Editor’s Note: This is the second in a two-part series in which Profiles of a 3-Star Community focuses on Mountain People’s Health Councils. We began the series last month by discussing MPHC’s recent prestigious awards, as it was named one of the top community health clinics in America. In this second and final installment, we focus on the history and goals of Mountain People’s.
Mountain People’s Health Councils Inc. has roots in Scott County that date all the way back to 1965.
It was then, during President Lyndon Johnson’s “unconditional war on poverty,” that the community health center model was born as a way to make sure everyone from every walk of life had access to health care. And although it might not seem that the war on poverty has improved the gap between the haves and have-nots in the half-century that has followed, one place the gap has absolutely improved is in that access to health care.
In addition to the traditional physician’s offices in Scott County today, there are Mountain People’s clinics in Oneida, Huntsville, Winfield, Norma and Elgin. That means that one in Scott County — no matter which furthest-flung corner of the county they live in — is ever more than 15 or 20 minutes from an available health care provider.
It took a few years for Johnson’s vision of health clinics in every underserved community to make it to places like Scott County. But, in the early 1970s, Congress approved funding for health centers, and MPHC was born in 1974.
“The people of Scott County came together and in a partnership with Vanderbilt University brought providers to the area,” said James Lovett, who has served as CEO of MPHC for the past 16 years.
When Mountain People’s first started, the idea was to ease the burden of travel. In those days, it took well over an hour to get from Smokey Junction to Oneida on roads that were often rough and rutted, especially during the winter months. In the beginning, providers who were recruited to the community saw people in their homes. They would stay with board members and others who were a part of Mountain People’s. In fact, James Walker was one of the original MPHC directors, is still on the organization’s board today, and opened his doors to some of the providers when Mountain People’s first started.
“We had several of the board members that are still on the board today, and I don’t want to leave anyone out because there were several people who were very instrumental in bringing Mountain People’s to Scott County,” Lovett said. “But James Walker is an example. He talks about the times the providers would come in and stay with him.”
Eventually, the rural clinics as we know them today began to open. One of the United States’ very first health clinics in an underserved area, in fact, was the Norma clinic. That was MPHC’s first clinic, and the organization continues to operate that same clinic in the same location today.
“In 2021, certainly the roads have improved,” Lovett said. “But, you know, being able to get transportation and get to the doctor is still the same issue that it was back then. So we try to make sure we have locations that can get people close to where they are in their community. The main premise of what we do is make sure people can get care. That means both making sure people can get access to care, places you can get to easily, and also care that you can afford.”
The latter issue is where MPHC’s sliding scale fees come into play. The sliding scale payment system is central to everything the organization offers.
“It’s not just the sliding fee that we concentrate on,” Lovett said. “A huge share of our patients are private (insurance). They’ve got the Cadillac insurance program. We’ve got those, and we’ve got the people who have no insurance and couldn’t afford care if it wasn’t for Mountain People’s. We are just honored to have them all. Our goal is to make sure the county has the best health care that it can get.”
In recent years, Mountain People’s has undergone greater growth than at any other point during its 50-year existence. Lovett said that’s because there’s so much need within the community.
“Through the years, there’s been a lot of change,” he said. “Scott County was at one point certainly a proud coal mining community. We used to have a lot of big factories and things, but a lot of those things have gone away. But it’s still a community with proud people in it. People drive to Knoxville every day and come back here because they love where they live. Being able to provide the services that allow them to come back, that allows us to have the level of health care that they need, is very important to Mountain People’s.”
As part of that emphasis on all-encompassing services, MPHC has recently added a pediatric clinic, a dental clinic, and has added behavioral health to its offerings. As drug abuse has become a bigger issue over the years, the organization has also aded a MAT — Medication-Assisted Treatment — program for those who are battling addiction.
Lovett is especially proud of the behavioral health component of MPHC’s offerings.
“It’s real hard to live your best life if you have a mental health condition and you’re struggling with that,” he said.
Lovett points out diabetes as an example.
“Diabetes is so prevalent, not just in Scott County but everywhere,” he said. “You may have someone who can’t control their diabetes and we struggle to get it under control with their office visits. And you may find out later that maybe they’re depressed, which has a significant impact on your overall health. Once we’re able to get that depression or anxiety under control, it may be easier to control their diabetes.
“The flip side of that,” Lovett added, “is you may have someone who comes in to be treated for depression, and one of the reasons they’re depressed is they just feel awful all the time. Maybe that’s because of undiagnosed diabetes or another chronic health issue.”
Lovett said part of MPHC’s approach is to bust the stigma surrounding mental health.
“Do people have to see the mental health provider? Absolutely not. But it’s there,” he said. “And all of us run across situations in life where we might need a little help, where we might need to talk to a counselor. Diabetes isn’t a life-ending diagnosis, but it’s a life-changing diagnosis, and it’s one that can hit you pretty hard.”
So MPHC now utilizes a care team for its sickest patients. The care team consists of the primary care provider, a behavioral health provider, a case manager, a case coordination professional, and pharmacy services are also available.
“We utilize all of those working together as a team to provide the best level of care and help somebody who is struggling,” he said.
What is now offered by MPHC is probably something that even President Johnson couldn’t have envisioned back in 1965 when he had a goal of delivering health care to the poorest, most under-served communities in America. But there’s no doubt in the minds of Lovett and others that it is making a difference.
“If you want to know why community health centers like Mountain People’s exist, it is to make sure people have access to care,” Lovett said. “Why is that important? Because from a monetary standpoint, when people get sick and don’t have access to the doctor, they just get sicker. Over time that has a real negative impact on the individual, and eventually they’re going to get sick enough that they make it into the hospital which requires a great deal of services and a great deal of money.”
Reaching people before their chronic illnesses like diabetes, COPD and heart disease progress is a win-win for everybody, Lovett said.
“If we’re able to keep you healthy, you win,” he said. “And if we’re able to keep you healthy, we win from a taxpayer standpoint. And the community wins. If we can help make as many people in our community as healthy as we possibly can, that’s a win-win across the board.”
However much MPHC has evolved since 1974, it’s bound to continue to evolve. For Lovett and his team, there are always new issues to tackle and plans on the drawing board. He’s reticent to talk about them in terms of specifics, because the best-laid plans don’t always come to fruition. But, he said, Mountain People’s has no intention of resting on its laurels. There are more sick Scott Countians to care for.
“If there’s a need and an opportunity to make things better, we’re going to do our level best to make it happen. That’s what I can guarantee,” he said.
Some of those plans may come to fruition “fairly soon,” Lovett said, while others might take longer to realize.
“We’re just trying to figure out the best way to get them to Scott County, and not just provide the services but provide them at a high level,” he said. “I’m a firm believer that the people in Scott County deserve the very best, and we’re going to do our level best to make sure that they get them.”