our mission
To improve the health of our community by providing high quality, caring, culturally appropriate primary health care that addresses the needs of people regardless of their ability to pay.
Front Cover and all Annual Report photos: 2010 Amos Morgan Photography, www.amosmorgan.com
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dear friends,
Country Doctor Community Health Centers is celebrating its 40th year of providing healthcare services to our community. This year and next are shaping up to be the most challenging in our history. The number of people in Washington who have no health care continues to increase as the economy and job growth remain stagnant. As Federal, State and Local budgets are cut to reduce deficits, Country Doctor finds itself on many of these lists of cuts. The reserves that were set aside over the years to meet challenges like the one we now face are being called on in the face of massive cutbacks by the government, and we are working harder than ever to find new sources of funding as well as continuing to bring the case for meaningful healthcare reform to our representatives at the Local, State and Federal levels. As a patient of Country Doctor Community Clinic for over 10 years, I cant begin to tell you how important this organization has been to me. When I was a single parent in school and with no insurance, Country Doctor was there for me when I needed a doctor. Now as a patient with health insurance I continue to go to Country Doctor because the care I have always received is first class. Along with all of our Board members, I feel a special calling to do whatever I can to make the services of both clinics Country Doctor Community Clinic and Carolyn Downs Family Medical Center available to the people who will need them in the future. Country Doctor and Carolyn Downs will continue to meet our mission to offer quality affordable healthcare without regard for the patients ability to pay, and our Board of Directors will continue to work to meet the challenges we face now and in the future. Your support, past and present, has been an essential part of meeting our mission. On behalf of the Board of Country Doctor Community Health Centers, thank you for your help. Sincerely,
ACCOMPLISHMENTS
During 2010 Country Doctor Community Health Centers (CDCHC) maintained focus on its three primary goals, increasing access to patient care, providing care of the highest possible quality and developing the strong financial systems and diversified funding sources needed to achieve the previous goals.
2010 was again a year of growth for CDCHC. Overall the medical program increased the number of visits provided by 6% and the number of individuals seen by 8%; of great significance was the achievement of the Carolyn Downs Family Medical Center (CDFMC) medical team in 2010 the CDFMC site provided 11% more visits than in 2009! A GREAT SUCCESS in terms of working to maintain future access to care was the addition of the Swedish Medical Centers Cherry Hill family medicine residency
The increase in patient visits at the CDFMC site was the result of the addition of 5 new exam rooms in July. This was part of a remodel funded with Stimulus dollars which also expanded provider office space for the new residency program and allowed us to make some significant, structural repairs to the Country Doctor Community Clinic (CDCC) site. These improvements were all made without closing the clinic sites for even one hour both patients and staff deserve great praise for their ability/willingness to work and receive medical care in a construction zone, while our contractor (Aldrich Construction) deserves accolades for their collaborative, sensitive approach to working in a clinic setting.
CDCHC was accredited by the Joint Commission for the FIFTH time with minimal findings. In 2010 CDCHC also achieved six of eight clinical goals: CDCHC enrolled 85% of pregnant women into OB care during the first trimester increased the number of 2 year olds that are fully immunized to 79%, 5% higher than goal increased the number of diabetic patients with HgbA1c levels under 9 to 78%, 4% higher than goal increased to 54%, 9% above goal, the number of hypertensive patients with blood pressures less than 140/90, and achieved a 67% level of providing fluoride varnish to children between 1 and 2 years of age a 37% increase over 2009!
program at the CDFMC site in July. We welcomed two first year residents with great excitement but little disruption to patient care. The CDFMC site is now Cherry Hills third community-based residency site, joining SeaMar Community Health Center and Seattle Indian Health Board.
Challenges: the success of CDCHCs private development program was especially important given the challenges of maintaining public funding and providing care to increasing numbers of uninsured patients.
The success of increasing access at the CDFMC site was tempered somewhat by the alarming 33% increase in sliding scale visits at that site and a 12% decrease in patient payments. The CDCC site had a similar experience with virtually no change in the number of patient visits, it saw a 7% increase in sliding scale visits and the same 12% decrease in patient payments. 2010 state budget cuts resulted in a 21% reduction in the volume of maternity support services visits, and gradually eroded enrollment in the Basic Health Plan from 541 in January, 2010 to 400 in January, 2011, a 26% loss. One of the impacts of Basic Health Plan changes is the need for eligibility staff to spend extra time with many Basic Health Plan enrollees to try to maintain their BHP enrollment at recertification time.
