Published: April 13, 2008 12:39 am            

Officials believe they have remedy for rural area’s ills

CHEROKEE — How do communities address the problem of health care in rural Oklahoma?

A lack of facilities, a lack of primary care physicians, a lack of physician assistants, a lack of nurse practitioners, a basic lack of health care centers and hospitals exist in many areas. In some cases, residents in these areas have to drive 45 minutes or more to receive health care.

The solution may begin with clinics and health care centers like Great Salt Plains Health Center in Cherokee.



‘There was a need here’



After Alfalfa County Hospital in Cherokee closed in 1993 due to lack of funding, the city was left without a source for health care. The closest health care op-tion for most residents in Cherokee was Enid, an hour away, or Alva, a 30-minute drive.

Residents of Cherokee would go without a health care center or hospital for 15 years. The dubious streak ended Jan. 14 when Great Salt Plains Health Center opened.

“We were federally designated as a medically underserved area,” said Tim Starkey, executive director and CEO of the facility. “The federal government targeted the 50 lowest income counties in the nation for potential sites for health centers. There was a need here.”

The center has six exam rooms, used primarily for primary care purposes, although ultrasounds can be performed, as well. MRI’s and X-ray patients are sent out to other hospitals.



‘Staffing is a challenge’



Great Salt Plains Health Center staff consists of one doctor, an OB/GYN, who comes once a week; a full-time nurse; and two to three other nurses, including one physician’s assistant. Help always is needed, Starkey said. He is looking to bring more medical professionals in, which has not been an easy task in rural areas anywhere in the United States.

“We have had the same difficulties as any health care facility,” Starkey said. “The important point is we qualify and are eligible for the National Health Service Corps as a medically underserved area for graduates to warrant loan forgiveness. It makes it a little easier.”

Starkey said he is using recruiters to try to bring in primary care phy-sicians.

The center also is interested in recent medical school graduates and could use first-year residency students.

“Staffing is a challenge,” Starkey said. “We are really looking right now.”



‘Starting slowly ...’



Starkey and Crystal Rose, Great Salt Plains director of nursing, are hopeful they will be able to expand the center to include several rooms currently not being used in an adjacent building connected to the center. The health center building used to be part of Alfalfa County Hospital. With this, Rose and Starkey could try to attract different types of doctors, including psychiatrists and substance-abuse counselors.

Expansion already has begun. Residents will be able to receive dental care beginning Friday. Two dentists from surrounding areas will come to Cherokee for appointments.

“Starting slowly, right now, we are looking at a mobile dental service,” Starkey said. “As the business increases, we are looking at bringing the dental service in-house.”

Starkey said the amount of service dentists will provide will be up to them, speaking of root canals and surgeries.

One service the health center will not be providing, though, is emergency services. The facility just is not set up for that kind of service, he said.

“We definitely are available, but we don’t want to represent ourselves as an emergency room,” Starkey said. “We provide primary care outpatient services, not emergency services.”

Right now, the health center can accommodate anyone, including walk-in patients. This means patients will not have to put up with long waits and won’t be turned away.

“We will take all the new patients that will come our way,” Starkey said.

This includes pediatrics, although the center doesn’t have a pediatrician on staff right now. Rose said some examples of what they can do currently are varicella vaccines for chicken pox and hepatitis B and tetanus shots. They are hoping to bring a pediatrician on in the near future.

‘We accept all insurance’



The health center is open 8:30 a.m. to 5:30 p.m. Monday, Tuesday and Friday and 8:30 a.m. to 12:30 p.m. Wednesday and Saturday. It closes Sunday.

Rose said the center accepts any insurance, Medicare, Medicaid and Sooner Care.

“We accept all insurance,” she said. “That is very important, because we go based upon the federal government sliding scale fee. We are also going to participate in the 340B drug program.”

The federal government has allotted the health center a $600,000 grant for the first three years. Last year was the first year of the grant. Rose said if the hospital is going to expand, donations are something they really will need.

The grant also stipulates a certain amount of patients each year to maintain the facility.

That is what Rose and Stark-ey say they hope will happen with the prog-ress of care the facility is providing patients.

“I would like for us to be the sole clinic provider in this area,” Rose said. “I would like for people to say, ‘There is this great clinic in Cherokee, where they have doctors that come in who are wonderful, and the prices aren’t bad.’ I would love for people to say that, and my hope is we can expand into that.”