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By Connie Leinbach
The Ocracoke Health Center has taken its own pulse, and although it’s steady, it has a weakness.
A charitable private nonprofit, the health center has the only physician in Hyde County.
While it serves Ocracoke—both residents and visitors—a few years ago, the Ocracoke Health Center joined with the Engelhard Medical Center to become a Federally Qualified Health Center (FQHC).
“That collaboration was essential,” said Cheryl Ballance, R.N., the CEO of both centers. As more patients boost the numbers served, that increases federal reimbursements.
Although that alliance has yielded an influx of federal dollars, the health center is “not rolling in money,” she said.
When the Ocracoke center opened in 1981, it relied on state funding for operations, Ballance said, but no longer.
“We’ve been able to stay open because of the FQHC funding,” she said. “Before that, state funding was rapidly diminishing.”
Operational help is a hole that’s not being filled because supplemental (or operational) funding is not something most grantors fund.
To help operations and about $145,000 in needed building repairs, the health center board of directors is working on securing more money from Occupancy Tax funds and with some island fundraisers.
The first one will be from 7 to 10 p.m. Saturday, Dec. 8, with the Ocracoke Rockers in the Ocracoke Oyster Company, featuring a dessert table, cash bar and prizes for a $10 admission.
At the center’s recent health fair, the raffling of a quilt made from old Ocracoke T-shirts by former Ocracoke United Methodist Pastor Joyce Reynolds netted $2,400.
The board also is exploring having a fundraising seafood festival Labor Day weekend.
It’s all about cash flow, which is problematic with health care nationwide.
When you buy gas, you pay and drive off.
But with health care, patients receive service, but both the patients and the providers typically have contracts with insurance companies who may or may not pay for all of the charges, most of which are on a sliding fee scale according to household income and the federal poverty guidelines.
“The sliding fee scale is required by the feds, but there’s always some money that’s not paid,” Ballance said. And some people in the county simply can’t afford the co-pays, she said.
“The need for discount services is amazing,” she said.
Federal guidelines dictate how much reimbursement the health center receives, and these are tied to new federal mandates to providers to provide “quality over quantity” to produce “better outcomes,” Ballance said.
Those outcomes translate into preventing or mitigating health issues before they become full-blown illnesses, which leads to lesser health care costs.
“Because our quality reports improved from last year, we got some money for that,” she said. “If you catch all that stuff early, you can treat it,” which leads to better outcomes.
“Along with the school, the health center is the most vital thing in the community,” said Susan Dodd, a board member. “My staying here (on the island) depends on it. It’s only 60 years from when midwives were the only medical care here.”
Ocracoke can claim the only practicing physician in Hyde County in Dr. Erin Baker, who has lived on the island for more than eight years and has no plans to leave.
“I love it here,” she said during the center’s health fair Nov. 17 at the Ocracoke Volunteer Fire Department. “I’m raising a family; it’s a close community and I get to know all of my patients.”
In addition to Baker, the island’s health care is supplemented by Gail Covington, a nurse practitioner, who does house calls, and the mainland has Donald Spradlin, a physician’s assistant, who provides care at the Engelhard center.
Since hospitals are a one-hour drive from the mainland and more than three hours for Ocracoke, both areas rely heavily on Hyde County EMS services for emergency care and transport. The Hyde County Health Department in Swan Quarter also has some basic services overseen by a nurse practitioner.
Mandated measures create extra work for the staff, she said.
“But the whole staff is committed,” Ballance said. “We’re fortunate we have FQHC designation that enables all of this. Health care is empathy. Health care is putting yourself in the other person’s position.”
Each year, counties must file detailed reports with the State of the County Health (SOTCH).
In 2017, Hyde ranked 56 out of the 100 state counties for health factors, based on weighted scores for health behaviors, clinical care, social and economic factors, and the physical environment.
See www.countyhealthrankings.org and search for Hyde County.
The county also lacks a dental office and a pharmacy.
On Ocracoke, prescription drugs are delivered weekdays by Beach Pharmacy in Hatteras Village.
To donate to the Ocracoke Health Center, a charitable nonprofit, donations can be mailed to P.O. Box 543, Ocracoke, NC 27960.
Hours are weekdays from 9 a.m. to noon and 1 to 5 p.m.