♪ ♪ ♪ ♪ >> WHERE DO YOU GO FOR HEALTHCARE WHEN HAVE YOU NOWHERE ELSE TO TURN?

STAY WITH US AS WE TALK WITH Dr. SWANNIE JETT ABOUT FEDERALLY QUALIFIED HEALTH CENTERS NEXT ON "KENTUCKY HEALTH."

♪ ♪ ♪ ♪ >> A LACK OF ACCESS TO GOOD QUALITY HEALTHCARE RESULTS IN POOR HEALTH OUTCOMES AND HAS A SIGNIFICANT NEGATIVE IMPACT ON FAMILY WEALTH.

WE CONTINUOUSLY HEAR THAT WE IN THE UNITED STATES HAVE ONE THE BEST HEALTHCARE SYSTEM IN THE WORLD.

WHILE THAT MAY BE TRUE, SADLY FOR THOSE WHO ARE EITHER LOW INCOME OR HAVE POOR OR NO HEALTH INSURANCE, THIS GREAT SYSTEM IS NOT ACCESSIBLE.

WE KNOW THAT WHEN PATIENTS HAVE ACCESS TO A MEDICAL HOME, COMPLICATIONS FROM EXISTING CONDITIONS ARE DECREASED, AND OFTEN OTHER ILLNESSES MAY BE PREVENTED.

FOR THOSE LIVING IN MEDICALLY UNDERSERVED AREAS, WHERE DO THEY GO?

FOR THOSE IN NEED, FEDERALLY QUALIFIED HEALTH CENTERS ARE A PROMINENT AND CRITICAL COMOAN OF THE HEALTHCARE SAFETY NET AND AVAILABLE IN URBAN AND RURAL AREAS.

TO GIVE GREATER INSIGHT INTO FEDERALLY QUALIFIED HEALTH CENTERS WE HAVE AS OUR GUEST TODAY Dr. SWANNIE JETT.

Dr. JETT OBTAINED A BACHELOR OF SIGH TENSE FROM UNIVERSITY OF TENNESSEE AND MASTER OF SCIENCE FROM THE UNIVERSITY OF TENNESSEE IN BIO SYSTEMS ENGINEERING AND MASTERS IN HEALTHCARE ADMINISTRATION FROM SUFFOLK UNIVERSITY AND HIS DOCTORATE IN PUBLIC HEALTH AND PUBLIC MEDICINE FROM THE UNIVERSITY OF KENTUCKY.

Dr. JETT IS A PAST PRESIDENT OF THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS AND RECEIVED THE 2015 GLOBAL LEADERSHIP AWARD FROM THAT SAME ORGANIZATION.

HE IS A LIEUTENANT COLONEL IN THE AIR FORCE NATIONAL GUARD AND AND RECEIVED THE BRONZE STAR MEDAL SERVING IN OPERATION IRAQI FREEDOM.

GERMANE TO TODAY'S DISCUSSION, HE IS THE CURRENT C.E.O.

OF PARK DUVAL COMMUNITY HEALTH CENTER.

Dr. JETT, THANK YOU FOR BEING WITH US.

>> I APPRECIATE YOU.

>> I KNOW WE ARE IN LOUISVILLE WHERE WE HAVE THE PEOPLE'S CHAMPION BUT YOU ARE WHAT KIND OF PEOPLE'S-- WHAT KIND OF CHAMPION?

>> THE PEOPLE'S CHAMPION.

>> I'LL LET YOU BOW THAT OUT WHEN YOU GET TO THE PEARLY GATES.

>> THAT'S RIGHT.

>> CONGRATULATIONS ON THAT.

>> THANK YOU.

>> YOU HAVE A VERY INTERESTING BACKGROUND.

HOW DID YOU HAPPEN TO WIND UP IN HEALTHCARE?

>> YEAH, THAT'S QUITE INTERESTING.

MOST OF MY LIFE I WANTED TO BE AN ARCHITECTURAL ENGINEER.

THAT'S WHY YOU SEE BOW SYSTEMS ENGINEER IN AGRICULTURE AND I STARTED WORKING FOR THE HEALTH DEPARTMENT IN METRO HEALTH AND I LEARNED ABOUT PUBLIC HEALTH BUT ALSO THAT THEY PROVIDED MENTAL HEALTH CARE AND I BECAME MORE INTERESTED.

AND I HAD JOHN WIGS WHO IS NOW DECEASED AND Dr. JOE LEAF FROM U.K.

CAME AND DROVE FROM LEXINGTON FOR TWO YEARS AND SAID YOU WOULD BE THE PERFECT CANDIDATE FOR THE SCHOOL.

SO I TOOK THEM UP ON THEIR OFFER AND THE REST IS HISTORY.

>> THAT'S FANTASTIC.

GOOD PEOPLE RECOGNIZE GOOD TALENT, I GUESS.

>> I DON'T KNOW.

