Congressionally Directed Spending for Construction Projects - The proposed Clinic Expansion and Residency Training Project aims to improve healthcare access, quality, cost efficiency, and workforce availability for some of the most vulnerable and chronically underserved residents of Aiken County and surrounding communities. Led by the nonprofit Rural Health Services, Inc. (RHS), this project is a $6 million effort to expand an existing federally qualified health center (FQHC) by building and outfitting a 20,000 square foot, state of the art maternal and child health clinic that will double as a training hub for a new family medicine residency program that launched last year in partnership with Aiken Regional Medical Center (ARMC). The $421,465.76 RHS is requesting in congressionally directed funds through the Fiscal Year 2023 appropriations cycle will be used acquiring medical equipment and supplies necessary for the expanded FQHC to reach full clinical functionality ahead of its expected opening in mid-2024, while RHS has committed to finance the other construction portion of the project from its resources. The Georgia-Carolina borderlands of Aiken County and the neighboring counties of Edgefield, Barnwell, and Allendale have a long history of medical neglect relative to nearby Augusta, GA, and the City of Aiken, reflecting persistent socioeconomic disparities and traditionally limited access to regular primary care. According to the most recent Census Bureau data, median household incomes in Aiken County's rural municipalities are more than 40% lower on average than in the City of Aiken. In comparison, Edgefield County rural incomes are 52% lower, and median incomes in completely rural Barnwell and Allendale counties are 33% and 53% lower, respectively. The community’s poverty is sustained and compounded by a lack of education—rural Aiken and Edgefield municipalities combined with Barnwell and Allendale counties average 11.8% of adults with a four-year degree—which is an imperfect but broadly accurate proxy for basic health literacy on a large scale. The consequences of basic health illiteracy are evident in chronic disease prevalence. Over a third of Aiken County residents are obese, and 13% are diabetic (matching statewide levels). Still, the percentages rise further from the city: 38% and 18% for Edgefield, 41% and 18% for Barnwell, and 37% and 22% for Allendale. These figures are inversely proportional to the ratio of primary care physicians in each jurisdiction, which limits residents' ability to diagnose, monitor and control their health conditions with simple outpatient check ups before an untreated disease (or comorbidities) becomes a costly visit to the emergency room at public expense. The entire four-county region falls under HRSA federal medically underserved area (MUA) and Health Professional Shortage Area (HPSA) designations for primary care, and the ratio of primary care physicians to resident ratios range from 1:2,710 in Edgefield County to 1:5,280 in Barnwell (versus 1:1,490 statewide). This is the core of the public health problem that the Clinic Expansion and Residency Training Project is designed to address by expanding not only the reach and supply of health services in the area but the pipeline of doctors necessary to ensure its viability in the long term. Cohorts of family medicine residents from a newly accredited GME program at Aiken Regional Medical Center (graduates of the Virginia College of Osteopathic Medicine) will spend half of their time during each of their four years of residency rotating through RHS's Clyburn Center for Primary Care, an FQHC in Aiken County. Experiential training at the Clyburn Center will be conducted under the preceptorship of RHS’s doctors and advanced practice registered nurses. Training will occur at the Clyburn Center for Primary Care and the maternal and child clinic, the onsite expansion that congressionally directed funds would help finance by offsetting the cost of medical equipment.
