Federal grant boosts efforts to fill gaps in health servicesHow badly does Astoria need health care providers? It's pretty clear to the staff of the new Coastal Family Health Center.

"The phone was ringing off the hook even before they opened," said Stuart Matulich.

Matulich is a board member of the new center, which opened last month in offices at Columbia Memorial Hospital. The facility offers a variety of health care services, including men's and women's health, pediatrics, immunizations, dental care and mental health services, targeted at uninsured and underinsured residents.

Coastal Family Health Center helps fill the gap in local medical services left by the closure of the PeaceHealth medical clinic in 2001. The Astoria facility served a large proportion of the un- and underinsured and those covered under Medicaid and the Oregon Health Plan, and its closure left many of them with limited options for medical care. Some went to clinics as far away as Longview, Wash., while others resorted to the CMH emergency room.

The center's opening was made possible by an $805,000 federal grant awarded last fall by the U.S. Bureau of Primary Health Care. The grant was secured by Columbia Memorial Hospital and administrator Terry Finklein, who led the effort to have the county designated a medically-underserved area and secure the grant.

"The clinic serves as an excellent foundation on which to stabilize access and delivery of health care to those who need it most," Finklein said. "With the failure of Measure 28, the clinic takes on an even greater meaning and role in the community than before."

The center is an independent entity with its own administration, staff and board of directors, but it maintains a close relationship with the hospital, not only by leasing hospital space but also through contracts for services such as lab work. Terry Finklein also sits on the center's board.

The center has one physician and two physician assistants, part of a 12-person staff. Leading the medical staff is Dr. Vincent Thompson, a native of Philadelphia with 12 years' experience at community health facilities in Buffalo, N.Y.

Working with low-income and underserved clients has always been the focus of his career, he said.

"It's where I always felt I could do the most good," he said.

Thompson is joined by physician assistants Alan Riddle, a veteran of 20 years in the medical field, and Sandy Kosik, a native Oregonian and recent graduate of Pacific University in Forest Grove.

With little publicity, the center has already attracted a large clientele, and the medical staff is already seeing 20 to 30 patients a day.

The center's official service area stretches from Seaside to Westport, but that doesn't limit who it will serve. The center is already seeing patients from Washington.

"We have an open-door policy," said administrator David Connolly. "We will turn no one away." The center also will not inquire about a patient's immigration status, he said.

"The whole purpose of community health centers is to try to reduce and eliminate barriers to access to health care for the community," he said.

For those with no insurance or other health coverage, sliding-scale discounts are offered.

An 11-member board of directors oversees the center. Under the rules of the federal grant, at least half of the center's board must include actual users of the facility, and representation from low-income residents, people with disabilities, and different ethnic backgrounds.

One of the clients is Matulich of Astoria, the incoming board president. Matulich, who became disabled three years ago, lost his coverage under the Oregon Health Plan and went without health insurance for two years before the center opened its doors.

Matulich had no background in medicine, but when he saw a notice inviting applications for the new center's board last year at Clatsop Community College, where he attends classes, he signed up.

"This is very positive, and I'm very glad to be involved in it," he said.

Coastal Family Health offers services either by its own staff or through contracts with other local providers. Dental care, for example, will be provided through Tyack Dental Group, and mental health services from Clatsop Behavioral Healthcare.

The center's operating hours are currently 8 a.m. to 5 p.m. Monday through Friday, but the board is considering adding one evening a week or a half-day on the weekend. And possible expansion is already being considered.

"Probably before the initial grant period is over (in February 2004) we will need to look at other sites to expand," he said.

Along with the federal grant, the center also received $40,000 in state lottery funds from the Northwest Oregon Economic Alliance, plus $5,000 each from Care Oregon Inc., the state's managed care provider, and the Oregon Dental Foundation.

When the current funding period for the federal grant ends in February 2004, the center will be able to apply for more funds, up to $3 million, for a three-year period, Connolly said.

The federal grants are provided through a program that's been in place since the 1960s, and the Bush Administration has made a priority of increasing funding for it, Connolly said.

But while the federal funding is reliable, Oregon's budget crisis, and in particular the proposed cuts to the Oregon Health Plan, is a concern, Connelly said. The state is expected to make cutbacks in coverage for dental services and mental health, both of which the center provides. "It means that many more people will no longer have coverage," he said.

The center is open 8 a.m. to 5 p.m. Monday through Friday at 2055 Exchange St., Suite 210. Appointments are recommended, at 325-8315.

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