>> WHEN WE TALK ABOUT A FEDERALLY QUALIFIED HEALTH CENTER, EXACTLY WHAT IS THAT 1234.

>> SO STARTING PROBABLY IN THE 60s, FEDERALLY QUALIFIED HEALTH CENTERS WERE BORN.

AND THE INTENT WAS TO ENSURE THAT THE PEOPLE HAD ACCESS TO HEALTHCARE.

NOW PARK DUVAL COMMUNITY HEALTH CENTER IS THE OLDEST IN THE STATE.

IT WAS ESTABLISHED ON THE WEST END AND PEOPLE DIDN'T HAVE ACCESS TO HEALTHCARE, MAINLY AFRICAN-AMERICAN PEOPLE.

SO 1968 WE OPENED OUR DOORS AND WE HELPED FAMILY HEALTH CENTER TO OPEN THEIRS.

IT WAS MAINLY PROVIDING ACCESS TO HEALTHCARE, PEOPLE UNINSURED AND THE FEDERAL GOVERNMENT PROVIDED SEED MONEY FOR TO YOU PROVIDE SERVICES.

NOW ALONG WITH PEOPLE THAT HAVE ACCESS TO HEALTHCARE, THEY COULDN'T EVEN GET TO THE HOSPITAL.

SO PARK DUVAL ESTABLISHED THE FIRST AMBULANCE SERVICE FOR THE CITY AND LATER ON THE CITY TOOK IT OVER.

SO WE FILLED IN GAPS.

>> NOW YOU MADE A POINT OF SAYING THAT THERE ARE OTHERS THROUGHOUT THE STATE OR YOU ARE THE FIRST THROUGHOUT THE STATE WHICH IMPLIES THERE ARE OARSZ OTHERS.

SO HOW FAR SPREAD ARE THESE COMMUNITY HEALTH CENTERS?

>> EVERYWHERE IN ANY CITY AND ANY RURAL COMMUNITY.

SO I DON'T HAVE THE EXACT NUMBER , BUT THEY'RE EVERYWHERE; INCLUDING US BECAUSE WE ARE NOT ONLY IN LOUISVILLE BUT WE ARE IN SPENCER COUNTY AND HENRY... >> I WAS GOING ASK THAT.

WHAT IS A PROGRAM OUT OF THE WEST END IN LOUISVILLE DOING, BECAUSE YOU HAVE A PROGRAM IN EMINENCE AND TAYLORSVILLE.

HOW DOES THAT WORK?

>> THAT'S GREAT.

SO WE GET OUR, SAY DESIGNATIONS, PROBABLY ON A MONTHLY BASIS OF WHERE THERE IS A LOW AMOUNT OF PHYSICIANS IN THE AREA OR MEDICALLY UNDERSERVED AND THEN THEY HAVE A NUMBER ASSIGNED TO IT.

AND THAT'S HOW PARK DUVAL DECIDED TO EXPAND.

WE GO WHERE THE NEED IS.

SO NOT ONLY DO WE SERVE-- BECAUSE FEDERALLY QUALIFIED HEALTH CENTERS WAS BASICALLY FOR PEOPLE WHO DIDN'T HAVE ANY INSURANCE OR HAD VERY LIMITED INSURANCE OR UNDER SERVED.

WE TAKE CARE OF ALL WALKS OF LIFE.

SO IT'S NOT JUST IF YOU HAVE INSURANCE OR NOT.

YOU CAN HAVE GREAT INSURANCE.

OUR FACILITIES ARE GREAT.

IT CAN COMPETE WITH ANYBODY.

THEY'RE VERY PRISTINE.

WE WANTED TO MAKE SURE THAT WE NOT ONLY PROVIDE FOR PEOPLE THAT HAVE INSURANCE, PRIVATE AND THOSE THAT DON'T.

WE DON'T PUT THEM... NOW IF YOU WALK IN OUR CENTER AND YOU DON'T HAVE INSURANCE BUT DO YOU HAVE MONEY, WE PUT YOU ON WHAT WE CALL A SLIDING FEE SCALE AND WE PAY-- YOU PAY BASED ON YOUR INCOME.

THAT'S JUST TO MAKE SURE WE DON'T TURN YOU AWAY.

THAT'S THE DIFFERENCE.

>> LET'S TAKE THAT POINT IF YOU DON'T MIND.

WHEN YOU TALK ABOUT A SLIDING SCALE, WHAT DOES THAT TAKE INTO ACCOUNT BECAUSE ON PAPER WE MAY HAVE ONE LEVEL OF INCOME, BUT WHEN YOU LOOK AT THE FINANCIAL RESPONSIBILITIES THAT WE HAVE,OUR INCOME SUDDENLY CHANGES.

SO HOW DO YOU GAUGE THAT?

>> SO, IT'S GAUGED BY YOUR INCOME FIRST AND THEN YOUR FAMILY SIZE.

WE REALLY CAN'T TAKE INTO ACCOUNT YOUR EXPENSES.