CDCHCs relatively new maternal behavioral health program experienced significant growth during 2010 by the end of the year 1,112 women were screened for depression almost twice the number anticipated. One unfortunate result of screening more women is identifying more who would benefit from counseling or other interventions. As the number of women who screen positive grows, identifying agencies to which to refer them especially for those who speak languages other than English becomes more and more difficult. Many of these agencies experienced funding cuts similar to those experienced in 2010 by CDCHC and have weeks-long waiting lists.
DIVERSIFYINg FUNDINg
2010 was a good year for CDCHCs private development program. For the second consecutive year the private development program exceeded expectations in most areas an achievement that is particularly significant given the economy and its impact on many CDCHC supporters. The second annual special event netted $102,119, approximately the same amount as in 2009, despite slightly reduced attendance. Annual giving exceeded expectations by 99% (!), major gifts by 47%, and grants by 47%. Additional support came from the Strangers Strangercrombie fundraising effort and the Eat Out in Columbia City event.
21% Administrative
79% Program
REVENUE SOURCES: Federal . . . . . . . . . . . . . . . . . . . . . . 17% City . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15% County . . . . . . . . . . . . . . . . . . . . . . 1% State . . . . . . . . . . . . . . . . . . . . . . . . . . 4% Patient . . . . . . . . . . . . . . . . . . . . . . . 53% Private . . . . . . . . . . . . . . . . . . . . . . . 7% Other . . . . . . . . . . . . . . . . . . . . . . . . . 3% Total Expenses: $11,469,912 (Audited)
*Included in these visits are 3,993 Health Care for the Homeless primary care visits at the CDCC site and 2,381 at the CDFMC site. **Included in these visits are 1,593 Health Care for the Homeless health maintenance visits provided at the shelters.
PATIENT DEMOGRAPHICS
PATIENTS BY COVERAgE
SELF PAY MEDICARE MEDICAID PRIVATE INSURANCE BASIC HEALTH
THANK YOU TO OUR VOLUNTEERS Heather Barr Jeanne Chamberlain Julie Conklin Mary Curiel, MD Sue Fleiger
6% 6% 6%
3% 2% 3%
PATIENT ETHNICITY
ASIAN BLACK CAUCASIAN HISPANIC OTHER
Elizabeth Grande Alice Hall, Pharm. D. Kate Homewood Sarah Hufbauer, MD Bobbe Kovar Monica Lake
4% 4% 4%
6% 5% 6%
gENDER
MALE FEMALE
Sarah Lesko, MD Angel Mathis Debra Monroe Laura Morgan Ly Sieng Ngo Ray Padilla
RESIDENCE
CAPITOL HILL CENTRAL AREA OTHER SEATTLE KING COUNTY OUT OF COUNTY
Justin Pat Tammy Peterson Carrie Rubenstein, MD Chau Tran Astra Doty Vargas Cameron Winter Raleigh Watts
7% 5% 8%
Lane Youngblood
8% 5% 9%
10% 5% 12%
AgE
0-4 5-12 13-19 20-44 45-64 65+
5% 8% 3%
4% 7% 3%
4% 6% 3%
4% 4% 3%
Dr. Megan DeBell saved my life. If you guys didnt have an on-site colposcope, I would be dead.
After years of employment with health insurance benefits, Bridget found herself without insurance. At the same time, she knew something was wrong but without insurance or the money to self-pay, she ignored her symptoms for several years. A friend, knowing there were resources out there, encouraged her to be proactive and do something about this! Bridget recalled with a knowing smile. A colposcopy during her first visit with Dr. Megan DeBell in May 2009 showed that Bridget had invasive cervical cancer. She was immediately referred to a specialist at Seattle Cancer Care Alliance for surgery. In 11 days I went from avoiding my health problem to having my life saved! Though Bridget now has a job with health insurance, she continues to see Dr. DeBell. I know these doctors could work elsewhere but they dont, they choose to work at the clinics.
After a month of outside counseling, Marjorie, to her credit, was ready to swallow the pill of reality
Marjorie arrived at Country Doctor as a new Seattle transplant overwhelmed with numerous anxiety issues. According to her provider Eileen Petralia, ARNP, Marjorie was convinced the anxiety was due to hormonal changes, that she was going through menopause. In reality, Marjorie wasnt going through menopause, but was abusing alcohol. It was her vehicle for dealing with the real issues in her life that were causing a high level of depression and despair. After a month of outside counseling, Marjorie, to her credit, was ready to swallow the pill of reality, as Eileen describes the situation. Marjorie joined a gym, stopped drinking, and was ready to take antidepressants. She opened up to Eileen, and Eileen learned that her patient was genetically predisposed to depression and had suffered previous social and emotional stresses. Marjories trust of her provider and counselor combined with her commitment to an ongoing medication regime resulted in radical improvement in just a month, says Eileen, who is very pleased with Marjories progress. Several months later, Marjorie is doing really well. Marjories clinic visits are down to just a few times a year. In the words of her provider, Marjorie has gone from barely functioning to fully functioning. Eileen continues, Marjorie sent me a holiday card. It was the first one Id ever received from a patient. Ill keep it forever.
