Beatrice Bostick, CEO of the Alliance Medical Center, gave an overview of the facilities operations and their place in the healthcare picture in Sonoma County.
Beatrice Bostick, CEO of the Alliance Medical Center, gave an overview of the facilities operations and their place in the healthcare picture in Sonoma County. She also presented a brief synopsis of the Sonoma County community health needs assessment document that has recently been prepared and released by Sonoma County. ( )
The Alliance Medical Center (AMC) came into existence in the late 1960’s to help serve the medical needs of the migrant farmworkers who would come to our area during harvest season. Over the years the program has expanded and is now providing a full service range of medical and dental care. They are a Federally Qualified Health Center(FQHC) which helps with their funding, as well as with allowing a larger number of uninsured patients to qualify for government -assisted insurance, particularly under the Affordable Care Act. Under the federal qualification they are also allowed to apply a sliding fee scale to patients who are insured through programs other than the government for primary care services, thus reducing the financial burden of high deductibles that are frequently part of employer-based insurance plans. They have expanded into providing services for primary care for veterans in the area through a program called VA Choice. They also provide dental care to pediatric and adult patients.
Alliance Medical Center has a budget of approximately $11.5 million per year. 5% of this money comes from grants and donations. The remainder comes from fees for the services that they provide. They have been grateful for monies given to them in years past by the Healthcare Foundation of Northern Sonoma County. In addition to monies received from the Healthcare Foundation, the Alliance Medical Center is initiating a more direct role in solicitation of donations which will be rolled out in the next one or two months.
The patient population at present consists of over 10,800 unduplicated patients, each of whom visits the clinic two or three times per year. This is contrasted with the Alexander Valley Medical Center, also another community Health Center, that has a unduplicated patient base of approximately 3100 patients. 66% of the patients at AMC are Hispanic, 32% Caucasian and 2% other ethnicities. 53% are on Medi-Cal, 9% are on Medicare, 9% have private insurance and 19% are uninsured.
100% of the support staff and physicians at the clinic speak fluent Spanish. 95-97% of the rest of the staff Spanish proficient.
The demographics of the population served at the clinic are quite different from the general demographics of the county as a whole. There are a higher percentage of Hispanics and other minorities at the clinic, there is a much higher prevalence of living at or below 124% of poverty, there are language problems that are not present in other healthcare facilities in the county. Many of the patients seen in the clinic list a country other than the United States as their country of origin.
Some special areas that the clinic deals with include differential mortality rates for their demographic, prenatal care and outcome, drug use, teen births, obesity, issues of adolescence, oral health and general access to care issues.
AMC was the first community clinic to have dedicated dental services available for children as well as adults. They currently have three dental chairs in their facility. Oral health impacts all other areas of health and almost every patient that is seen initially in their clinic receives a dental evaluation.
They have excellent outcomes for maternity care and special programs for teenage pregnancy. The pregnancy rate for teens served in their facility is below the state average. They focus on pediatric issues in general but specifically look for iron  deficiency, asthma, overweight and obesity problems and encourage physical activity in children.
Adolescent issues that they address include chronic depression, alcohol abuse both chronic and binge drinking as well as counseling on date violence and bullying.
They have difficulty with recruiting providers for their facility. Primary care in general is declining as a specialty of choice. The low rates of reimbursement for primary care services by government as well as private insurance programs make it difficult for young doctors with high medical school debts to work at facilities with low pay rates. AMC works closely with the government to find programs of loan forgiveness for primary care physicians that are serving in federally qualified health centers. AMC also relies heavily on family nurse practitioners and PAs (FNP's/PA's) to provide many of their primary care services.
Most, if not all, of the people working at AMC want to be there regardless of the low pay rates and high volume of work demanded. The entire staff has a service mentality that respects and supports the health care needs of every patient coming to the facility.
Those Club members interested in reading the entire community health needs assessment document can refer to the website listed earlier in this document.