[LAUGHTER] MIGHT BE FLAWED BUT BASED ON HOW MUCH INCOME YOU PRESENT TO US AND WE VERIFY THAT.

AND THEN BASED ON YOUR FAMILY SIZE.

>> OKAY, SO SOMEONE THAT COMES IN WITH A FOUR-MEMBER FAMILY, THAT'S ONE.

EIGHT MEMBERS IN THE FAMILY, THAT'S SOMETHING DIFFERENT.

>> UH-HUH.

>> OUT OF CURIOSITY, ARE YOU CAPTURING ALL THE MEMBERS OF THE FAMILY IN BOTH OF THOSE EXAMPLES, THE FOUR AND THE EIGHT?

>> YES.

YES.

AND IF YOU DON'T HAVE ANY INCOME, THEN YOU JUST HAVE TO SIGN A FORMAL DECLARATION THAT YOU DON'T HAVE ANY INCOME AND WE WOULD CHECK THAT.

SO ALMOST LIKE THE HONOR SYSTEM.

>> YOU KNOW, AND I DID NOT WANT TO USE THE TERM IN THE PEJORATIVE SENSE WHEN I SAID SAFETY NET.

BUT IS THAT A BAD THING TO SAY, THAT YOU ARE A SAFETY NET FACILITY?

>> HEALTH DEPARTMENTS WERE ESTABLISHED AS A SAFETY NET, RIGHT?

SO THEY WERE LIKE THE LOUISVILLE METRO PUBLIC HEALTH IS ONE OF THE OLDEST HEALTH DEPARTMENTS IN THE NATION ALONG WITH BOSTON PUBLIC HEALTH.

>> REALLY?

>> RIGHT.

SO LOUISVILLE IS PROBABLY NUMBER 3 OR NUMBER 4 IN THE NATION.

MOST OF THE SERVICES, HEALTH DEPARTMENTS HAVE THE ABILITY TO EXPAND OR RETRACT, BASED ON THE NEEDS OF THE COMMUNITY.

SO WHEN I WAS AT LOUISVILLE METRO, I RAN CLINICAL OPERATIONS.

WE HAD 22 SATELLITE SITES THAT PROVIDED THE SAME SERVICES NOW THAT THEY PROVIDE.

SINCE PARK DUVAL HAS EXPANDED AND FAMILY HEALTH CENTER HAS EXPANDED AND SHINY CHRISTIAN CENTER HAS EXPANDED, THE HEALTH DEPARTMENT NO LONGER DOES CLINICAL OPERATIONS.

WE HAVE FILLED IN THE SAFETY NET.

AND BECAME A PROVIDER OF ONE-STOP SHOP MECHANISM BECAUSE WHEN YOU COME TO OUR OPERATION, NOT ONLY IS IT PRIMARY CARE BUT YOU ALSO HAVE ADULT MEDICAL, PEDIATRICS, MENTAL HEALTH, DENTAL, PHARMACY, LABORATORY, AND WIC SERVICES AND WE ALSO HELP YOU ENROLL INTO AN INSURANCE PROGRAM IF YOU QUALIFY.

SO IT'S A ONE-STOP SHOP MECHANISM AND WHAT A LOT OF PEOPLE DON'T KNOW AND THAT'S WHY I SAID YOU CAN'T LOOK AT IT AS A FEDERAL HEALTH CENTER.

WE ARE NON-PROFIT.

WE HAVE TO RAISE MONEY.

BUT OUR LAB IS RATED IN THE TOP TWO IN THE STATE.

SO WE CAN PROVIDE A PLETHORA OF SERVICES THAT MANY OTHER PEOPLE CANNOT PROVIDE.

>> SO WHEN YOU TALK ABOUT HAVING LAB SERVICES, FOR INSTANCE, AND X-RAY SERVICES, THESE ARE ALL THINGS THAT ARE DONE IN-HOUSE?

YOU ARE NOT SENDING IT OUTSIDE TO AN OUTSIDE FACILITY.

>> IN-HOUSE.

WE ALSO PROVIDE-- WE HAVE TIP IT FORWARD, WHICH PROVIDE MASSAGES, SO WE HAVE FOUND THAT PEOPLE WITH CHRONIC DISEASES, THE STRESS LEVELS IS RELIEVED BASED UPON IF THEY HAVE SOME TYPE OF THERAPY.

AND SO WE HAVE A STUDY RIGHT NOW GOING ON WITH THAT.

SO WE GOT A COUPLE OF NEW THINGS IN THE QUEUE.

>> IS THERE A RELATIONSHIP BETWEEN THE FQHS, SO, IN OTHER WORDS, WHAT YOU HAVE HERE IN THIS AREA, VERSUS SAY IN EASTERN OR WESTERN PARTS OF THE STATE?

>> SO WE DO MEET THROUGH KENTUCKY PRIMARY CARE ASSOCIATION, WE HAVE TWO CONFERENCES A A YEAR AND WE SHARE OUR IDEALS.