OUR DONORS
Joan Kleinberg and Phil Katzen Laboratory Corporation of America Scott LaMontagne Susan Leavitt and Bill Block Tanya Martinez-Lemy McKinstry Charitable Foundation Linda McVeigh Microsoft Matching Giving Program Peter Morgan and Raleigh Bowden, MD Jeffrey Ofelt and Wade Weigel Carol Pencke The Polyclinic Lynn Rowland, DDS George Sandison Schiff Foundation Schwab Charitable Fund Seattle Childrens Hospital Winnie Sperry Greg and Bronsa Swint David Taft and Dana Persson-Taft The Philip and Julia Meshberg Family Foundation The Radia Fund Sara Thompson, MD and Richard Gelinas Tulalip Tribes Charitable Fund Raleigh Watts Wells Fargo Foundation Michael Westley Catherine Holmes Wilkins Charitable Foundation Kevin Wold
$500 $999 Joe and Kay Beavo Deborah and Richard Berger Robin DeBell Jason Eintracht, MD and Tara Eintracht Pat Clayton and S. Frederickson Sam Cullison, MD Gino Gianola and Esther Herst Paul and Alice Hill Sarah Hufbauer, MD and David True, MD Diana Judson Kaplan-Nelson Fund Kinsella Construction
Janet and Eric Kormondy Mikael Kvart and Sascha Dublin Bonnie Lemert Jeni Mallinen McKesson Clara Nicon John and Joann Nicon Freddie Overstreet, MD and Gordon Hicks Michael and Susan Peskura August Piper, MD Bruce Pulmano Carrie Rubenstein, MD and Justin Roberge Joe and Barbara Shickich Kathy Smith-DiJulio and Donald DiJulio Dr. and Mrs. Matthew Studer Gayle and Jack Thompson Tutta Bella John Von Lossow Dana C.G. Walker & Associates, AIA George and Shirley Wallace Karen Watts and Mark Harris Jodie Wohl, MD and Rich Hert
$100 $499 Anonymous (4) Anonymous, In honor of Emily Woodrow Elaine and Thomas Adams Richard Ahern Emily Bader Brad Barkin Debra Barnabee Mary Bartolo, In memory of Peg McVeigh Bill and Melinda Gates Foundation Matching Gifts Amie Bishop Claire Bishop Pamela and Raul Borromeo
Addie and Greg Brandenburg, In memory of Peg McVeigh Charles Carosella Deb Carstens, In honor of Mr. Jerrett Sale Abie Castillo, In honor of Peg McVeigh Judith Cederblom Christa Chambers Patsy Chandler Janine Childs Benjamin Chotzen Bruce Clurman Keith Collins Julie Conklin Community Health Plan, In honor of Peg McVeigh Elizabeth Coveney Mary Curiel, MD, In honor of anniversary of Sonja Olson Feuerborn and Nathan Feuerborn Hal Cutting Lloyd David Patricia Dawson Colt de Wolf Megan DeBell, MD Mark Diamond and Deborah Perluss Mary Dickinson Jeri and Douglas Donnelly Guru Dorje Patricia Doyle Catherine Duke Pamela Dunn Bill Duroe Cheryl Ellsworth and Walter Sive Employees of King County Linda Endicott Ann and Michael Erikson Marlys Erikson and Chris Hurley Linda Evans Patrick Ferguson John Flinn Foster Pepper PLLC Jeffrey Frank Full Tilt Ice Cream Teri and Joe Gaffney Eugene Garrett, Jr. Carol and Adam Geballe Jennifer Gee
OUR DONORS
Geraldines Counter Penn Gheen Carl Russell Goedde Courtney Goodheart David Grainger Dean Grainger Lyn A. and Brian Grant Rolf Gruen William Gunther Steen Halling, In honor of Jan O. Rowe Wade Harmon, In honor of Peg McVeigh Rae Hayashi and Bruce Pulmano Judith Hennes Paul Herstein Katie Hester and Sarah Smith Susan Hester Highmark Matching Gifts Program Dale Hoff Paula Hooser Pauline Houx Doug Hughes John Hughes Michele Hughes Elizabeth and Lance Hunsinger, In memory of Peg McVeigh Reese Imworthy International Community Health Services Amy Isaacson Dean Ishiki Island Soul Restaurant Fiona and Jim Jackson Doug Jackson, DMD, PhD Robert Jarmick Doug Johnson Rebecca and Damani Johnson Sarah Johnson and David Huston Robert Kaplan and Margaret Levi Paul Kassab Stacy Kessel Eva Khan David Kimelman Jane King, MD and Allen Cheadle Elizabeth Kister Dan Klabunde Josephine Klevit, In memory of Harvey Klevit, MD
