Health Center Cluster/UK North Fork Valley Community Healthcare Center

North Fork Valley Community Health Center (NFVCHC) was established as a result of a cooperative effort between the University of Kentucky College of Medicine (UK COM) Department of Family and Community Medicine-Hazard, KY (a residency program and Family Medicine clinic) and a dedicated group of citizens who recognized the immense need for accessible primary health care services for the rural, low income, and uninsured Appalachian residents of Perry and Knott counties in southeastern Kentucky. The designated service area includes five census tracts each in Perry and Knott counties, as well as an adjoining census tract in Leslie County. The eleven census tracts contain a 2012 population of 38,025 and encompass three Medically Underserved Areas/Populations (MUA/P) and three Federal Health Professional Shortage Areas (HPSA). Perry and Leslie Counties also comprise the federally designated southeastern Kentucky Promise Zone, which will support job creation and expand educational opportunities in persistently impoverished, mining dependent communities impacted by the demise of the coal industry in southeastern Kentucky. A combination of geographical, cultural, and financial barriers have prohibited local residents from obtaining necessary health care. There are high levels of poverty (51% at 200% of federal poverty level within our service area), and elevated unemployment rates. Our populations of 19,387 individuals in the eleven census tracts reside below 200% of the federal poverty level and comprise our targeted population within our communities. Decades of entrenched, persistent poverty further complicate the treatment and management of those chronic conditions (diabetes, lung cancer and cardiovascular disease) that disproportionately afflict our population and result in excessive mortality and morbidity rates. Our areas most vulnerable populations (women, children and the elderly) also face significant obstacles to accessing care and have historically lacked access to health education and preventive programs, as well as regular primary care, mental health, and dental visits. UK NFVCHC operates from two facilities in Perry and adjoining Knott County, both of which offer primary, preventive, and mental health services. Unfortunately, as a result of escalating cost concerns, one of our previous site services, Women’s Health Services, had to be separated from North Fork Valley Community Health Center in 2013. Dental outreach services were also temporarily suspended for six months, all of which resulted in a decrease of unduplicated users to 8,713, which simultaneously decreased encounter volume to 32,041, and required a total of 56.55 FTE’s offering clinical and support services. For FY 2015 we propose a target population of approximately 9,887 unduplicated patients in 35,593 encounters as a result of increased dental visits, vigilant efforts towards Medicaid service enrollment, and increased volume from school-based health programs.