SO WE HAVE GOOD COLLABORATION.

BUT ALSO WITHIN LOUISVILLE AS WELL, WE HAVE LOUISVILLE PRIMARY CARE ASSOCIATION AND WE SHARE OUR IDEAS.

>> SO THERE ARE, AS YOU MENTIONED WITH THE HEALTH DEPARTMENT GETTING OUT OF THE CARE PROVIDING SIDE OF THINGS, HOW DOES IT BREAK DOWN AS TO WHO IS GOING DO WHAT?

>> WELL, IT DEPENDS.

IT DEPENDS ON WHERE THE MONEY COMES FROM.

IF IT'S GRANT MONEY, AND THE HEALTH DEPARTMENT DOES WANT TO DO IT, THEY REACH OUT TO COMMUNITY PARTNERS TO SEE WHO CAN TAKE THAT.

BUT ALSO, WE CAN GO AFTER GRANTS AS WELL.

ESPECIALLY FOR SOME THINGS LIKE H.I.V.

SO WE HAVE ONE OF THE HIGHEST RATES OF H.I.V.

IN THE WEST END.

AND HIGHEST INCIDENTS AMONG WOMEN, AFRICAN-AMERICAN WOMEN.

SO BECAUSE OF THAT, I'VE HIRED A DIRECTOR OF H.I.V.

PREVENTION WHICH FAMILY HEALTH CENTER OR PARK DUVAL NEVER HAD.

>> I SEE.

>> THAT'S JUST THE TOP OF THIS ISSUE.

>> AND WHAT OTHER PREVENTATIVE MEASURES HAVE YOU BEEN TAKING?

>> RIGHT NOW I HAVE A CHRONIC DISEASE MANAGEMENT PROGRAM, WE HAVE-- WITHIN OUR PATIENT QUEUE, 10,000 OR MORE PEOPLE WITH TWO OR MORE CHRONIC DISEASES.

>> 10,000.

>> 10,000.

MAINLY WE LOOK AT DIABETES, BUT YOU KNOW, I LOOK UPSTREAM AND HOW TO SOLVE COMMUNITY PROBLEMS BECAUSE IF YOU COME TO ME WITH DIABETES, I TREAT YOUR DIABETES, I SEND YOU BACK HOME.

>> YES.

>> THERE IS NO GROCERY STORES, THERE IS NO FRESH PRODUCE.

IVY ESSENTIALLY FAILED.

IF YOU COME TO ME WITH ASTHMA AND I SEE THE ASTHMA ISSUE AND I TREAT IT BUT YET WE HAVE AIR POLLUTION IN THE WEST END, SO WE HAVE BEEN MOVING TO NOT ONLY TREATING DIABETES, BUT WE PROVIDE PEOPLE WITH iPADS AND WE HAVE AN AVATAR THAT TALKS TO THEM AND HELPS THEM THROUGH SESSIONS AND GROUP SESSIONS TO HELP THEM WITH DIABETES PREVENTION.

AND ALSO WE HAVE DARE TO CARE PROVIDE FOOD TO US.

I HAVE A KROGER FOOD TRUCK THAT COMES ONCE A WEEK.

AND THEN I AM MOVING MORE TOWARDS A FARMERS MARKET TO THE WEST END, TO BE ABLE TO PROVIDE FRESH PRODUCE.

RIGHT NOW WE DON'T EVEN HAVE A GROCERY STORE RIGHT ACROSS FROM PARK DUVAL.

YOU HAVE TO GO ALL THE WAY TO 26th AND BROADWAY, AND YOU GOT TO MAKE SURE THE PRODUCE IS FRESH.

>> GOT YOU.

>> AND REASONABLE SO SO MANY CAN AFFORD IT.

>> YOU TOUCHED ON TWO THINGS THERE.

WHAT ROLE DOES A PARK DUVAL, BY ANY OTHER NAME, HAVE IN LOOKING AT THE ENTIRE ENVIRONMENT IN WHICH THE INDIVIDUAL IS LIVING?

AND WHAT IMPACT CAN YOU HAVE?

>> THAT'S A GREAT QUESTION.

SO MY LENS IS DIFFERENT THAN MANY C.E.O.s THAT RUN FEDERALLY QUALIFIED HEALTH CENTERS.

BECAUSE I HAVE A PUBLIC HEALTH BACKGROUND AND I HAVE RAN THREE HEALTH DEPARTMENTS.

SO MY WHOLE APPROACH TO HEALTH AND HEALTHCARE IS HAVING A POPULATION HEALTH APPROACH.

HEALTH IS THE END STAGE.

WHEN YOU COME TO SEE ME, THERE IS SOMETHING THAT PROBABLY HAPPENED, RIGHT, BECAUSE YOU ARE NOT COMING FOR PREVENTATIVE CARE.

