The history of Northeastern Oklahoma Community Health Centers is inextricably intertwined with the history of Hulbert and of Cherokee County, and is a testament to communities and organizations working together. The steps leading to the formation of a network of community health centers based in Hulbert span nearly a decade, and have their roots in a long line of targeted initiatives. Simultaneously with early efforts to start a health center in Tahlequah and other towns, the City of Hulbert was working to improve its infrastructure, encourage economic development, and improve quality of life for its residents. By the time county efforts arrived at the point of asking Hulbert to serve as the site for a health center, Hulbert had developed an infrastructure that would support such an effort.
Community Health Coalition In response to the overwhelming need for accessible health care in rural northeastern Oklahoma, in January 1994, five area health care providers formed the Community Health Coalition, the first rural health coalition in Oklahoma. The Coalition, with a membership of now over 100 organizations and interested individuals, continues to be active. As concerned Cherokee County residents, representatives from Hulbert have been active in the Coalition since it began.
The first Hulbert health clinic In 1996, Wagoner Community Hospital expressed an interest in establishing a health clinic in Hulbert. An agreement was reached between the hospital and a local resident with property fronting Hulbert’s main street, allowing for the installation of a modular medical building (the community health center continues to operate out of this modular building). The clinic operated for several years, first with a Physician Assistant working out of Muskogee Regional Hospital, and later utilizing physicians through the J1Visa waiver program, who also worked out of the Muskogee Regional Hospital. This program increases access to primary health care in communities that have shortages of primary care physicians, by helping medical clinics recruit foreign physicians. Qualified foreign physicians must have completed their advanced clinical training in an approved U.S. residency training program, must agree to work in the shortage area for three years, and must increase access to primary health care. The collaboration of Wagoner Community Hospital, a branch hospital of Hillcrest Healthcare Systems headquartered in Tulsa, and Muskogee Regional Hospital, to operate the first Hulbert health clinic, is an example of the type of cooperation that exists in Cherokee County.
Introduction to community health centers Shortly after the Turning Point Initiative in Cherokee County was underway, a meeting was held at Northeastern State University to provide information about the Bureau of Primary Health Care’s community health center program. Representatives of organizations and communities throughout the area, including Hulbert, attended this meeting. Oklahoma did not participate in the early days of the community health center program, and thus was behind the rest of the United States in the number of funded community health centers per capita population. While Oklahomans were providing tax dollars, which were then used to fund community health centers, this tax money was effectively being used to fund health centers in other states. Communities were encouraged to take advantage of the community health center program.
Cherokee County Health Services Council The informal nature of the Cherokee County Community Health Coalition was, and continues to be, an important vehicle in the accomplishment of community communication and networking. However, it became apparent that the county needed to create a more sustainable entity that could raise funds and create policy. An array of alternatives was considered. Ultimately, the Cherokee County Community Health Coalition turned to a public sector option that would allow for the sharing of public and private resources under Oklahoma law – a public health authority. The creation of the Health Services Council in 1998 elevated the role of health to that of other sectors that have authorities in Oklahoma, such as economic development, hospitals, and transportation, and provides a potential model for partnerships between Native American tribes and local agencies.
County health assessment In 1999, the Cherokee County Community Health Coalition organized and completed an assessment of the county’s health status, health care delivery system, and citizen concerns. The group then made recommendations based what they had learned from this assessment. The recommendations took the form of a Community Health Improvement Plan, which was presented to the Health Services Council. One of the first recommendations was to assist in the development of a rural health clinic.
On July 1, 2001 the Oklahoma Legislature created the Oklahoma Center for Rural Development at Northeastern State University. The mission of the Center is to improve the effectiveness of citizens, enterprises, and communities in rural Oklahoma to better meet quality of life challenges. One of the reasons the Center was established was to help individuals to set up businesses in the area, and a community health center was a topic that received considerable interest. Initially there was talk about trying to establish a community health center in Tahlequah, but that community did not qualify because of the high number of physicians in the area. Two other communities were approached, but they did not want a community health center. Thus, Hulbert was not initially seriously considered as a possible location for a community health center. However, because of the faithful attendance of Hulbert citizens at county events and on county committees, and their vocal assertion that “Hulbert can do it!” after first looking at three other communities, the effort was finally brought to Hulbert, and a town meeting was held at the Senior Citizen’s Center. This initial meeting was well attended by members of the Cherokee County Health Services Council, state legislators, and local citizens. Hulbert embraced the concept of a community health center, and saw this as one cog in the wheel of economic development for residents of the area. A board was named, and work began in earnest to bring a community health center to Hulbert. An area consultant was hired to drive the process.
