One Community Health (OCH), a Federally Qualified Healthcare Clinic (FQHC), with an active H80 grant (H80CS00426), has been providing healthcare for the past 36 years in the Pacific Northwest. We provide care to all without question of ability to pay, but with a focus on those who are medically underserved, the Migrant Seasonal Farmworkers, American Indians and those who are low income. Our service area of Hood River and Wasco Counties in Oregon and Klickitat and Skamania Counties in Washington are HRSA-defined rural and designated Healthcare Provider Shortage Areas. Since the pandemic we, like many other healthcare clinics, have struggled to provide timely primary care. Appointments for new patients are typically scheduled 29 days out, for well child checks the wait time is 41 days, physical exams are 31 days out, and so the list goes on. For those on Medicare/Medicaid or low income, we are the largest provider of care in our service area, and delays such as these impact many in our communities. We have hired providers, we have increased our scheduling efficiency and now we are faced with the only option left, to increase the hours that we are open. Through this application, we will increase our operational hours at 3 of our 5 main clinics as follows. 1). We will add Saturday hours to our Express clinic in The Dalles, Wasco Co., OR. This clinic was opened in 2023 to allow walk-in patients to be seen by a healthcare professional. We will increase the operational hours of this clinic to be open every day except Sunday. All will receive care on the same day from a team of providers of different specialties, and if they need a referral to a different healthcare professional for their next steps, this will be put in place. 2). Ease of access and to accommodate patient demand, particularly for behavioral health as part of primary care, we will add Sunday hours to our clinic in White Salmon, Klickitat Co., Washington, again making obtaining healthcar
e easier for those with weekly commitments such as schoolchildren and working family members. These Sunday hours will be staffed by both medical and behavioral health providers and nonclinical supporting staff. 3). We will also add 2 full days to our mobile medical unit (MMU) schedule to be able to address the needs of those who cannot get to the clinic. At a minimum, the MMU will be staffed by a medical provider able to deliver Medications for Opioid Use Disorder and supporting staff. A Peer Support Specialist, a Community Health Worker and a Behavioral Health Consultant may be included as needed for the Correctional Facility and houseless populations we will visit during these hours. We will also add capacity hours at 2 of our main clinics as follows: 1) We will add early morning hours of pediatric-focused and general primary care to our main clinic at The Dalles at 7am, a more convenient time for those who must get to work and take care of their family. 2). We will add capacity for primary care on Saturdays at The Hood River clinic with primary medical care, including gynecology-focused specialists, to provide more access for the women of our area to obtain care. This increase in clinical operations will be supported by non-clinical and administrative staff to create a seamless expansion of service. By adding these operational and capacity hours at 5 of our clinics, we will increase access to high quality primary care that is designed to meet the needs of all in our community.