I HAVE MORE PEOPLE THAT SHOW UP AT PARK DUVAL NOT FOR PREVENT PREVENTATIVE CARE, BUT TOOTH EXTRACTION.

I NEED YOU TO KEEP YOUR TEETH.

I NEED TO PUT ORAL HEALTH BACK IN YOUR HOWTH MOUTH.

THAT IMPACTS YOUR SMILE.

IF YOU CAN'T SMILE, THAT IMPACTS YOUR MENTAL HEALTH AS WELL.

SO I WANT TO DO EVERYTHING THAT I CAN TO HELP IMPROVE THE COMMUNITY, YOU KNOW, I HAVE BEEN WORKING WITH COUNCILWOMAN TAMMY HAWK HAWKINS BECAUSE I HAD A CHILD GET HIT IN FRONT OF PARK DUVAL.

>> SORRY.

>> SO I WAS UPSET BY IT BECAUSE THE SPEED LIMIT IS 25.

>> YEAH.

>> RIGHT?

BUT EVERYBODY DRIVES DOWN THE STREET AT EXCEEDING RATES OF 50 TO 60 MILES PER HOUR.

>> WOW.

>> THAT IS PRETTY MUCH UNSAFE.

I HAVE A SENIOR CITIZEN HOME RIGHT ACROSS THE STREET.

THERE IS A PEDESTRIAN WALK WAY, CROSSWALK, NOBODY CROSSES.

IT'S UNSAFE.

AND THERE IS A BUS STOP RIGHT THERE SO I'VE ASKED THE CITY, MAYBE WE NEED A STOP LIGHT.

MAYBE WE NEED TO HAVE SOME TYPE OF MECHANISM, SPEED BUMPS.

UNFORTUNATELY, IT HAS TO BE 10 OR MORE RESIDENTS THAT LIVE IN THAT AREA THAT CAN ACTUALLY APPLY TO GET THE SPEED BUMP.

I SAID WELL PARK DUVAL, I HAVE NO PROBLEM FOR US PAYING FOR IT BECAUSE IF SOMEBODY GETS HIT, THEY HAVE TO COME INTO OUR FACILITY, IT'S BETTER FOR ME TO DO PREVENTIVE THAN TO TREAT.

AND THAT'S HOW WE HAVE TO LOOK AT SOME OF THE SCENARIOS THAT HAVE BEEN CREATED.

IF WE WANT TO CHANGE HOUSING AND MAKE HOUSING AFFORDABLE, WHAT CAUSED THEM NOT TO BE AFFORDABLE?

IF BEE WANT TO CHANGE HEALTH OUTCOMES, WHAT CREATED POOR HEALTH OUTCOMES, RIGHT?

THERE IS SOMETHING OR POLICY THAT WAS BEHIND IT THAT CREATED THE SCENARIO IN THE FIRST PLACE AND WE HAVE TO REALLY ASK THOSE TOUGH QUESTIONS.

WHAT CHANGE CAN WE MAKE.

PARK DUVAL HAS ALWAYS BEEN A BEACON IN THE WEST END NOW FOR 55 YEARS.

WE NEED TO DO EVERYTHING WE CAN TO BE ABLE TO HELP THE COMMUNITY.

AND NOT JUST IN PARK DUVAL AREA AND OUR NEWBERG SITE AND RUSSELL SITE AND EMINENCE SITE AND TAYLORSVILLE SITE AND IN THE SCHOOL SYSTEM AS WELL.

>> WHICH GETS TO AN INTERESTING POINT.

IS THE MISSION DIFFERENT AT EACH ONE OF THOSE LOCATIONS?

>> NO.

UNFORTUNATELY WHETHER WE ARE IN AN URBAN SETTING OR RURAL SETTING, PEOPLE HAVE BEEN MADE VULNERABLE OVER TIME.

>> GOTCHA.

>> SO THE NEEDS DON'T NECESSARILY CHANGE.

SOMETIMES THEY BECOME GREATER IF YOU ARE IN THE RURAL SETTING.

>> YEAH.

>> BECAUSE THERE IS NO CLINICAL CARE, NO PRIMARY CARE, NO HOSPITAL.

AND IF YOU LOOK AT AN EMINENCE SITE, PEOPLE HAVE TO DRIVE TO LaGRANGE OR FRANKFORT, TAYLORSVILLE, THERE IS NOTHING CLOSE BY.

>> YEAH YOU'VE MENTIONED A COUPLE TIMES ABOUT PAYMENT.

NOW, WE TALK ABOUT THE SLIDING SCALE THAT'S THERE AND THERE ARE SOME PEOPLE THAT HAVE INSURANCE THAT I ASSUME WOULD GO YOUR WAY.

BUT HOW ELSE ARE THE SERVICES COVERED AT A FEDERALLY QUALIFIED HEALTH CENTER OR IN PARTICULAR AT A PARK DUVAL?

>> SO, I MEAN THAT'S A GOOD QUESTION.

