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A new health center is coming to Roanoke Island.

Joseph Rockenstein, chief executive officer of Ocracoke Health and Engelhard Medical Centers, made the announcement at the Sept. 13, 2022, meeting of the Health Care Task Force formed by the Board of Commissioners of the Town of Manteo.

The two existing medical centers are federally qualified health centers with the mission to create whole-person care without any financial barriers, serve the underserved and bridge the gap in health care for Medicaid, Medicare, uninsured and underinsured people.

That mission is spelled out by the Health Resources and Services Administration that governs these health centers. Locally, a board of directors is in charge of the health centers. Patients must comprise 51% of board members.

Rockenstein said these medical centers are the “best health care models for primary care.” They are “focused on quality not quantity.”

Patient care is a focus of the task force, created by an access to care crisis.

On May 23, 2022, Vidant’s Outer Banks Family Medicine sent 2,418 patients at the Manteo practice letters saying the medical practice could no longer provide care to individuals who received the letter. The letter included a list of practices accepting adult patients. The practices were all out-of-county because it was reported no primary care practice in northern Dare County is accepting new adult patients. Outer Banks Family Medicine has since opened a waitlist for impacted individuals as it brought in one new provider and will soon have another.

The Engelhard practice offers a whole person approach to primary care. Medical professionals address all patient issues, not just the one issue that sent someone to the doctor’s office.

The health care plan presented by Rockenstein calls for two to three medical providers, five to six clinical personnel like nurses and lab workers and administrative personnel.

Federally qualified health centers feature closed pharmacies with medications only available to center patients. Rockenstein anticipates that existing pharmacies will experience a small impact.

The plan eventually calls for meeting mental health needs and providing dentistry services.

Medical services are provided on a sliding fee scale based on a patient’s ability to pay.

Medical centers look to build partnerships with medical service providers.

The Engelhard center has an outreach program. Medical professionals visit homes. The center provides transportation. The Engelhard center made provisions with the Salvation Army to deliver food to those patients who are food insecure.

Rockenstein called the health centers the “model of the future” as it allows for affordability.

One physician is already on board. Dr. Jennifer Harrison is now employed by the Engelhard Medical Center and will move to the Roanoke Island/Manteo center when it opens. Applause erupted from the large audience, as Harrison previously worked at the Vidant Manteo practice.

“We need to give people choice,” said Rockenstein.

Betty Jo Shepheard, representing U.S. Senator Richard Burr, jumped up saying the senator has always been supportive of federal funding for medical centers. She lauded the health care centers as “the very best health care you can get.”

North Carolina Senator Norm Sanderson asked about area served. The Engelhard Medical Center serves patients from five different counties was the answer. For an appointment, the wait time is two weeks.

Dare commissioner Rob Ross said he can typically get an appointment in less than two weeks. The answer was the daily schedule sets aside four same-day appointment times for folks needing services.

In response to a question from Dare Public Health director Sheila Davies, Rockenstein detailed the percentages of current patient mix by visits: 43% are Medicare and Medicaid patients, 7% are self-pays and 50% have commercial insurance.

If a patient needs a specialist, the medical center functions like a regular practice and makes an appointment or referral.

A medical center can have contracts with medical providers, such as dentists, who accept the center’s sliding fee scale or already have a comparable or better sliding fee scale.

The Ocracoke Health Center and Engelhard Medical Center are merged and do business as the Engelhard Medical Center. The Roanoke Island/Manteo practice would be incorporated into this corporate structure. A search is underway for a medical center location and/or facility in or close to Manteo.

The meeting started with a summary presentation from Davies about the 2021-22 Dare County Community Health Needs Assessment.

Access to health services is on the assessment’s watch list.

Some 27% of survey respondents reported access to healthcare issues and 54.2% of those respondents reported the access issues were related to primary care providers. Some 37.7% reported access issues to specialist care and 27.3% reported access issues to dental care.

Over half of survey respondents with access issues reported not being able to get an appointment; 27.4% said the wait was too long or that COVID-19 was a barrier.

Residents to provider ratio shows in 2021 Dare County had a 1600:1 ratio when North Carolina had a 1400:1 ratio of primary care providers. For mental health providers, the ratio was 610:1 for Dare County and 390.1 for North Carolina. On non-physician primary care, Dare County had a 1280:1 ratio while the state had a 750:1 ratio.

The dentist ratio was the only one where Dare County beat the state: Dare County was 1480:1 and North Carolina was 1720:1. Davies cautioned about this statistic that includes all licensed dentists in Dare County, whether or not they are practicing.

At the end of the meeting, the task force adopted an organization structure. Kevin Phillips will head the patient care committee. Randy Finninger will chair the recruitment and retention committee. Dare commissioner Jim Tobin will lead the facilities committee. Manteo commissioner Tod Clissold is in charge of project funding.

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