Becki Kniveton Johannes Koch Peter Kolb Mary Kollar Rimma Kopyt Bobbe Kovar, In memory of Florence and Morris Levine Richard Kovar, MD and Bernie Creaven Roberta Kovar Roy La Croix la medusa Jeff Landrum Lease Crutcher Lewis Matching Gift Sandra Lee Leonard Lemm and Alfonso Soriano Katrina Leonard, MD and Robert Kraft Tom Linde and Mary Weiss Roxanna Lopez Lotties Lounge Marc Allen Lowe and Kathy Kearney Peter Mabee Theodora Mace and L. Stone Christopher Malarkey Stephen and Laurie Markowitz Bill Marks, MD Richard Marks and Spring Zoog Gillian Marsden and Ros Bond Christopher Mathews Peter McCormick and Kathleen Albrecht Taffy and Dick McCormick Colleen and Peter McGough Ann McKee and Dale Hoff Cecil McLennan Megan Melo John Mensher, MD Ingrid Michelsen Hal Moore, MD Jean Moore David Morris Trisha Muller Ly Sieng Ngo Clara Nicon, In memory of John Nicon on his birthday John and Joann Nicon, In memory of Ruthann Maxine Bergeron
John and Joann Nicon, In memory of Teagen Densmore on the occasion of completing her post graduate education John and Joann Nicon, In memory of John Dimos John and Joann Nicon, In memory of Edouard Gardneau John and Joann Nicon, In memory of Anna Miller John and Joann Nicon, In memory of Albert Reichert John and Joann Nicon, In memory of Arnold Taub North by Northwest Entertainment Rebecca Over Bill Parson Jamie and Eric Pedersen Angela and Steve Pelletier Susan Peters John Hall Philo and Evelyn Hall PTSO of Washington, In memory of Peg McVeigh Melissa Rabelhofer Emily and Dan Raymond Guillemette Regan Megan Reitz Donna Richman and Mike Ehrenberg Carol and Bob Riede Diana Roberts Jennifer Robertson Shiquitta Roberts-Williams Brad Roter, MD Jeff Rueckhans Steve Savage Eric Schinfeld Elizabeth Schuh Barbara Schwartz Carrie and Grant Scull Linda and Mark Secord, In memory of Peg McVeigh Gerry Seligman Tina Shereen and Gerald Seidler Pamela Shortlidge-Jones Laura and Noah Silver Theodore Sive Karine Smith Benjamin Smith Paul Smith, MD
Tricia and David Spach, MD Sam Sperry Spice Room Linda Stemler Suzanne Sutton, In memory of Gary Stein Kiyomi Taguchi Susana Tantico Stephen Tarnoff and Suzanne Kotz Dorothy and David Teeter Connie Thompson and Don Roberts Cesar Torres and Mariko Lockhart Chau Tran Trent Family and Clifford Trent Reiko True Helen Tsao and Mark Gibson Verve Wine Bar Alison Voinot Jeff Warner, MD Washington Association of Community and Migrant Health Centers, In honor of Peg McVeigh Georganne Washington Jack Weinberger Caroline Wildflower Jennifer Clarke Wilkes Cameron Winter Yakima Neighborhood Health Yakima Valley Farm Workers Clinic Rodney Zani
UP TO $99 Anonymous (4) Edward Baiter Amy Bannister Emile Belliveau Kate Bennett Nari Benson Pamela Blakely Nancy Blase, In honor of their dog Norton, Alison Voinot and Rick Rosenberry Laurie Boroughs Laurie Brown Joy Bryngelson Hazel Carlough, In memory of Peg McVeigh
We have made every effort to be accurate and complete. Our apologies for any misspellings or omissions. 10