WE HAVE MEDICAID, MEDICARE, AND COMMERCIAL INSURANCE.

SO WHEN I FIRST ARRIVED, 80% OF OUR CLIENTELE AND THE THOARN WE TOOK WAS MEDICAID, RIGHT?

IT IS DOWN TO 40% NOW AND WE HAVE 40% COMMERCIAL INSURANCE.

WE NEVER HAD COMMERCIAL INSURANCE BEFORE.

>> REALLY?

>> WE ESTABLISHED THE SAME CONTRACTS WE HAD WITH H.M.O.s, WE ESTABLISHED THE SAME FOR COMMERCIAL.

>> YEAH.

>> SO OUR COMMERCIAL IS NOW UP TO 20%.

WE HAVE A LOT OF PEOPLE THAT ACTUALLY PAY CASH.

SO WE HAVE $2 MILLION IN OUR BUDGET THAT GOES TO THAT.

SO BY THE INSURANCE THAT WE TAKE IN, RIGHT, OFFSET THE PEOPLE THAT CANNOT PAY.

AND WE END UP HAVING TO WRITE THAT OFF.

SO WE HAVE TO HAVE A GOOD BUSINESS MODEL.

AND EVERYBODY, EITHER THEY TAKE 90% OF CLIENTELE COMMERCIAL OR THEY MIGHT TAKE 10% MEDICAID.

RIGHT.

WELL, WE REVERSED THAT BECAUSE WE TRY TO TAKE CARE OF EVERYBODY.

SO WE HAVE-- YOU SIGH 12 PEOPLE ON THE MORNING SCHEDULE, 10 MIGHT BE COMMERCIAL.

WITH US, 10 MIGHT BE MEDICAID.

OR EIGHT MIGHT BE MEDICAID.

AND COMMERCIAL MIGHT FILL IN THE REST.

THAT MAKES SURE WE TAKE CARE OF EVERYBODY.

AND THAT WAS ONE OF THE REASONS THAT I PUSHED FOR PARK DUVAL TO BE A CENTER OF EXCELLENCE.

HISTORICALLY WE WERE NOT VIEWED AS A REAL NICE HEALTHCARE FACILITY BECAUSE THEY CLAIMED IT WAS FEDERALLY QUALIFIED AND ONLY FOR THE POOR.

WE HAVE PEOPLE THAT COME THROUGH OUR DOORS, ALL WALKS OF LIFE, THAT HAVE MONEY AND MAKE MONEY.

THE MEDIAN SALARY IN THE PARK DUVAL AREA IS $51,000.

SO MY RATIONALE MOVED TO COMMERCIAL IS THEY HAVE TO GO COMER.

RIGHT-- THEY HAVE TO GO SOMEWHERE.

THERE IS A REASON UNIVERSITY OF LOUISVILLE WANT TO BE ON THE WEST END.

THERE IS A REASON WHY THE HOSPITAL WANTS TO BE ON THE WEST END AND PROVIDE PRIMARY CARE BECAUSE THERE IS MONEY IN THE WEST END.

SO I WANT TO GET RID OF-- REMOVE THE MISNOMER THAT THERE IS 2340 MONEY.

YES THERE IS MONEY IN THE WEST END.

THEY'RE GOING OTHER PLACES.

THESE ARE HARD WORKING PEOPLE IN THE WEST END.

AND OUR FACILITIES NEED TO MIRROR THAT.

>> YOU RAISE A VERY INTERESTING SUBJECT THERE ABOUT COMPETITION BETWEEN HEALTHCARE INSTITUTIONS, PARK DUVAL OR THE PRIVATE HEALTH SYSTEMS.

WHAT IS THE RELATIONSHIP OTHER THAN-- I DON'T WANT TO SAY ADVERSARIAL, BUT THERE IS A RELATIONSHIP THAT YOU HAVE BECAUSE OBVIOUSLY YOU ARE NOT ADMITTING PEOPLE TO AN INPATIENT FACILITY THERE AT PARK DUVAL.

THEY HAVE TO GO SOMEWHERE ELSE.

WHAT IS THE RELATIONSHIP?

>> WELL, THAT'S A GREAT QUESTION.

SO I HAVE A RELATIONSHIP WITH TOM MILLER AT THE U OF L, WITH RUSS COX AT NORTON'S AND I TOLD THEM JUST LIKE THIS.

I DO EVERYTHING PRIMARY CARE.

YOU HAVE IN-BED HOSPITALS WHERE YOU HAVE BEDS.

IF PEOPLE ARE GOING TO YOUR BEDS AND YOU ARE ADMITTING THEM FROM THE WEST END FOR CHRONIC DISEASES, ANYTHING BESIDE, YOU KNOW, EMERGENT CARE THAT THEN I HAVE FAILED.

MY JOB IS UPSTREAM APPROACH TO PROVIDE ALL THE PREVENTATIVE CARE TO PREVENT SOMEONE GOING TO THE HOSPITAL.

