Established in 2006 as a free clinic staffed by volunteer physicians, the Community Health Center in downtown Fort Dodge has expanded to serve thousands.
Renae Kruckenberg, acting director of operations at the clinic, and Shana Flatgard, outreach coordinator since 2009, talked about some of the changes since those early days.
"It's gown rapidly," Kruckenberg said. "We currently have five full-time providers on the medical side, a full-time dentist and a part-time dental hygienist.
-Messenger photo by Hans Madsen
Dr. Janet Secor, complete with her friendly giraffe reflex hammer, checks on a patient recently at the Community Health Center of Fort Dodge.
They are needed and kept busy.
"We serve over 6,000 patients," she said.
They said there have been several increases in patients, one was in 2009 when dental services were added and again in January 2012 when the clinic was certified as a preferred provider for the IowaCare program.
The clinic also offers the advantage of having all the patient's care under one roof which offers health benefits, record-keeping benefits and access to services benefits.
"Dental and medical can work together," Flatgard said. "For example, for a patient with diabetes, if they have an infected tooth it can affect their whole body system."
No patient is turned away.
"We take all insurance," Kruckenberg said. "We are a Medicare provider, Medicaid and private insurance as well."
"We do take a sliding fee based on income and household size," she said.
For care that can't be done in-house, the clinic will refer patients to Trinity Regional Medical Center or other specialists and dentists.
"We do have an agreement with the hospital that they will take our sliding fees for limited services," Flatgard said. "We have a great relationship with them."
The remodeling at the clinic was done in October 2010. At that date, the dental program moved to the downtown location from its former site at Iowa Central Community College. In addition, new office space was provided and additional room was made available on the medical side.
None of it went to waste.
"We ran out of space before we were into the space," Flatgard said.
There is room to expand into the space next door, but beyond that 10,000 square feet the clinic is landlocked.
"There's room to expand next door," Flatgard said. "We're taking donations anytime."
Kruckenberg would like to see that happen.
"The ideal is to expand to accommodate more patients," she said.
One of the items on the wish list is a machine used in the laboratory to blood work.
"It provides a complete metabolic panel," Kruckenberg said. "We order dozens per day and we have to send them out."
Having their own machine would offer a serious savings in time.
"It takes seven minutes as opposed to 24 hours," she said.
They clinic has also worked to overcome the stereotype that it is only for the poor or indigent patient. Nothing is further from the truth.
"We are a doctor's office just like any other," Kruckenberg said. "We have more guidelines and stringent rules to follow than a regular clinic."
In addition to the guidelines and rules, the clinic also has to file regular reports.
"We have to report to the federal government," she said. "We have to meet our goal-based outcomes."
She said that they need to demonstrate that their care efforts are working, for instance, does a patient with high blood pressure show improvement under the clinic's care and if not, why not.
"We have to show a trend that we're improving," she said.
They also said that patient care comes first, providers are given enough time with their patients to give them proper care.
"We're available for everyone, Kruckenberg said. "We do pediatrics to geriatrics, everyone gets high-quality care."
There's a simple reason for that.
"We value our patients," she said.