photo by: Mike Yoder

A hallway mural at Heartland Community Health Center's new facility features artwork by Lawrence artist Stephen T. Johnson. The mural includes photographs of people using American sign-language to spell "Heartland."

It makes sense that the largest piece of art in the new medical clinic for Heartland Community Health Center features hands.

It is an approximately 40-foot-long mural by local artist Stephen T. Johnson that depicts a line of diverse hands spelling out the word “Heartland” in American Sign Language.

Heartland is nothing if not about hands. The nonprofit’s mission involves providing a helping hand to people who can’t afford quality health care.

“If we weren’t here, I’m not sure where some people would go,” said Julie Branstrom, chief development officer, for Heartland Community Health Center. “A lot of them would end up in the emergency room because they would be worried about being denied care somewhere else.”

So, it is not hard to understand why Branstrom was drawn to the idea of a piece of artwork featuring hands of all shapes, sizes, ages and colors being a centerpiece of Heartland’s vastly updated and expanded home at 1312 W. Sixth Street in central Lawrence.

“I wanted a piece of art where everybody could feel like they could see themselves in it,” she said.

But you also could understand why the center could have also added one other piece of famous hand art: The old Uncle Sam poster with the most famous of pointing fingers and the message “We Want You.”

Heartland didn’t hang that art on the wall, but the center definitely does want a new batch of patients to come to the new location. A key part of the moving project — which completely remodeled the former Anderson Rentals building at Sixth and Michigan streets — was to present a new image of Heartland that made it clear the center wasn’t just for the uninsured but rather was for everybody in the community.

“I hope this facility will lend confidence to patients who have insurance to know that they can be our patients too,” Branstrom said of the facility, which opened last week.

Instead of an old poster, though, Heartland thought it could be more convincing with a lot of brand new things. Those include an 80-seat waiting room that features a modern check-in desk, plus self-service kiosks, if you don’t feel like interacting with a person upon arrival. It includes 36 primary care exam rooms — a more than 100% increase from Heartland’s former location — equipped with everything from video screens to state-of-the-art electric lift examination tables. And the location also features a large parking lot, which visitors to the center’s former location near perennially-congested LMH Health can appreciate.

All that hopefully paints a powerful picture to new patients, Branstrom said.

“I think what patients are going to notice first when they walk in is a beautiful, new, state-of-the art facility,” she said.

That hasn’t ever been the case at Heartland’s previous location at 346 Maine St. Branstrom said the offices were worn and contributed to the image that Heartland wasn’t a medical center for everyone.

“I think that is one of the obstacles we really have to overcome,” she said. “It already is hard enough when you have the image that Heartland is the clinic for poor people. That is hard enough to overcome on its own, but then when you have a facility that is older and a little bit rundown, it sort of furthers that misconception that patients aren’t receiving quality care.”

Branstrom said that is why Heartland leaders — along with the building’s owners and major project donors Tom and Marilyn Dobski of the local McDonald’s franchise — spent so much time thinking about design details of the center.

“I think this building is a real game-changer,” Branstrom said. “I think this will really change how Heartland can deliver services to our patients.”

Under one roof

While the new furniture, fresh floors and latest equipment might be what stands out to visitors, the approximately 140 employees who run the center may appreciate something more fundamental — the roof and all the different type of health care providers underneath it.

The new center allows Heartland’s three main types of service providers to be under the same roof. That means traditional family care physician offices are next door to what is likely the largest dental office in Lawrence, plus a team of behavioral health specialists also are located in the building.

“It is part of a whole person treatment plan,” Branstrom said. “All of the disciplines and providers will work together to address the needs of the whole person.”

Branstrom, who previously was the leader of the Douglas County Dental Clinic before it merged with Heartland, said she knows that sometimes a dentist and a family practice doctor need to consult before a procedure can be completed, for example.

In the past, such an occurrence could easily lead to a patient coming in for a procedure only to have it delayed — a hassle for anyone but a particularly burdensome one for a low-income patient who perhaps had to take a day off work or make special transportation arrangements to get to the appointment.

Now those consultations can be as simple as the various providers walking down the hall to get the information they need.

That working shoulder-to-shoulder philosophy is a key one in the design of the center, Branstrom said. The building includes four medical pods for its primary care providers. Each pod — they are named after the four seasons and are painted in colors reminiscent of each season — features one large workspace area for doctors, nurses and other providers. There are no individual offices for the physicians; instead, their work stations are in a common area with nursers and other practitioners.

“The idea is it will foster more collaboration between providers,” Branstrom said.

Amenities and more

Of course, doctors do have private exam rooms for patient visits. The number of exam rooms is one of the largest changes in the new facility. The new location has 37 primary care exam rooms, up from 17 that Heartland had at its old location. Many of the new exam rooms also come equipped with a new type of motorized exam table that providers can lower and raise to help patients with mobility problems get up and down during an exam.

Other features in the facility include:

• Fourteen exam rooms for dental care. Each dental room is equipped with a video monitor that allows a dentist or hygienist to show X-rays and other images directly to a patient.

“It will allow them to talk about oral health with the patients, and maybe show them what they need to do a little differently,” Branstrom said.

photo by: Mike Yoder

Heartland Community Health Center’s new facility includes areas for dental care.

photo by: Mike Yoder

Mollie Day, chief dental officer, right, and Erin Bates, left, work Wednesday, Oct. 20, 2021, to move into the dental clinic area of the new Heartland Community Health Center facility at 1312 W. Sixth St.