Community Health Center is established Northeastern Oklahoma Community Health Centers was incorporated on December 3, 2001. The formation of the health center is tied to the many years of work and dedication by Cherokee County leaders in their efforts to improve quality of life in the area. However, without the leadership and the dedication of the citizens of Hulbert, the health center would not exist as it does today. The health center represents the culmination of more than two years’ concentrated effort and day-to-day dedication by the citizens of Hulbert. When other communities were unable or unwilling to accept the challenges of establishing a community health center, the citizens of Hulbert leveraged community resources to offer their own town as the location for the health center and continue to donate much time, talent, and resources to the effort.
Opening on faith As a testament to the faith and sheer determination of the Board of Directors, Northeastern Oklahoma Community Health Centers officially opened its doors (prior to federal funding) on March 25, 2002, relying on the patronage of local residents, and the generosity of legislators and local business to keep it going. For several months, Board members volunteered their time to work in the health center, as did other individuals involved in the project. The health center began operation in a modular medical facility with three-exam rooms. Federal funding was received in November 2002, and the health center has experienced steady growth ever since.
Improvement of the Hulbert site In mid-2003 a Medical Director was hired, as well as a full contingent of medical and administrative staff. The Bank of Cherokee County loaned the health center space for administrative offices, and space across the street was purchased for outreach and accounting services. The empty building that was to be renovated for the permanent health center site was determined to be structurally unsound; thus, before being open yet a year, the health center was facing the need to build a new building. Toward the end of 2003, the site was razed, architectural plans drawn, and a contractor hired to build the new building.
Tahlequah site In just over a year of operation, the health center had grown dramatically, such that it was necessary to expand to a second site in nearby Tahlequah. The Tahlequah site opened with four exam rooms and a Physician Assistant, without any additional grant funds.
Midwives added to staff In late 2003, the health center received funding from the W. K. Kellogg Foundation to establish a birthing center. With technical support provided by Vanderbilt University School of Nursing, who had established several birthing centers in Tennessee, the health center began negotiating for space and planning the birthing center. Midwifery services began in July of 2004 with one midwife. Soon after, an OB/GYN physician was hired to supervise and to provide services.
OB/GYN services expanded The addition of a second OB/GYN physician in September 2005, who was a well known and experienced local physician with a busy practice, was a great boon to the NeoHealth practice. In addition to expanding the practice to two sites, women in the high risk category of pregnancy now found an avenue for management of their pregnancy closer to home.
Pediatrics added Word reached the NEOCHC administration through Tahlequah City Hospital that a Stillwell pediatrician was interested in moving his practice to Tahlequah. In December 2005 the NEOCHC Pediatric practice was opened. Within a very few months it was running at capacity, with patients coming from as far as Tulsa and Warner to see the doctor.
Tahlequah site moved Due to substantial growth, the Tahlequah Health Center site was moved to more spacious quarters. Unfortunately, sufficient medical office space could not be found to house a large enough facility to meet the needs of the growing patient population. When a new strip mall was built just behind Wal-Mart in Tahlequah, space was leased and remodeled for the new Tahlequah Health Center. The new facility has six exam rooms.
OB-GYN offices combined To provide a more comprehensive service to patients, and to facilitate economies of scale, the two NEOCHC OB/GYN practices were combined in one facility. The practice operates with two full time physicians and one full time certified nurse midwife, with a third physician starting part time in June, 2007.
American Recovery and Reinvestment Act of 2009 Allowed NeoHealth to open a health clinic in Westville Oklahoma. Given 120 days to open, NeoHealth was able to open the doors in 105 days. We now provide family practice and behavioral health services for the residents of Adair County.
Funds provided by this act, thru Health and Human Resource Administration (HRSA), also allowed NeoHealth to retain jobs and purchase new computers and implement Electronic Medical Records throughout the NeoHealth system.
In addition, HRSA was able to expand their “loan repayment” program for health professionals- making it easier to recruit and employ health professionals.
Health Professional Shortage in 2009 Health and Human Resource Administration (HRSA) designated Cherokee and Adair Counties as a Health Professional Shortage Area, opening the door to recruit National Health Scholar placement.
First National Health Service Corp Scholar NeoHealth was able to employ our first National Health Service Corp scholar; our second pediatrician for our Tahlequah office.
Health Care reform in 2010 the Health Care reform bill was passed, which is designed to increase access to health care insurance and health care access for more Americans. Within this bill, funds have been made available for expansion of Federally Qualified Health Centers across the nation.
TMC Building Purchase NeoHealth purchased the TMC building in Tahlequah, located at 1500 E. Downing Street. With this purchase NeoHealth was able to consolidate all three of our Tahlequah facilities into one building.
Hulbert Pharmacy On April 13th, 2012 NeoHealth opened the NeoHealth Hulbert Pharmacy. NeoHealth is proud to offer this service to our patients and to bring pharmacy services to the citizens of Hulbert.
The NEOCHC Vision The vision of NEOCHC includes a string of health centers scattered throughout eastern Oklahoma, with each clinic attuned to the particular needs of its community, while tied to the larger organization for economies of scale and managerial oversight.
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