C.B. and Jean Carlson Patricia Clearly Bonnie Collins Costco Matching Gift Program Jessica Crabb David Craft Jeff Crowl Sian Cullen Kathleen and Tom Cunningham Mary Curiel, MD, In honor of anniversary of Sonja Olson Feuerborn and Nathan Feuerborn Zach Damm Barbara DeCaro Diabetes Research Group Claire Dietz Jennifer Doak Wayne Dodge and Larry Kreisman Paul Eriks, In honor of John Nicon on his birthday Debra and Ken Fantel, In memory of Peg McVeigh Daniel Fathi Myra and Larry Faust Lee Ferguson Sonja Olson Feuerborn Colin Fields William Freeberg Leslie Frosch Michelle Gantz Amy Gardner Birgit Grimlund, MD Warren Guntheroth Virginia Hassinger Carla Helm Judith Herrigel Rita Holland, In honor of anniversary of Sonja Olson Feuerborn and Nathan Feuerborn David and Jane Huntington Courtney Jeanpierre Clara and Joybelle JohnsonEriks, In honor of Bob and Karen Johnson Hoven Carole Jordal Kevin Kaul Chris Kawakami James Larson Alan Lederman, In memory of Peg McVeigh
Wai King Lee Scott Leonard Barbara Luecke Hugh Lurie and Edythe Bruce-Lurie Gary MacDonald Judy and Jim McAteer David McComas Corinna McDonald Marilee McGuire Ohlendorf Chris McKay, In honor of anniversary of Sonja Olson Feuerborn and Nathan Feuerborn Don McVeigh, In memory of Peg McVeigh Richard McWaters, In honor of Peg McVeigh Natalie Meacham Patricia Melgard Betty Mercure, In honor of anniversary of Sonja Olson Feuerborn and Nathan Feuerborn Vincent Micelotta Sam Miller Jacob Moody Jacob Mooney Tiffany Nelson and Carol Sterling Diane Ngo Meang Ngo Paula Lee Nodtvedt Barbara Nordin Cathleen OFarrell Maxim Olson, In honor of anniversary of Sonja Olson Feuerborn and Nathan Feuerborn Robin Ozerkis Pamela Parker Will Parry, In honor of my son, Jon Parry Tammy Peterson Michael Peskura, In memory of Cheryl Dineen Judith Phelan Hilary Pickerel
James Prince Regence Employee Giving Campaign Kristin Richardson Sami Sbitani, In honor of Dr. Michael Giuli Eugenia Sheldon Brian Sheppard Lissa Shook Ruban Sivanesan Linda Sorensen Sound Therapy, Inc. Howard Springer, In memory of Peg McVeigh Ronald Stenkamp Terrell Stills Hally Swift Kalinda Thompson Mark Thompson William Treacy Julile VanArcken, In honor of anniversary of Sonja Olson Feuerborn and Nathan Feuerborn Sol Villarreal Jeffrey Walton Mathew Wanderski Loretta Wasse William Watts Charles Wenig Nancy Worssam and William Seach Polly Zetterberg John Zmolek and Jerry Jutting
IN-KIND DONORS
Alison Allgor Amos Morgan Photography Cheryl Anderson Mari Anderson Emily Bader Heather Barr Big Dipper Wax Works Lauren Brown Sheila Burroughs Lisa Capaldini, MD Chocolopolis D. W. Clark Susan Costa Colt de Wolf Megan DeBell, MD Pamela Dunn Henry Ehrenberg Jason Eintracht, MD
Patrick Ferguson Kitty Flaherty Noreen Forck Gail Gatton glassybabys Nichelle Hilton Sarah Hufbauer, MD Fiona and Jim Jackson Jones Design Studios Sarah Johnson Lela Joseph Nancy Josephson Carla Kepler Laura King Joan Kleinberg KOMO TV 4 Bobbe Kovar Rich Kovar, MD Wendi Kovar Alicia Kramer Bob Lesko Heather Libman Timothy J. Lorang, Image Media Partners McCallum Print Group Laury McKean Linda McVeigh Jo Moniz Hal Moore, MD Mary Morgan Ly Sieng Ngo Shonnie Noma Tammy Peterson August Piper, MD Trish Ratcliff / Mary Kay Cosmetics Ricks Toys for Kids Jerry Sale Mary Sammy Jamie Shanks Winnie Sperry Paula Stokes Greg Swint Susana Tantico Connie Thompson Sara Thompson, MD Helen Tsao / Go2Design.com Paula Weiber Mary Weiss Rickie Wolfe The Womans Century Club Lane Youngblood Deanne Zink
Thank you!
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Country Doctor Community Health Centers 500 19th Avenue East Seattle, WA 98112 Working together for the health of our communities