>> IS THIS THE SAME KIND OF THING WE WOULD FIND IN ALL PARTS OF THE COMMONWEALTH?

>> IT SHOULD BE.

>> WITH THE RELATIONSHIP WITH THE VARIOUS HOSPITALS AND UNIVERSITIES?

>> IT SHOULD BE BECAUSE IT'S PART OF A SYSTEM.

AND FOR YEARS, YOU KNOW, PARK DUVAL FAMILY HEALTH CENTER WAS LEFT OUT OF THE SYSTEM.

AND WE HAVEN'T RECEIVED ANY SAFETY NET FUNDING FROM THE STATE.

THE SAFETY NET FUNDING IS ESSENTIALLY WENT TO U OF L OR NORTON'S.

FEDERALLY QUALIFIED HEALTH CENTERS HAVE BEEN LEFT OUT OF THE LOOP BECAUSE THEY'RE NOT RECOGNIZED AS A SYSTEM BUT WE ARE PART OF AN OVERALL SYSTEM OF HEALTHCARE, RIGHT?

I'M JUST TAKING A DIFFERENT SPIN IN TERMS OF MAKING SURE WE DO THE PREVENTATIVE SIDE AT AN EVEN GRANDER SCALE.

>> WHEN WE THINK ABOUT PREVENTATIVE SERVICES, ARE YOU INCENTIVIZED TO ENCOURAGE PEOPLE AS FAR AS VACCINES AND THINGS LIKE THIS BY A PAYMENT MODEL AT ALL?

>> NOT REALLY.

>> NO?

>> BUT WE HAVE RECEIVED GRANT MONEY FROM HERSA IN ORDER TO PROVIDE VACCINES AND IN ORDER TO DO TESTING.

NOW, IN THE EARLY STAGES, IT WAS FREE.

NOW HAVE YOU TO PAY FOR THE VACCINES.

THE FEDERAL GOVERNMENT REALIZED WE PROBABLY NEED TO GIVE YOU A LITTLE BIT OF MONEY TO DO IT.

>> ONE OF THE GREAT THINGS YOU TALKED ABOUT, LABS, X-RAY, BEHAVIORAL SERVICES, WOMEN SERVICES, ET CETERA THERE AT PARK DUVAL.

ONE OF THE MOST IMPORTANT THINGS IS THE PHARMACY.

SO HOW IS IT THAT YOU ARE ABLE TO KEEP YOUR PRICES DOWN OR ARE YOU ABLE TO KEEP YOUR PRICES DOWN FOR YOUR CLIENTELE?

>> WE PROVIDE A REDUCED RATE FOR OUR DRUGS BUT THE INSURANCE PAY US WHAT THE DWRUGS ARE WORTH.

-- WHAT THE DRUGS ARE WORTH.

WE PASS THE COST SAVINGS TO OUR PATIENTS.

I WANTED TO INCREASE, WHEN I FIRST ARRIVED AT PARK DUVAL, WE ONLY HAD ONE SITE THAT PROVIDED A PHARMACY.

SO NOW WE HAVE THREE SITES.

>> THREE?

>> THREE.

AND SO ONE IN NEWBERG, TAYLORSVILLE AND ONE OPENING SOON IN RUSSELL.

SO I WANT TO HAVE THAT ONE-STOP SHOP MECHANISM SO NOBODY HAS TO GO ANY OTHER PLACE FOR THE MEDICATIONS.

ONE OF THE THINGS I NOTICED IS SOMETIMES PATIENTS WILL COME AND THEY WILL HAVE 15 SCRIPTS.

>> YES.

>> AND THEY CAN ONLY PAY FOR 5.

>> RIGHT.

>> SO WE DECIDED TO START THE Dr. HARVEY SLOANE FUND, FORMER MAYOR OF LOUISVILLE, IN ORDER TO INCREASE THAT ENDOWMENT SO WE COULD PASS IT ON TO OUR PATIENTS AND YOU CAN APPLY FOR IT.

SO JUST BY CHANCE, YOU KNOW, Dr. SLOAN WAS THE FIRST C.E.O.

FOR PARK DUVAL COMMUNITY HEALTH CENTERS.

>> PUBLIC HEALTH DIRECTOR IN D.C. AT ONE POINTED ALSO.

>> THAT'S CORRECT.

>> LOOK, A LOT OF WHAT YOU GUYS -- AND I IMAGINE SOME OF THE OTHER FQHC'S DO IS COMMUNICATION INTO THE COMMUNITY.

BUT YOU HAVE KICKED IT UP A NOTCH AS FAR AS COMMUNICATING WITH YOUR CONSTITUENTS AND PEOPLE WHO AREN'T YOUR CONSTITUENTS.

>> CORRECTED.

>> HOW DID YOU GET TO DOING THIS?

