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Treasure Coast Community Health also trying to serve island patients in need

STORY BY MICHELLE GENZ

Treasure Coast Community Health Care, which as a federally qualified health center serves low-income residents throughout Indian River County, has quietly opened a new clinic with a slightly different patient group in mind: adults, including those living on Vero’s barrier island, who are either on Medicare and/or have high deductible insurance.

The spacious, newly renovated clinic, which began welcoming patients in December for lower-cost medical and behavioral healthcare, is located in a medical office complex a couple of blocks east of Cleveland Clinic Indian River Hospital.

The clinic – which Treasure Coast CEO Vicki Soule points out is close to the Barber Bridge – was opened with an eye to potential patients living in Central Beach who could be part of what the United Way calls the “Alice” population – Asset Limited, Income Constrained and Employed. Or they could be older people who have lost a spouse and find themselves struggling to make ends meet with a sudden drop in income or benefits.

“The reality is that we can all identify someone we know who is presumed to be well-off and yet if you were to open their refrigerators you’d be surprised and perhaps appalled at how little there is inside,” Soule said.

“As they become widows or widowers and their income is cut in half, they are finding themselves in the very uncomfortable dilemma of having to sell the house in order to make [life] more affordable,” Soule said in the agency’s biannual presentation to the Hospital District Board.

Healthcare, particularly preventive or chronic care, can be one of the first things to fall by the wayside.

Offering a low-cost alternative to such seniors – TCCH waives Medicare deductibles – and in a setting indistinguishable from private practice physician offices, can mean economically stressed seniors getting care in the same neighborhood where they have long come to doctors.

It is also meant to be respectful of prideful patients who are uncomfortable using public health services. The 787 building is at the back of a larger, busier medical office complex built in 1980 that fronts 37th Avenue.

“Having both my in-laws and my parents live by us in their last years, I understand the difficulty in getting primary care once you turn 65,” Soule said. “Not that we don’t have very good doctors here, but some of our seniors don’t have very good prescription coverage.

“They may have Medicare for doctors’ visits, but they don’t have prescription coverage so they don’t take their medications because they’re too expensive. Then they end up in the ER and then go to a specialist and get more medications.”

Another targeted adult population is military veterans. In March, TCCH began seeing behavioral health patients with prior authorization from the Veterans Administration. It has just won approval to begin medical care as well.

Altogether, TCCH expects to see more than 22,000 patients this year in its seven clinics – eight clinics if it wins Hospital District approval to open a new clinic in Gifford in October.

At TCCH’s six other existing clinics, pediatric patients make up more than a third of the 21,000 patients seen annually. At the busiest locations, including in Vero’s K-Mart plaza, parents bring sick children trailed by a sibling or two to waiting rooms where space is at a premium.

Of the 250 people employed by the growing system, there are 14 medical and pediatric physicians on staff, with two more slated to start in July; five psychiatrists; nine physician assistants and advanced-practice nurses; 11 dentists; and three pharmacists.

TCCH has its roots in Fellsmere, where, in 1993, three medical providers opened the Fellsmere Community Health Coalition.

The clinic won Federally Qualified Health Center status in 1995 when it became Treasure Coast Community Health Care, and it remains the only such clinic in the county, though Whole Family Health Center is pursuing that designation. Full FQHC status allows clinics to receive federal grants as well as discounted pharmaceuticals.

Today TCCH has two offices in Fellsmere which together offer medical, dental and behavioral health services to that largely rural population. In Sebastian, it offers adult and pediatric medical and behavioral health.

In Vero, it has a medical and behavioral health clinic in the K-mart plaza. The clinic on Oslo Road offers medical and dental services. And a stand-alone dental clinic is in downtown Vero along State Road 60.

The new 787 office in Vero is offering women’s health and gynecological services, behavioral healthcare, primary care, and health navigation services. TCCH also offers gynecological surgery services at Steward Sebastian River Medical Center.

All clinics take nearly all major private insurances plus Medicare and Medicaid. For the uninsured, TCCH offers treatment on a sliding fee scale or tries to qualify patients for Hospital District reimbursement.