By Vanesa Brashier, email@example.com
For the last 15 years, an oversized map of Southeast Texas has hung on the wall in Steve Racciato’s office in the Health Center of Southeast Texas (HCSET) clinic in Cleveland. Every day, Racciato looks at red push pins that mark the locations of HCSET clinics in Shepherd, Livingston and Liberty as he mentally tries to chart where the next clinic will be most needed.
“I look at that map every day. There is too much to be done to be complacent,” he said.
Pointing to an area near Plum Grove, Racciato hints that the next clinic may be located there, but as the process always begins, grant funding must be secured first. Over the years, Racciato has become somewhat of an expert in successfully obtaining federal and state funding for HCSET clinics. He estimates that since 2006, when HCSET was a fledgling clinic, he has helped secure roughly $10 million in grants. The most recent is a $45,000 grant from the U.S. Department of Health and Human Services through the Health Resources and Services Administration (HRSA) for Patient-Centered Medical Homes.
According to Racciato, Patient-Centered Medical Homes, like HCSET, are believed to provide the best treatment for patients in terms of continuity of care from a medical provider. Having a medical provider who knows a patient’s history increases their chance of a better outcome for their illness or injury.
“If you are a provider and know nothing about a patient, then you may have to follow the normal progression for what they present to you. If you have experience with somebody, and if you are seeing symptoms or issues today, you will know what is likely going to happen down the road with their illness,” he said.
The Health Center of Southeast Texas is one of 1,400 Federally-Qualified Health Centers in the nation. These FQHCs, also referred to as Community Health Centers, operate an estimated 11,000 clinics throughout the United States.
When grant opportunities are announced, the competition is stiff as many are competing for the same pool of resources. Some grants provide funding for expansion while others fund new access points, which is how HCSET came into existence back in 2006.
“Anyone can apply for the new access point grant. That’s how we got started. The year we got our grant they were giving out like 78 grants. That was in 2006 for the 2007 grant year. We didn’t make the cut when the grants were announced in May 2006. They announced later that year that they had found more monies and were going to award another 40 or so grants,” Racciatto said.
HCSET started in 2006 in a 1,000 square-foot building leased by Cleveland Regional Medical Center. The hospital at the time was seeking to recruit physicians to the area by offering incentives and grant assistance.
“Because Cleveland was so underserved at the time, the federal government allowed hospitals to give a one-year incentive to clinics like ours to help offset the costs. It was meant to pay salaries until the practice grew,” he said. “This was an incentive to get people to move into rural areas. The problem that the hospital found was that people would come, practice medicine in the area for three years, which was a requirement for the grant, and then move to areas where the revenue opportunities were greater, where the demographics were better for them.”
Dr. Jasmin Sulaiman, who was later named the 2016 Country Doctor of the Year and is now the medical director for HCSET, was the driving force for HCSET in its early days. As the only medical provider, she saw 1,696 patients and provided 3,238 patient care visits in 2006. By 2007, the number had grown to 4,209 patient care visits. In subsequent years, from 2008 to 2015, the number of patient care visits grew from 5,274 to 11,918 as more clinics were opened and more providers were hired on for the neighboring communities.
In 2016-2018, HCSET added more providers and patient care visit numbers exploded. Last year, HCSET clinics saw 28,000 patients and are projected to serve roughly 35,000 patients this year. Today, there are 11 medical providers, including three physicians.
The growth prompted the expansion of HCSET’s main clinic at 307 N. William Barnett Ave. in Cleveland. The recently-completed expansion grew the size of the clinic from 6,330 to 17,100 square feet. Instead of one clinic, the Cleveland location now boasts two – Clinic B to serve patients with appointments and Clinic A to serve walk-in patients.
The clinic expansion in Cleveland is also allowing HCSET to provide additional services, including mental health providers and basic preventive dentistry care.
“We can provide dental care to a limited number of patients every year. It’s basic stuff like tooth extractions and fillings, and teeth cleanings. It’s contracted out through local providers,” Racciatto said.
As an FQHC, HCSET often works on a sliding scale for payment of services. Patients living at the poverty level may see most, if not all, of their healthcare visits covered while self-pay patients and those with insurance may pay a higher rate for services depending on what they can afford.
“We are allowed to collect from any insurance that a patient has. We can also assist patients in getting Medicare or Medicaid if they qualify,” he said.
Having insurance does not always guarantee a customer’s ability to pay, however. Some patients with medical insurance cannot meet their deductible, which might keep them from seeking medical treatment. HCSET is able to slide the deductible in some cases.
“I think the federal government is realizing that if they are ever going to get the people you always hear about during elections – the ones who are uncovered by insurance – then something has to be done,” he said. “I don’t have the answers for the whole system, but I do think the Federally-Qualified Health Centers are a good way to get people the quality of healthcare they need at a price they can afford.”