>> I TAKE THE APPROACH JUST LIKE I'VE BEEN A HEALTH COMMISSIONER SO I'M USED TO ENGAGING WITH ELECTED OFFICIALS, AND I'M USED TO BEFORE FACING THE COMMUNITY.

I HAD A CONVERSATION WITH ALI ONE DAY-- >> I'M SURE.

>> I BELIEVE IN BEING OUT IN THE COMMUNITY.

I BELIEVE IN BEING ABLE TO WALK AMONG KINGS BY HAVING A COMMON TOUCH.

I'M ENGAGED WITH THE PEOPLE.

IF I'M NOT ENGAGED WITH THE PEOPLE, I DON'T KNOW WHAT IS GOING ON.

I DON'T HAVE A PULSE ON THE COMMUNITY.

AND I LOVE LOUISVILLE, SOY I WANT TO MEET EVERYBODY HIGH AND LOW TO MOVE THEIR THREAND OF PARK DUVAL, NOT JUST PARK DUVAL BUT LOUISVILLE.

I'VE SEEN THE SAME SYSTEMS OCCUR IN LOUISVILLE SINCE 1995 AND NOT MUCH HAS CHANGED.

SO I SPENT A LOT OF NIGHTS TRYING TO LOOK AT DIFFERENT SOLUTIONS AND WHO I CAN ENGAGE.

AND BEING FORWARD FACING, YOU KNOW, WHEN WE RECEIVE MONEY FROM MACKENZIE SCOTT, I WANTED TO MAKE SURE THE COMMUNITY KNEW OVERALL AND CALLED A PRESS CONFERENCE AND I THINK THAT'S THE RESPONSIBILITY OF A COMMUNITY LEADER.

>> BUT YOU GUYS HAVE-- YOU'VE GOT-- YOU ARE ON YOUTUBE BUT YOU ALSO HAVE A TV SHOW.

>> THAT'S CORRECT.

>> YOU ARE NOT COMPETING WITH US NOW.

>> NO, NO.

>> WHAT IS IT ON?

YOU ARE ON WAVE 3.

>> WAVE 3 C.E.O.

TALKS, AIRS ON SATURDAYS AT 12:00.

>> WATCH IT ANY TIME AS LONG AS PEOPLE ARE NOT WATCHING THIS SHOW.

>> YOU CAN GO ON YOUTUBE IF YOU MISS IT WHEN IT ACER.

>> IN 30 SECONDS THOUGH, YOU ALSO HAVE THINGS ON THERE FOR YOUR PATIENTS TO LOOK AT, TO EDUCATE THEM ABOUT HEALTHCARE.

>> THAT'S CORRECT.

>> ARE THESE SELF GENERATED OR REACHING OUT?

>> THESE ARE SELF GENERATED.

MY GREAT MARKETING DIRECTOR HAS DEVELOPED THIS WITH FRED AND IT'S COMMERCIALS, IT'S ENGAGING.

WE ARE ON BUS STOPS.

WE ARE ON BILLBOARDS AND IT'S JUST SHOWING PEOPLE, THESE ARE THE SERVICES PROVIDED BECAUSE YOU PROBABLY DIDN'T KNOW.

>> THAT'S GREAT, MAN.

ANY TIME I HEAR SOMEBODY IS A GRAT WATT OF AN HBCU, IT IS GOING TO BE INTERESTING AND YOU ARE CARRYING THE TORCH AND MOVING IT FORWARD.

THANK YOU VERY MUCH FOR BEING WITH US.

YOU BROUGHT UP US SOME REALLY INTERESTING THINGS ABOUT WHAT IS GOING ON AS FAR AS HOW WE ARE GETTING HEALTHCARE OUT INTO THE COMMUNITY.

THANK YOU FOR BEING WITH US TODAY ALSO.

I HOPE THAT YOU HAVE A BETTER UNDERSTANDING OF THE ROLE THAT FEDERALLY QUALIFIED HEALTH CENTERS PLAY IN OUR COMMUNITIES AND NOW KNOW HOW TO ACCESS CARE WITHIN THE SYSTEM.

IF YOU WISH TO WATCH THIS SHOW AGAIN OR WATCH AN ARCHIVED VERSION OF PAST SHOWS, PLEASE GO TO WWW.ket.org/HEALTH.

IF YOU HAVE A QUESTION OR COMMENT ABOUT THIS OR OTHER SHOWS, WE CAN BE REACHED AT KYHEALTH@ket.org.

I LOOK FORWARD TO SEEING YOU ON THE NEXT "KENTUCKY HEALTH" AND IF YOU HAVE ANY QUESTIONS, LOOK FOR THE FEDERALLY QUALIFIED HEALTH CENTER IN YOUR AREA AND REACH OUT TO THEM BECAUSE THEY'RE MORE THAN HAPPY TO HELP YOU.

SEE YOU NEXT TIME.

>> "KENTUCKY HEALTH" IS FUNDED IN PART BY A GRANT FROM THE FOUNDATION FOR A HEALTHY KENTUCKY.