Tears and laughter marked the 40th anniversary celebration of the Athens Neighborhood Health Center (ANHC). About 50 people with powerful emotional ties to the city’s oldest community clinic gathered late last month for an evening that was part reunion, part revival.
Doctors, nurses, lab techs and other past and present staff, members of the board, patients, community members and Mayor Nancy Denson gathered at Trumps Catering to pay tribute to ANHC, , which provides medical care to underserved children and adults in Athens Clarke County (ACC).
“I can’t express how much it meant to be invited to celebrate the 40th anniversary,” said Martha C. Cottrell, the clinic’s first physician and medical director.
Cottrell, still charismatic at age 84, has retired from practice but still leads health-related workshops in Asheville, NC.
ANHC was born because local citizens tapped into President Johnson’s “Model Cities” initiative, one of the Great Society programs meant to remedy poverty and violence in urban areas.
Cities could only apply if they had a Citizens’ Participation Committee (CPP) in place, and for this Mayor Julius Bishop turned to three strong women who came to be known as the Band of Sisters.
Evelyn (Corene) Neely, Miriam Moore, and Jesse Barnett led the CPP. Neely, now 86, attended the celebration and spoke briefly.
These three women worked with the Athens city council (forerunner to the Athens-Clarke County Commission), the mayor, and other community volunteers to secure a $2.6 million federal grant.
The money was designated for 35 local projects – one of them a clinic to serve people who had been largely shut out of the health care system.
“When the Model Cities program came up, there was a tremendous need among the African American community and others in the community, said Cottrell. “I was inspired by the fact the people there were trying to put this together.”
She volunteered to practice medicine at the clinic, only to discover that it didn’t quite exist. In order to access the federal dollars that had been approved, the local team had to show that they had a clinic building. Which they did not.
“You know how the government works,” Cottrell asked rhetorically. “It doesn’t.”
That drew a laugh but the challenges the clinic founders faced 40 years ago were daunting. Cottrell traveled the state of Georgia, until she finally found a banker willing to front the cost of a building where medicine could be practiced and lab tests run.
The clinic opened in 1971.
“We started out in a trailer,” said Cottrell. “It was a very humble beginning.”
There were other issues as well, of course, and sometimes stakeholders disagreed.
“We butted heads sometimes on my ideas of how it should be done and their ideas how it should be done,” said Cottrell. But these were resolved, and the clinic took hold and grew.
At one point she wiped away a tear, talking about those early days. “It brought up so much emotion for me because it was challenging,” she said later in an interview.
A fire destroyed the trailer in the mid 80’s and in 1987 the ANHC relocated to 675 College Ave., where it operates today.
In 2000, the ANHC opened a second location at the Miriam Moore Community Center in East Athens.
The center handles over 13,000 patient visits each year.
Today the AHNC is led by pediatrician Diane Dunston, who came to the clinic in 1987 to repay medical school loans guaranteed by the National Health Service Corps. She currently serves as the executive director for both ANHC locations.
“I am able to see any patient regardless of their circumstances in life,” said Dunston, “Especially those who may be economically disenfranchised, living paycheck to paycheck.”
It is not hard to find such people in Athens, which had a 39 percent poverty rate in 2010.
The presence of ANHC makes Athens a unique community, according to Melinda Craig, ANHC administrative director.
”Even though we have a high poverty rate there is an outlet, a place people can go to that has a sliding scale fee and they can get top medical care from actual physicians here on staff,” said Craig.
The clinic treats anyone who needs care, whether or not they can pay. But people who can afford to pay are charged on a sliding scale, according to their means. This system has been in place since Cottrell ran the clinic.
“We know that if you don’t pay for something you don’t appreciate it,” said Cottrell. Chipping in for their own care also helps empower people, she believes.
“We have to get people to realize that this is their clinic, this is their health, and that they need to invest in it,” said Cottrell. There are other benefits as well: clinics that are financially supported by their communities are in a better position when it comes to winning government grants.
This matters because the clinic, like the people it serves, has been experiencing financial woes for some time now.
The clinic operates in the red because it serves so many un- and under-insured patients.
“Most people think of a community health center as having large federal dollars,” said Craig, “but that’s not true.”
In 2010, ANHC applied to become a Federally Qualified Community Health Center but was turned down. The Georgia Health Sciences University-University of Georgia Medical Partnership, along with Medlink Clinics, applied at the same time. Neither application was approved.
“As the Athens community becomes saturated with a lot of non-profit agencies, everyone is competing for the same amount of monies and funders are basically having to say no,” said Craig.
For now, the federal government regards ANHC as an FQCHC “look-alike,” which means that the clinic gets enhanced Medicaid and Medicare reimbursement and some breaks on drug prices, but no large lump sum.
Because the clinic cares for underserved populations, it also receives some additional payments from the state, as well as other grants and private donations.
There were hurt feelings and some angry words when ANHC and the new medical partnership filed separate applications for FQCHC status. But in a city where more than one-third of the population lives in poverty, and where many medical needs go unmet, such a feud probably can’t last.
Craig says ANHC “ would be a good rotation for the medical students, the ones who may want to go into community health.”
Dunston believes that the center will have to mend relations with the medical partnership. “Both on our end and theirs,” she said, “there has to be a respect of the needs of the community.”