t look like much: weeds are growing from cracks in the concrete outside, while inside, mysterious stains dot the tattered white carpet and old security cameras stick out from the ceiling.

But soon — after a multimillion-dollar renovation — it will be western North Carolina’s first one-stop bilingual community health center, providing low-income area residents with everything from dental care to support. in cases of domestic violence.

“I’m glad you all see it for what it is – dirty carpet, weeds in the parking lot – I mean, that’s where we start,” said Marianne Martinez, executive director of the organization of Community Health Vecinos (meaning “neighbours” in Spanish) who purchased the building, during the organization’s fundraising launch event.

“A year and a half from now, when we meet again to crack a bottle of champagne above the ship, you can think back to what it looks like today. And then we’ll all take a nap on the tables in the exam room.

Extend care to all

Since 2004, Vecinos has been the “medical home” for many Latino farm workers in the area, providing them with medical care and health education. Their outreach first started using a mobile clinic. Later, Western Carolina University donated space at its Cullowhee campus in Vecinos, where the organization runs a twice-weekly outpatient clinic.

Currently, between the mobile clinic and the WCU office, Vecinos staff and volunteers provide a total of 16 clinical hours per week to the community. In an average year, they see about 700 patients. In their first year in the new space, which will have seven permanent clinical exam rooms, the organization estimates it will serve at least 2,000 people, reflecting the rapid growth of Carolina’s Latino community. of the North and its unmet health needs.

The idea of ​​creating something like this started in earnest last year. Like other nonprofits, Vecinos creates a new strategic plan every few years, and 2021 marked the start of a new planning cycle.

“With the pandemic and the emergency work that we started doing with COVID awareness and all that, our board kind of really took a step back and looked at what we were doing, and what the community continued to be needed a year into the pandemic,” Martinez explained.

Between its mobile clinic and its twice-weekly outpatient clinic, Vecinos serves around 700 patients a year. With the expanded eligibility and permanent location, they expect that number to grow to at least 2,000.

For years, Vecinos had considered expanding its patient eligibility criteria so that they were only open to farm workers at an income-based clinic – meaning anyone who couldn’t allow for care, any uninsured or underinsured person, could seek care with the organization.

Fanny Garcia, a phlebotomist at Vecinos, said the new community health center (as the organization calls it) will make care much more accessible and comfortable for Spanish speakers in the area.

“The Blue Crest [Health] exists, but cannot always meet the needs,” Garcia said. Blue Ridge Health is another low-income clinic in the area, but the organization is often stretched to capacity. Garcia said he’s heard from patients that there are sometimes problems finding translators or a Spanish-speaking provider.

If ever there was a time to make that change, Vecinos executives believed, it would be now.

A fully integrated model

The organization’s board and management decided to go ahead with the vision, but that would mean they would need a much larger, permanent space.

Western North Carolina has lower overall proportions of Latinos than the eastern part of the state. Less than 5% of residents in the far west of Graham, Swain, Haywood, Cherokee and Clay counties are Latino, but that is not the case for Macon and Jackson counties, where about 10% and 8% of inhabitants, respectively, are Latinos.

Plus, nearly 40% of Vecinos’ patient population lives in Franklin, so they knew they wanted to find a location there. But they still didn’t like the idea that people would come to them for medical care and then have to go elsewhere to get the rest of their non-medical health needs — like help with an immigration case or tax filing assistance – satisfied .

“Any time someone takes time off to come get health care or any other service, they don’t get paid,” Martinez said. “That’s what we’re trying to reduce, it’s all these kinds of barriers to health care, whether it’s the social determinants of health or primary and mental health care.”

For about as long as the organization has been around, they have worked in tandem with other organizations that provide complementary services to the same patient population – El Centro Comunitario of Macon County, Blue Ridge Free Dental Clinic in Cashiers, Asheville-based Pisgah Legal Services which helps with immigration cases and is launching a new program to help people register for insurance coverage and file taxes, and the 30th Judicial District Domestic Violence-Sexual Assault Alliance , based in Waynesville, which helps Spanish-speaking survivors access therapy and navigate the criminal justice system.

Martinez started thinking: what if it all worked under one roof? She posed the question to different nonprofit leaders and workers. Soon people from all five (and counting) organizations formed a steering committee to start working out the details.

There were similar patterns to this kind of work. In Charlotte, Camino Health Centers provide integrated physical and mental health care as well as a pantry and health education classes. Behind the Buncombe County Courthouse is the Family Justice Center, and there is a similar facility in Alamance County.

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Many agricultural workers have occupational injuries due to the physical stress of their job. With their new permanent location, Vecinos hopes to help the community resolve these issues and any others they may have.

In these multi-agency environments, there may be staff from the domestic violence shelter, rape crisis center, hospital, district attorney’s office, and law enforcement who all cooperate to help victims of sexual abuse or violence navigate the criminal justice system.

What this community of organizations is trying to do would be something similar.

In the end, they decided that Vecinos would buy the building and the other four organizations would rent space from them. There would also be additional unoccupied rooms that other community organizations that work with this population could flexibly rent or use for events.

And there would be child care. Often times, people have to cancel their appointments, either because childcare fails at the last minute or because the cost of a babysitter is more than what they earn in a day.

“With our dental clinic that we partner with, after two or three cancellations, they can never come back, ever,” Martinez said. “And so if you have childcare that has been canceled two or three times, then you have, again, no dental care. It is therefore very important for us to have a space where their children can come and play safely.

How do they pay it?

Dogwood Health Trust, the organization created with part of the proceeds from the sale of Mission Hospital to HCA, gave Vecinos a $1.6 million bridging loan to buy the building until they find their funding. long-term. They will eventually have to repay this amount, and construction costs are estimated at $3 million.

“It’s a big project, and it has to be done,” Martinez said. The building is not “health care ready”. A new HVAC system will be required, water will need to run under the dental clinic floors, and exam rooms and offices will need to be locked away from publicly accessible parts of the building to ensure patient privacy.

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Vecinos’ new clinic is located just outside of Franklin, in the heart of the Macon County mountains.

Although counties can direct some of their pandemic relief money from the U.S. bailout to nonprofits to support projects like these, Macon County has already earmarked all of its federal funds for raises and bonuses for county employees, so that’s not an option.

Martinez said they are looking for grants and loans through the US Department of Agriculture, as well as money from foundations or, potentially, private loans.

“We have a lot of work to do, and it takes a lot of money,” she said. “But we have a solid fundraising and capital campaign plan. We are not doing this alone.

Part of the hope is that every organization that will work in this building can tap into their networks to help raise funds for this project.

“I don’t think we’re going to raise five and a half million dollars in the next six months – that would be nice – but, you know, it’s going to take time,” Martinez said, “And that’s good, because it it’s a long-term investment in the community.

This article first appeared on North Carolina Health News and is republished here under a Creative Commons license.

North Carolina Health News is an independent, nonpartisan, nonprofit news organization dedicated to covering all things health care in North Carolina. Visit NCHN at northcarolinahealthnews.org.

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