August 2016 Feature Story: North Country Family Health Center

Back from the brink

Joey Marie Horton is the executive director of North Country Family Health Center, Watertown. The center has clawed its way back from near closure three years ago.  Photo by Justin Sorensen, NNY Business.

Joey Marie Horton is the executive director of North Country Family Health Center, Watertown. The center has clawed its way back from near closure three years ago. Photo by Justin Sorensen, NNY Business.

North Country Family Health Center turns corner

By Gabrielle Hovendon, NNY Business

How healthy is the North Country Family Health Center? Take a look at its numbers.
In 2013, the center had a negative operating margin; in 2015, it was 19.3 percent positive. In 2014, its budget was $6.6 million; currently, it’s $7.7 million. In fiscal year 2014-15, it increased its revenue by $800,000, finishing the year nearly $1 million in the black … and that’s not to mention the awards and grants it’s received since then.

“I’m very pleased with the progress that we’ve made so far in the last two years,” said Joey Marie Horton, executive director of the North Country Family Health Center for the past two and a half years. “We’re very excited about future health care reforms and health care system transformations and looking forward to how we can engage in those.”

Things weren’t also so sunny for the health center. Back in the summer of 2014, it had just regained its financial independence under Ms. Horton’s leadership. In 2013, it had been on the brink of closure, with inefficient management, no cash reserves and outdated funding and billing procedures.

Since then, the organization’s newfound financial stability has allowed it to invest in different programs, improve and enhance patient care and begin dialogues with different communities and school districts about expanding its services in those locations.

For example, with the help of $263,000 from the U.S. Health Resources & Services Administration, the clinic has recently reopened their Lowville school-based preventative dental program, begun providing preventative dental services in the Alexandria Central School District and planned to provide preventative dental services in the Copenhagen School District.

“We focus heavily on dental as well as medical services, and we do see a high need for dental services in this area, particularly for patients who are uninsured and for Medicaid patients,” Ms. Horton said. “We see a lot of patients who are not going because of the cost, and our focus is on how to break down that barrier and get them preventive care and basic restorative care, regardless of their ability to pay. Dental services should not be a luxury.”

This focus on integrated, affordable services is one thing that makes the North Country Family Health Center is distinct from ERs and Urgent Cares. Offering discounted fees and payment plans for qualifying patients, the center is committed to providing care to everyone regardless of age, income or insurance coverage. It doesn’t seek to treat just an emergency symptom; it seeks to ensure the patient has access to medical, dental and behavioral care as well as proper nutrition, education, insurance enrollment and other support.

“The idea is, if I can prevent a patient from going to the emergency room, I’m saving the health care system money,” Ms. Horton explained. “If I can ensure that from a young age they’re getting their annual wellness exams, Pap smears and dentist visits, I’m preventing bigger problems down the road. The providers’ focus has always been on quality, but this change in funding allows them not to worry about how they’re going to be reimbursed.”

These improved funds and services will affect a large number of north country residents. In 2015, more than 8,600 patients accessed the health center’s services for a total of nearly 33,000 visits, with the majority of patients being children and adolescents. The clinic’s WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) programs were similarly busy, receiving nearly 40,000 visits and passing out more than $5.2 million in food vouchers in 2015 alone.

According to Lynn M. Pietroski, vice president of the North Country Family Health Center’s board for the past two years, these expanded services and financial gains are the result of strong leadership and collaboration within the community.

Among the key players she mentioned were the Fort Drum Regional Health Planning Organization, Samaritan Medical Center and Ms. Horton herself.

“Leadership has been a key. Joey is a very sound executive director, and she has great backing from the board,” Ms. Pietroski said. “I think that she’s established great relationships with community partners, and that’s supported the center as a whole.”

Looking forward to the future, Ms. Pietroski anticipates that the clinic will continue its strategic collaboration within the community, including with various health organizations and school districts, as well as across the state with other federally qualified health centers.

“I think it’s headed in the right direction, and it’s really got strong leadership. I don’t just mean one person; I mean the entire senior team,” she said. “What was maybe the lead of one or two or three people has really become agency-wide and community-wide.”

With the help of a recent $1 million capital grant from the HSRA’s Health Infrastructure Investment Program, the North Country Family Health Center will continue its forward progress. The grant will fund the renovation of the 238 Arsenal St. facility, increasing the center’s number of primary care exam rooms to at least 15 and dental rooms to at least six — which will in turn allow the center to hire two new providers, grow its capacity by approximately 1,700 patients and streamline patients’ experience inside the clinic.

The health center has also begun participating in the state Department of Health’s Delivery System Reform Incentive Payment Program (DSRIP), receiving more than $120,000 to recruit two dentists and develop their care coordination program. This program aims to move the region to value-based contracts (wherein providers are paid for the quality rather than the quantity of their patient services) and away from the current fee-for-service model within the next five years.

“There’s always something new and exciting for the health center, and there’s always something changing,” Ms. Horton said. “Every couple of months, it seems that we learn something new or a new opportunity arrives. I think the future holds a lot of opportunities for the health center, and we’re ready to take them.”

Gabrielle Hovendon is a former Watertown Daily Times reporter, north country native and freelance writer who is pursuing a Ph.d. at the University of Georgia in Athens. Email her at