FAQ's about CHCCW

CHCCW is one of more than 1,000 Community Health Centers (CHCs) across the nation partially supported by the U. S. Department of Health and Human Services, Health Resources Services Administration, to provide comprehensive health care to the medically underserved.

Who are the medically underserved? People are medically underserved if they are in need of health care, including preventive care, do not have health insurance and/or are low-income. Also included are those unable to find a medical home because local private practices are full or do not accept Medicare or Medicaid. People are considered medically underserved in sparsely populated areas where no private practices exist. For example, CHCCW manages a satellite clinic in Dubois, Wyoming. In 2003 CHCCW provided medical, dental, and behavioral health care to 11,547 patients; 3,305 children (29% of the patient population) were under the age of 18; 6,894 (60% of the patient population) were female. These 11,547 patients are primarily children, the working poor, the disabled, and the elderly. Eighty-five percent of our patients live in households with incomes below $36,619, the median income for Natrona County, according to the 2000 Census. Half the patients have incomes below the Federal Poverty Level of $9,310 for one person and $18,850 for a family of four.

Can any community have a CHC? No. Communities have to satisfy several criteria including having high numbers of uninsured, elderly, and/or low-income populations, and the medically underserved such as those in sparsely populated areas, or in "Health Professionals Shortage Areas" where there are fewer primary care physicians (family practice and internal medicine) than the national average according to the population. To date in Wyoming, only Casper and Dubois have CHCs. Cheyenne will soon open a CHC.

Are CHCs "free clinics?" No. Patients are charged on a sliding fee scale. All patients must pay a co-pay. CHCs employ physicians, physician assistants and other health care providers whereas free clinics are usually staffed by volunteer providers.

What are the qualifications of the medical staff at CHCCW? Physicians are board certified in family practice, internal medicine or psychiatry. All physicians are M.D.'s or D.O's (Doctors of Osteopathy). CHCCW also employs physician assistants who work under the supervision of physicians. The physicians include those serving as faculty physicians for the UW Residency Program. CHCCW has one psychiatrist, a Ph.D. clinical psychologist, and a licensed clinical social worker in its behavioral health department. The dental clinic employs two licensed dentists, an oral surgeon and two hygienists. The pharmacy is staffed by two licensed pharmacists. A doctor of optometry supervises the eye clinic. CHCCW also has a dietician, nurse educator, nurse case manager, social worker and several Spanish-speaking staff. The CHCCW Children's Advocacy Project, a center for child victims of abuse, employs a therapist and psychologist as well.

What is the relationship of Community Health Center of Central Wyoming to the University of Wyoming Family Practice Residency Program? There is an affiliation agreement between the CHCCW and UWFPRP. The CHCCW provides the clinical experience for the resident physicians completing their three-year residency. Faculty physicians oversee the practice of the residents. CHCCW physicians provide rotational experiences to the residents. The UW School of Pharmacy also provides a residency program for pharmacists at the UWFPRP. CHCCW is housed in the UWFPRP building in Casper.

What are the qualifications of the residents? The residents all have completed medical school and their internship and are D.O.s or M.D.s in family practice. They could start their own practice after completing medical school; however, they choose to do a three-year residency to broaden and deepen their medical practice knowledge and skills.

What services does the CHCCW provide? Outpatient services include family practice, pediatrics, internal medicine and obstetrics. Pharmacy, dental, behavioral health, laboratory, x-ray, ultrasound, vision and hearing screening, health education, HIV/AIDS education, training and early intervention services are provided. CHCCW has Spanish language translators. Inpatient services are provided at Wyoming Medical Center and local long-term care facilities.

Isn't CHCCW competing with other medical providers in Casper? No. There are not enough medical providers taking low-income, uninsured, and Medicare/Medicaid patients. In the past, many of these patients went without care and/or overutilized the hospital emergency room for urgent and emergency care. They did not seek preventive care. As a result, their health care costs were higher, and taxpayer funded programs such as Medicaid faced higher costs. The hospital is required to provide indigent care, but it cannot do so without shifting the high emergency room costs to paying patients. In addition, hospital patients from out of town without a local provider often rely on CHCCW physicians during their hospital stay because there are not enough providers in Casper.

Does CHCCW charge lower fees than other medical providers? Patients are charged according to their ability to pay. A middle or high-income patient without insurance or on Medicare will pay a similar fee to that charged by a private physician. Lower income patients will pay a lower fee than those charged by medical providers. The mission of CHCCW is to provide affordable, accessible health care. Cases requiring special care such as urology or oncology are referred to local specialists, and patients then must make their own payment arrangements.

How is CHCCW funded? From one-fifth to one-fourth of CHCCW funding comes from the Bureau of Primary Health Care of the U.S. Department of Health and Human Services. About one-seventh is provided by the State of Wyoming. Private foundations provide about 3% of the funding, primarily for the Children's Advocacy Project. The balance of funding is derived from public and private health insurance, patient payments and contracts such as those with long-term care facilities in Casper.