• Six private offices that can be used for one-on-one counseling by behavioral health specialists on staff with Heartland. Branstrom said therapy type of sessions are sometimes the type of care behavioral health specialists provide at the clinic, but other times it is more collaborative with doctors. For instance, a behavioral health specialist can work in conjunction with a family practice doctor to help a patient better understand the importance of a smoking cessation program or other type of improvement class. In those types of cases, behavioral health specialists will be able to quickly and directly go into the family practice exam room, since they are located in the same building, Branstrom said.

• An in-house pharmacy will open in 2022. Branstrom said the pharmacy will have its own name — River City Pharmacy — and will be open to the entire community. The pharmacy will be just down the hall from the doctors’ offices, meaning patients can pick up prescriptions shortly after their appointments. The pharmacy also will have a drive-thru lane.

More importantly, Branstrom said, the pharmacy will be part of a special federal program that allows the pharmacy to sell drugs at reduced prices to people who meet certain income guidelines. The program, known as a 340B program, does require patients to apply and meet certain requirements. But for those who qualify, the savings can be large.

“Sometimes there will be something that costs hundreds of dollars versus $15 here,” Branstrom said.

The old location of Heartland did have a makeshift, in-house pharmacy that participated in the 340B program, but Branstrom said the new space will allow the pharmacy to greatly expand the number of drugs it can stock.

“We basically had a medication closet at the old location,” she said.

photo by: Mike Yoder

The new Heartland Community Health Center facility has a pharmacy and includes drive-thru access.

• A food pantry open to the community is located on the west side of the building, and will be run in conjunction with the Lawrence-based food bank Just Food.

“It really will function as a satellite location for Just Food,” Branstrom said.

The food pantry is situated so patients can walk through the store-like spot after their appointments, or people from the community can enter the space through its own entrance on the west side of the building.

A partnership with the AmeriCorps organization will provide employees to staff the food bank anytime that Heartland is open to patients.

photo by: Mike Yoder

Heartland Community Health Center’s Care Cupboard is pictured from outside the new facility.

photo by: Mike Yoder

Heartland Community Health Center’s Care Cupboard will include a shopping floor. Through a partnership with Just Food, it will offer a broad selection of fresh fruits, vegetables, bread and ready-to-eat items.

• Heartland will temporarily use a portion of its old space on Maine Street to serve as a special clinic for patients who are exhibiting symptoms of COVID-19. Branstrom said the center was locked into a lease at the space for the next 14 months, so it decided to use the space by creating a COVID response unit. The center will do testing for COVID, respiratory treatments, and will be an important way to keep potentially contagious COVID patients separated from other patients using Heartland.

Caring for all

The amenities make Heartland look much more like some of the larger health care centers in Lawrence, but Branstrom said Heartland still will have a mission that’s different than an ordinary doctor’s office.

The center long has offered its services on sliding fee scale. The price of your service is determined based on how much income your household receives. That sliding scale is available even to patients who have health insurance, given that many health insurance plans require a sizable out-of-pocket payment for many services.

“We have had patients who have come in and they can’t even afford the nominal fee that we charge at the bottom of the scale,” Branstrom said. “We treat them because we are not going to turn someone away because they can’t pay. We just aren’t going to do that.”

Heartland receives about $1.8 million a year in federal funds due to its status as a “federally qualified health center,” a type of safety-net health provider. It also gets some local government funding, with Douglas County commissioners currently considering an approximately $250,000 funding request.

But those funds make up a small portion of Heartland’s overall finances. Branstrom said the organization has a $15.3 million operating budget, and interim CEO Julie Schmidt recently told county commissioners that the organization’s finances had improved enough that it was now at least operating at a break-even level, with opportunities to improve upon those numbers.

A big part of the improvement is based on how many insurance-holding patients the new facility can attract.

“We need to be mindful of our payer mix,” Branstrom said. “We can’t just serve people without insurance. Our doors would not stay open that way. It is really important that some of our patients have insurance.”

She said the clinic particularly “would love” to have more patients with Medicare and Medicaid because as those patient numbers increase it improves the overall reimbursement formula the federal government uses to pay the center.

Branstrom said with a new location and more modern offerings, the center will really start making its case to area residents about how using Heartland can make you feel better in two ways — one by the care you receive, and another by knowing that any fees a patient or their insurance company pays to Heartland is used to help provide care to the uninsured.

The latest Census estimate from the 2019 American Community Survey estimated about 8,000 Douglas County residents had no health insurance. Without Heartland, Branstrom thinks wait times at the lone emergency department in the county at LMH Health would be significantly worse, and so would the health of thousands of people who simply wouldn’t be getting care at all.

“I think Douglas County is really fortunate to have Heartland here,” she said. “If Heartland were not here, there would be a lot of folks having a very hard time figuring out where to go to access basic medical care.”

photo by: Mike Yoder

Workers put finishing touches on the entrance to Heartland Community Health Center’s new facility.

photo by: Mike Yoder

The main lobby at the entrance to Heartland Community Health Center’s new facility.

photo by: Mike Yoder

This view of Heartland Community Health Center’s new facility shows the admissions and check-in area at left and lobby waiting rooms in foreground and background.

photo by: Mike Yoder

To help people navigate Heartland Community Health Center’s new facility, hallways will include color-coded walls and large directional signs.

photo by: Mike Yoder

The new facility includes more space for staff working areas and team offices. Julie Branstrom, chief development officer, is pictured inside a team office area, background right.

photo by: Mike Yoder

One of the new examination rooms at the new Heartland Community Health Center facility at 1312 W. Sixth St.

photo by: Mike Yoder

The large waiting room at Heartland Community Health Center will feature a “donor wall” recognizing people who have contributed donations for the center. A temporary donor display is currently on the wall.