From solo practicioner to community health clinic

ARLINGTON - One of Bennington County's last remaining solo practitioners is hoping to transition his practice into a community health center.

Dr. Michael Welther, 61, has operated a private medical practice for more than a quarter-century, but feels the time has come to restructure it for the long-term.

"My practice is small and it's not likely I'll be able to recruit any one to replace me. I'm not ready to leave but I have to start thinking about it," he said. "It's hard to find new medical students who want to come to a small town and try to make a living based on how busy they want to be."

The answer lies in transforming his present office, known as the Arlington Family Practice, into a federally qualified community health center. This center already has a name - the Battenkill Valley Health Center - plus a board of directors, which voted Monday, Feb. 25, to authorize a fund-raising campaign to bring in about $600,000. This would be enough to open the doors of the new not-for-profit clinic, which could offer an expanded array of services that would include dental care, pharmaceutical and mental health services, alongside the traditional physician practice, said Mary Ann Carlson, the chairwoman of the clinic's board of directors.

About $150,000 has already been raised. Their goal is to get the clinic up and running within the next six months, she said.

Once the clinic has opened its doors and has an established track record, the directors plan to apply for eligibility for federal reimbursement as a health center "look-alike" designed to serve federally designated communities deemed to be medically underserved. The Arlington-Sunderland-Sandgate area is one such underserved area, and the only one in Bennington County, Carlson said.

According to the U.S. Department of Health's Web site, a "look alike" health clinic is designed expand public access to quality primary care services consistent with all statutory requirements, but do not receive ongoing federal funding.

Such "look-alikes" do allow for added federal reimbursement for an expanded range of services, and are not competitive grant applications, Carlson said. About three years into the future however, the board hopes to complete the clinic's transition to a fully federally qualified community health center, she said.

"We're looking at a time line of about three years and we understand that to do the initial look-alike application we'll have to be up-and-running," she said. "The state (of Vermont) has been open (to this) and they want these centers - they dovetail with where the state is going in healthcare policy." Obtaining the look-alike status would be a stepping stone to eventually qualifying for a federal grant for a full-blown community health center, Welther said.

At present, there are eight other such community health centers which operate a total of about 40 satellite offices. Bennington County is the only one in the state without such a program.

An earlier attempt Welther launched about two years ago to transition to community health clinic foundered when the competition for federal dollars need to make the transition proved extremely intense. Even with strong support from Sen. Bernie Sanders - whose support for the initiative has been steady and ongoing, Welther said - only one application for such a clinic was approved at the time across all of New England, he said.

The important thing for area residents he currently serves to understand is that he is not going anywhere or planning to retire in the immediate future, and that their primary health care needs will continue to be met by his practice, and then by the nonprofit health clinic.

"The idea is to broaden access," he said. "What has to happen is the (nonprofit) board has to take over the practice."


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