Smooth transition

For nearly two decades, Enloe Medical Center has operated a pediatric clinic in Chico. It hasn’t been a big moneymaker—in fact, it’s a money loser, part of what the hospital considers the “community benefit” it provides—yet the Children’s Health Center has remained important to administrators and physicians alike.

That hasn’t changed, even as the clinic transitions to new ownership. Enloe spent the better part of a year arranging the transfer to Northern Valley Indian Health, another nonprofit health provider, which is committed to preserving all that’s made the Children’s Center so special. The name of the center will even remain the same, minus the word “Enloe”—it will be called the Children’s Health Center.

Enloe announced the transition earlier this month, and depending on the timetable of state regulators, NVIH could take over as early as Oct. 29. The pediatricians on Enloe’s medical staff unanimously approved the decision, which meant a lot to hospital decision-makers. After all, pediatricians played a major role in the establishment of the Children’s Health Center and continue to see patients there.

“It was the physicians who brought them up in the first place,” Enloe Vice President Aaron Wood said of NVIH. “The pediatricians came to us and said, ‘Hey, we know their providers and the reputation they have.’ I’m not a clinician, but from a business standpoint it was a no-brainer. From a clinical standpoint, the physicians have all been on board from the get-go.”

Dr. Patrick Tedford is one of the pediatricians who helped launch the Children’s Health Center. He called the transition to new ownership “inevitable” because of the economics of primary care at a clinic where government insurance covers the majority of patients.

“The Enloe Children’s Health Center, because it’s hospital-affiliated, gets twice as much [from Medi-Cal] as the private pediatrician does to see a patient in their office; Northern Valley Indian Health gets roughly three times as much [being a federally qualified health-care facility],” Tedford explained. “That’s really the reason this is being done.

“We really need to acknowledge Enloe for the dedication, work and monetary loss they felt over the last 19 years. Through all that, they remained really supportive of the children’s center. No one needs to feel that they were bailing out on these patients. They in fact are putting the facility in what they recognize is a better situation.”

NVIH offered jobs to all 34 current employees, and the vast majority are staying at the children’s center. The pediatricians will continue to rotate into the center each weekday afternoon to treat complicated cases. The social worker who splits time between the hospital and the center will continue to do so.

Moreover, NVIH has committed to hire a full-time pediatrician for the center and in a few years move the operation to NVIH’s planned new facility.

“I think of the children’s center as a well-running organization,” said Dr. Andrew Miller, medical director of NVIH. “Our job is not to come in and change it; our job is to add what we can and try to stay out of the way.

“We take this community responsibility seriously. It’s important to us, and we realize how important it is to the community, so we intend to make it thrive.”

The Enloe Children’s Health Center opened in 1993. The demand for pediatric services outpaced the ability of pediatricians to meet the need, so many children in families on Medi-Cal were not receiving primary care.

“A group of pediatricians were concerned at the time that we were sending people out of the nursery with no good follow-up and no good place to have their babies seen for well-baby care,” Tedford explained. “The idea of the children’s center came about, where the patients are seen by nurse practitioners and we supervise.”

Without the children’s center, these families would flock to the emergency room for treatment. With the children’s center, more patients received preventative care and also had a place to go besides the ER when they did become ill.

Wood said that “340,000 patients later, it’s become a very respected clinic”—albeit one that “the hospital has operated at a significant loss.”

Enter NVIH, which last year celebrated its 40th anniversary. NVIH operates family-medicine clinics in Chico, Red Bluff and Woodland.

“We had heard that Enloe was interested in finding another organization to manage it, and a good functional children’s center is in the best interest of our Native [American] population,” Miller said. “At least half of our Native kids get their care there, plus it’s a vital community service we wanted to make sure remained. So our interest was really two-fold.”

As an FQHC—federally qualified health-care—facility, NVIH gets larger payments from Medi-Cal. Miller said, “We’re hoping that higher reimbursement rates will allow us to protect those services and even expand them.”

Enloe and NVIH have much in common. Both are nonprofit health providers. Each has a board of directors featuring community members. Both serve roughly the same area of the North State.

Moreover, both treat all comers. NVIH may have been founded by Native American tribes, but its clinics do not discriminate.

“Frequently we have people who are concerned that because our name is Northern Valley Indian Health that we just see Natives,” Miller said. “We’re trying to get the word out that at the children’s center we will see everyone—and at our other clinics, we already see everyone.”

That’s just one reason why Enloe sees the transition as what Wood calls a “win, win, win”—good for the medical center, good for NVIH and good for families.

Tedford believes in the move just as strongly.

“I’m glad that it’s worked out this way for everybody,” he said. “The people at Northern Valley Indian Health are very caring, very patient-oriented, very tuned in to take care of people. And they were very willing to take on the model of the children’s center the way it is, so we [pediatricians] all feel they’re likely to keep the same level of medical care that patients have been receiving for the last 19 years.”