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Keystone Health
Center, a community health center at 820 Fifth
Ave., Chambersburg, opened for business in
1998.
By Lynne Newman Chambersburg - In 1986, Joanne Cochran embarked on a volunteer mission, helping a local doctor care for migrant workers one day each week. Fourteen years later, she heads a health center with a budget of nearly $9 million a year. Cochran is president and CEO of Keystone Health Center, which opened in 1998. When she moved to Chambersburg in 1980 with her husband, Bryce Cochran, an emergency room doctor, she was told there were no medical services available for poor people because there were so few poor in the county. "Health care has always been available in Franklin County if you speak English, have money, own a car and don't have a disease like AIDS," said Cochran. "The truth is that an overwhelming number of uninsured and medically underserved live right here in our backyard." A nurse who was once a Sister of Mercy, Cochran has made it her lifelong mission to provide medical assistance to the less fortunate. Cochran finds it amazing that the last census indicated nearly 2,500 Hispanics live in Franklin County, while her center treats more than 5,000 a year. "Hispanic people live and work in Franklin County - they are no longer just migrants. Many moved here from the cities because of the tons of entry-level jobs at $5 to $6 an hour as short-order cooks, dishwashers and janitors." They are people who do not have insurance or the money to go to doctors. Some of those who are treated at the health center have not seen a doctor in as long as 25 years, according to Cochran. When she began volunteering to help a family practitioner who opened his office one evening a week to treat migrants, she found one night a week wasn't nearly enough. "In 1986, we started Keystone Migrant Health Center in my basement. Within three years, we had moved to four different locations, each bigger than the last," she said. Originally, the program provided health care for migrants five months a year, June through November, when the workers were picking vegetables and fruits. But by 1989, so many people were in need of services that the center began staying open all year. Cochran accessed medical care for those who needed it through a variety of sources. Her husband, an emergency room physician at Chambersburg Hospital, introduced her to a number of doctors who could provide specialized care, and Dr. George Baker, a family practitioner in Fayetteville, came on board. Cochran's husband died in 1998, on the day Keystone Health dedicated its new 17,000-square-foot building. Today the program had evolved into Keystone Rural Health Center, a public, non-profit organization that employs more than 100 physicians, nurses and staff members and provides quality health care to individuals and families with and without health insurance. The center is just one part of a system that includes a women's center, a dental center and a satellite medical office in Path Valley. Keystone is one of only 5 percent of the health centers in the nation to receive joint accreditation, which means it has passed quality controls in a number of different medical disciplines. Keystone also operates the State Migrant Farmworker Administration Office, which aids farmworkers in all of Pennsylvania. Cochran said the growth of the system is a testament to the need for accessible health care in the county. In 1992, the practice treated 500 patients. Today, the system treats more than 40,000 people a year, not all of whom are low income, underinsured or uninsured. The transformation from an independent office that treats migrant and seasonal farmworkers to a federal qualified health center arrived in December 1994, according to Cochran. "I got Franklin County to be declared a health professional shortage area and a medically underserved area, which entitles us to the use of public service physicians." Public health service physicians are doctors who pay back the federal government for help with medical school bills by donating their services after they finish their schooling. It also qualified the entire system for federal health service grants. Currently, Keystone Rural Health Center generates the majority of its revenues through services paid by Medicaid, Medicare, health maintenance organizations, and private insurance companies. She said 50 percent of patients are poor, but the other half is paying patients with medical insurance. The poor patients pay on a sliding scale, with fees discounted anywhere from 25 to 100 percent. "What they pay is based on their family size and income. Some pay $5 a month, but the bottom line is we never deny access to anyone." The center also is a safety net for people who have been laid off and have lost their medical insurance. The $9 million budget is a "break-even" budget, with very little cushion if something goes wrong, according to Al Berberich, the chief financial officer. "This past year, we wrote off $947,000 through our sliding fee scale and an additional $499,700 in bad debts," said Berberich. "That's a lot of debt when you're trying to balance a budget." Cochran worries about how the center is going to be able to afford to take on additional patients. "In one year, our sliding fee use had doubled," said Cochran. "Each month, we worry about how we are going to pay our bills." "Our patient base goes up each month. From January to February, we had 550 new patients in just the family practice portion, while we had 248 new patients at the same time at our dental center." Keystone Rural Health Center has established an endowment fund named after Cochran's late husband. "The endowment fund is small, and only the interest can be used to fund the operations of the center," said Berberich. Cochran is hoping people will donate to Keystone Health Center to continue to fund the day-to-day operations. "They can specify where their donations go," added Cochran. Many doctors go overseas to help the poor in other countries, noted Cochran. "But there are poor in our own backyards who need help, too." Editor's note: Contributions may be sent to Keystone Health Center, 820 Fifth Ave., Chambersburg, PA, 17201. For more information, call 263-4313. |
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