BRISTOL — For roughly half a decade, a local nonprofit has sought to set up the Addison County Dental Center, a dental facility for low- to moderate-income citizens. Now, with Bristol health facilities shifting spaces and one clinic applying for special federal status, chair of the center’s board, Peg Martin, thinks the nonprofit’s stars might finally align in Bristol.
Martin and the center’s board want to work with town officials to obtain federal funding to set up a dental center in the Park Street building that Bristol Internal Medicine is leaving.
Around five years ago, the dental center received $200,000 in federal funds to set up a Middlebury facility. But the board still needed one thing: a dentist. Over a several-year period, four prospective dentists turned away from the job due to what board members said were tough economic times. Martin explained that typical Medicaid reimbursements for dentists are very slim.
“If you had an all Medicaid practice you’d be out of business because Medicaid simply does not pay enough,” she said.
The organization wasn’t able to fill the space its board had planned to occupy, and the space was rented out to another eager tenant.
Around the same time, the Five Town Health Alliance (5THA) — a Bristol-based nonprofit dedicated to providing universal health care in Addison County — began applying to become what’s known as a Federally Qualified Health Center (FQHC) to create a health facility for patients from a range of socioeconomic backgrounds. Such status would have equipped the 5THA with $650,000 in start-up funds and provided benefits like enhanced reimbursements for Medicaid and Medicare patients, better drug prices, and access to a range of grant and loan opportunities. As an FQHC, the 5THA would also be required to provide dental services.
The dental center and 5THA boards began talking. If the 5THA received FQHC status, the dental center would provide those necessary services, and its dentist or dentists would receive a higher reimbursement for treating Medicaid patients.
Although the 5THA wasn’t awarded the funds in 2011, it recently received about $110,000 from the state Legislature to apply for “FQHC look-alike” status, which would not bring with it the hefty start-up money or some of benefits that an FQHC would. Such status would, however, bring in those high federal reimbursement rates for Medicaid and Medicare patients, which appeals to the dental center board, said Martin.
The 5THA won’t apply for FQHC look-alike status until the end of September, but the dental center board is looking to set up a facility in Bristol and team up with the new 5THA center, which will be run by Mountain Health Center — reincorporating in September as a nonprofit under the 5THA umbrella to meet federal standards.
The issue for the dental center now is that the $200,000 in grant money, which it received through the Vermont Community Development Program, is no longer valid because the center wants to use the funds in Bristol, rather than Middlebury. Since the grant program allocates the funds through a municipal body, the program won’t administer those funds to a separate body under the same application, said Martin.
To apply for such funding again, the dental center needs Bristol’s help.
THE TOWN’S ROLE
On Monday, Martin met with the Bristol selectboard at their biweekly meeting.
“We are planning to move from Middlebury to Bristol in large part because of the efforts around the 5THA,” Martin told the selectboard, pointing out that Bristol and the four surrounding towns have been without a dental clinic for many years.
Although the center has about $250,000 — more than $100,000 from fundraising and about $143,000 from money earmarked by Sen. Bernie Sanders — it needs funding for equipment. That’s where a Vermont Community Development Program grant would come into play.
But there’s a hitch: The dental center can’t receive the money directly because the program only allocates funds to municipalities.
“If we were successful in getting a grant, you folks would be the entity that receives the grant and passes it along,” Martin told the selectboard. “This is not without a fair amount of bureaucracy, unfortunately … We don’t want to be a burden on the town of Bristol, and we think we have a service to offer to the people of this area that is valuable.”
Bill Bryant explained the grant arrangement in a separate interview.
“We would be the grantee,” he said. “We would receive the grant funds, but then we’d actually be using the money to grant it to the Addison County Dental Center.”
Meanwhile, Porter Hospital’s Bristol Internal Medicine clinic is moving to the Bristol Works campus, which means their current facility — once a dentist’s office — will become vacant.
“It was set up originally as a dental office and it hasn’t change much since,” said Martin in a separate interview. “So in terms of the physical rehab that would need to be done, there isn’t much … It’s also close to the 5THA and within walking distance of the high school, assuming we’d be serving a kids’ population, which we’d like to.”
Martin’s aim in meeting with the selectboard on Monday was to provide preliminary information to the town’s highest government body. Nothing about the project is set in stone at this point, but none of the board members batted an eye. All of them appeared to support the idea.
Martha Halnon, new director of the 5THA and Mountain Health Center, also pledged her support to the center in a separate interview.
“Speaking for the 5THA and Mountain Health Center, we’re very excited about this collaboration and the potential to provide this service,” she said. “It would make a huge impact for the area since we have no dentists, and it’s very difficult for low-income and uninsured patients to get the care they need.”
The dental center’s board is planning to submit an application in December for grants ranging from $200,000-$300,000. The center would then find out if it had received the funds by Feb. 14. If the development program supports the nonprofit, Martin said the center would be up and running by the end of summer 2013.
As for a dentist?
“We have a commitment from a very fine dentist who would start out at three days a week,” said Martin.
Reporter Andrew Stein is at firstname.lastname@example.org.