PART TWO: The need never ends …Healthcare needs, staffing go different directions

Cindy Peavey uses a unique analogy to describe the demand for health-care services versus the availability to provide it.

“It’s like trying to feed the masses with one fish,” said Peavy, executive director for Arbor Family Health Clinic, a federally qualified health center that provides health services in Pointe Coupee, Avoyelles, and Iberville parishes.

Growth of the healthcare entity – which provides for insured and underinsured/uninsured patients – coincides with an increase in the need for those services.

Demographics and social data from the 2020 census showed Pointe Coupee Parish with a population of 22,016 and a median annual household income of $41,480.

It shows the poverty rate at 20.3 percent.

In 1998, the Pointe Coupee Hospital Service District prepared a Need and Demand Assessment for expansion of primary health-care services for the Innis area in the northern end of the parish – a portion of the parish high in poverty and severely limited in health-care access.

The 1998 assessment findings led to the 1999 incorporation and establishment of a board of directors and a nonprofit status that led to the opening of the Innis Community Health Center Inc.

It was rebranded as Arbor Family Health in December 2017.

In the process, Arbor brokered relationships with Pointe Coupee Medical Center and other providers to help meet the needs of the community.

The same assessment in November 2020 showed the most significant gaps in services were the absence of physicians and a lack of access to primary, dental and mental health-care services.

In the same year, the United Health Foundation’s America’s Health rankings determined Louisiana to be the least healthy state in the country.

It was based on health outcomes that include premature death, frequent mental and physical distress, premature death and low birthweight.

It also covered behaviors, including sleep nutrition, sexual health and tobacco use.

Additionally, a 36.8 percent obesity rate ranked Louisiana fourth in the nation in that statistic, for which it has ranked in the top 5 percent of obese states in the past five years.

It shows 43.5 percent of black adults and 32.9 percent of white adults are considered obese, and it’s primarily concentrated in rural areas.

Medicaid and the uninsured comprise 50 percent of the Arbor patients, but many of the AFHC patients have private insurance.  

“It’s not just for the uninsured or those on Medicaid – it’s for the whole community,” said Jeanine Thibodeaux, AFHC president.

“Where we go with this is that we try to see where the gaps are in care and try to enhance us.”

It's not just about physical care.

Behavioral health services have become a growing need in the parish, particularly with children.

The needs range from children with ADHD, behavioral health issues, social issues, peer pressure and home issues.

It’s a fast-growing portion of the FQHC, not just from the underserve, but from all walks of life, Thibodeaux said.

“There’s a high need in the school system and we’re also trying to meet the needs for everyone else,” she said.

“We added a psychologist who does telehealth for us with our patients, but he can manage medications and extend the diagnosis, so we know exactly what we’re dealing with.

“Having a psychologist helps us to better manage those with intense needs, where they have better medication management.”

It’s a service rarely found in a rural area, but Arbor – as with many other clinics – face an underlying challenge.

Many patients can barely drive from a small community to New Roads.

They have a limited radius for transportation, and other issues such as gas prices and taking off work or not owning a car all factor into the accessibility issues.

“Those issues are extra burdens, and when you look at the economy and the stress on the whole population, it’s making the situation more difficult,” Peavey said. “Anything we can do to bring it home and keep it here helps.”

Arbor has seen a gradual increase in the number of behavioral health patients, and the need for those services has grown.

Staffing shortages have hit small communities particularly hard.

Arbor has three openings for social workers, as the referral and needs get higher by the day.

Those positions have been open for three years.

“It’s a struggle to increase the number you’re seeing when you’re dealing with the shortage,” Peavy said.

“Hiring three social workers would take some of the burden off the backup of patients,

“We’re serving the masses and we have a lot of opportunity, but we could do a lot more if we had more hands on-deck,” Peavy said.

The demand is even bigger than meets the eye in the northern end of the parish.

A drive down La. 1 toward Avoyelles Parish suggests it’s an area meager in population.

It’s not the case, Peavy said.

“You don’t see how populated it is when you’re driving down Highway 1, but it’s a substantial-sized community with limited access and health care, and when they started the community, they wanted to address an area heavily populated, yet woefully underserved.”

That’s why they started in Innis, she said.

“As we’ve grown, we started to realize that if we can offer discount services and have a one-stop shop for healthcare, take care of dental, behavioral health,” Peavy said. “We track what zip codes take care of our clinic.”

The patients don’t come only from Pointe Coupe Parish. Some drive from Avoyelles, Iberville, West Baton Rouge and even East Baton Rouge parishes.

In Iberville Parish, the town of Maringouin –a once-bustling town – is woefully underserved.

Yet, many consider it closer and more feasible to go to Innis, Peavy said.

It’s not just doctors that we need,” Thibodeaux said. “It’s clerical, it’s nurses and others.”

“I feel like the rapture came and I got left behind,” Thibodeaux said. “Where did everyone go who needed to work, including clerical and everyone else?”

It’s the biggest challenge Arbor, and virtually every other clinic across America faces, Thibodeaux said.

“It’s across the nation, but you have to try to find the talent, recruit the talent and move the talent,” she said. “The talent doesn’t want to move into a rural community, and with the shortages and the number of jobs and the number of jobs out there, people want to stay right where they’re at or stay in the bigger cities or those adjacent to them … it’s a struggle."

At the same time, the need remains great, and the focus is on growth and greater availability to services.

NEXT WEEK: A look at growth plans and working relationships.