Pam McManus often wakes up in the middle of the night, trying to figure out new ways to get more people seen at Peak Vista Community Health Centers.
The safety-net clinic has a waiting list of about 6,000 people — and that’s after McManus has whittled away at the 8,000 she inherited 18 months ago when she took over at Peak Vista.
“It’s the economy,” she said. “People need these kind of services more and more — and we’re going to be trying to meet that need however we can. I am always trying to figure out how to see more people, how to get more people into the clinic.”
Peak Vista provides health care to people who don’t have insurance or are under-insured. Their clinics cover primary care, pediatrics, senior care and dental care — even behavioral care.
“If your deductible is $10,000, then I don’t think you can say that you have insurance,” McManus said. “Most of our patients have jobs. They just work for small businesses that can’t afford insurance.”
Before the recession started in 2008, Peak Vista had a waiting list of around 250, easily managed through cancellations and working people into the system. Today, that’s just not possible, she says. Despite expanding to a total of 19 facilities in El Paso and Teller counties, Peak Vista’s 600 employees can’t keep up with the demand.
“We’ve seen 6 percent growth this year,” she said. “It’s pretty remarkable to have year after year of growth. It’s more than 40 percent growth in five years. We’re seeing a pretty strong demand.”
It makes for a busy days, she says. But people who work at Peak Vista do so because of the importance of its mission — not to earn the big bucks that some health-care professionals command.
“Mission is No. 1,” McManus said. “While we do recruit nationwide, the people are here because of our mission — they love working here they love caring for people who won’t otherwise get help. It takes a very special, amazing person to work at a health center.”
And it takes some very special relationships with other health care organizations to keep Peak Vista ahead of the numbers game. McManus created a partnership with the Gerontology Center at the University of Colorado Colorado Springs to provide graduate students and staff members who offer behavioral health to Peak Vista patients.
“We’re working with them to integrate mental health services into primary care at Peak Vista’s senior clinics,” said Dr. Sara Qualls, professor of psychology, Kraemer family professor of aging studies, and director of the Gerontology Center. “So we’re working to take care of the elderly who might be eligible for nursing home care but who want to stay at home. It’s an integrated model that takes in not only physical care, but mental health care as well. We can work with Peak Vista to provide home care, day care — along with primary care.”
Thanks to combined community efforts with Peak Vista, adults with developmental disabilities now have a medical home of their own. The Disabled Adults Health Center, at 3205 N. Academy Blvd. in a former Penrose Hospital building opened last year thanks to partnerships with The Resource Exchange, Memorial Hospital, AspenPointe and HealthSouth Rehabilitation Hospital. The clinic treats adults with developmental disabilities like autism or Down’s Syndrome, each of which comes with its own health issues.
The clinic includes items not normally seen in a typical doctor’s office: scales that can take wheelchairs, exam rooms big enough for wheelchairs, and specially designed tables for easier maneuverability.
“You don’t think of some of these things, like the scales,” McManus said. “Often, it’s just so hard to get someone out of a wheelchair to weigh them, so the nurses end up asking the patient to estimate their weight. We also will have staff that are familiar and trained in the nuances of health challenges that disabled people face — things like not having fluorescent lighting because the flashing can be difficult for them to take.”
David Erwin, CEO of The Resource Exchange, said the partnership was “made in heaven.”
“It’s been going like gangbusters,” he said. “Their expertise in health care and ours with developmental disabilities — it’s definitely one of those things where two are better than one. We don’t know about health care, and they don’t understand the intricacies of developmental disabilities. Together, we can provide a level of care that just wasn’t available.”
Adults with developmental disabilities always have had trouble with accessing health care. Most are on Medicaid, Erwin said, and doctors who take the government insurance don’t have much extra time for developmentally disabled adults.
“The reimbursement is so bad, they can’t afford to take the extra time,” he said. “The financial model requires they spend five, 10 minutes with each patient.”
But the developmentally disabled clinic spends an average of 45 minutes with a patient, making sure the doctor understands patients and their troubles.
“Human beings — all of us — can get anxious,” Erwin said. “The extra time means that patients can relax and get to know their doctor. It means they’re likely to return.”
Purchased a year ago, the clinic also houses 10 family health providers that offer what Peak Vista calls “convenient care” an after-hours services for families with sick children. Penrose-St. Francis Health Services also will operate an urgent care center at the location.
For Peak Vista, the future is steady, even though the health care landscape is undergoing some cataclysmic changes.
“We’re going to be focused on the same thing we’ve always been focused on — providing health care to the underserved population,” McManus said. “Even with the Affordable Care Act, we’ll still be needed to provide health care services.”
The 42-year-old health clinic will be providing additional support during the transition to Colorado’s health benefits exchange, she said.
“So many of our clients, they get left out of the process,” she said. “Even when the processes are meant to help them — there’s just no access for them. So, we’ll have people here to walk them through the exchanges, what they’re eligible for, what subsidies they’ll receive. It’s going to be just another part of what we do.
One thing will remain the same: Peak Vista will be busy.
“We take in about 2,500 new patients a month,” McManus said. “We serve one out of every 10 people in this town. We have clinics in Fountain and Divide, we have school-based clinics now. We have a homeless clinic downtown. We’re going to keep reaching out to people, providing care where it’s needed. That’s our mission.”