Archer Family Health Care
Ensuring quality health care for a community.
Archer, Florida, is a quiet little town about 15 miles outside of Gainesville. There is one stop light and two gas stations, and many of the streets remain unchanged since the town’s founding in 1850. The University of Florida College of Nursing has been an integral part of this Archer community, starting with community health nursing student rotations back in the 1970s.
In 2001, the community had been without a medical or health-care facility for more than three years. Poverty, a lack of preventive health care and scarce transportation contributed to high rates of death and chronic disease in the area. Residents turned to UF to for assistance, and it was no surprise that Gator Nursing stepped up to the challenge.
In 2001, the college envisioned a dream to bring quality health care to a local community in desperate need of affordable primary care and mental health services for its underserved residents. Archer Family Health Care, or AFHC, was born and has become a national model for nurse-led practices, providing over 6,000 patient visits a year and giving valuable learning experiences to nursing, pharmacy and medical students.
But numbers don’t tell the whole story. Behind those 6,000 patient visits are people who have developed relationships with their providers, staff and students at the practice. Patients whose entire families have benefitted from the nurse-led practice that entered the community 16 years ago.
“When I was first diagnosed with my Charcot foot I was working full-time, but I could not afford the insurance that the job offered,” James said. “When I was finally told that, medically, I had to quit and get off my foot or I would lose it, I was devastated. I was sitting there without any insurance, and no way to get help.”
AFHC was the miracle they needed. It gave both James and Clarissa, who was also diagnosed with type 2 diabetes, access to care and medications needed to treat their diabetes. James was also able to get a referral to the Malcom Randall Veterans Affairs Medical Center in Gainesville to treat his Charcot foot. He is still a regular patient at AFHC, where they manage his diabetes.
“Most importantly they treat me with respect,” James said. “They work with me—not talk at me—to develop a plan to fix my health care problems.”
In 2007, the original clinic was too small for the growing patient population and growing services offered. Another round of private fundraising, federal grants and a commitment by the college resulted in a new building, with over 5,000 square feet of space. Providers and staff were expanded to include an additional family nurse practitioner, a mental health nurse practitioner, a licensed practical nurse and a financial assistance counselor. At that time, the practice implemented a state-of-the-art electronic health record. Financial assistance counselors are on site to help patients find resources whenever possible. Federal grants are written and submitted continuously to help sustain and expand services in this underserved community. Private donations help offset costs of medications and equipment. When the roof leaked at the new practice location, donors stepped up to cover the cost of repairs.
“We have been able to help patients recognize and manage their chronic diseases despite limitations in financial resources. We have worked to provide primary care services in an area that is lacking quality, low-cost heath care options. Since 2001, we have provided integrated care for patients in need of both primary care and mental health services,” said Denise Schentrup, D.N.P, ARNP, lead nurse practitioner and the college’s associate dean for clinical affairs.
Providing access to quality affordable primary and mental health care and health professions student training are the primary goals for this rural practice. Patients depend on the practice to help them connect to community resources to ensure health. The UF College of Nursing has remained steadfast in its commitment to the health of this population, stepping up to fill a huge gap in services. Patients travel from all corners of Alachua County and six surrounding counties for treatment.
In 2014, AFHC was awarded a Health Resources & Services Administration, or HRSA, grant. This funding took AFHC beyond the traditional primary care model. AFHC was able to pilot a unique interprofessional care model, of which some patients like James Green are a part. The nurse-led team has been able to directly address complicated patients and identify resources to help them manage diseases like diabetes, chronic obstructive pulmonary disease and depression. The team, including staff and providers, came together to take care of the entire patient. The HRSA funding allowed for the addition of a case manager, expansion of mental health services and the opportunity to work with a UF College of Pharmacy faculty member whose expertise in medication management and diabetes has impacted all of the patients on the care team. They have been able to include students from medicine, nursing and pharmacy on the team.
“We incorporated principles of interprofessional education and practice to the team. Students have been able to experience an interprofessional practice firsthand and apply principles learned in the classroom to real life experiences,” Schentrup said.
Electronic health records, interprofessional care teams, nurse-led patient care, filling gaps for underserved patients — the possibilities are endless for what the “little clinic that could” can do. Far from a small practice any more, the future of Archer Family Health Care is limitless.
Lillie Fox, an 80-year-old patient, feels as if the staff at AFHC is there whenever she needs them. Fox, a resident of Archer, suffers from kidney problems. A lack of transportation prevented her from accessing care in Gainesville, so the practice has been a huge asset for her.
“I don’t have transportation to medical facilities so having them around has been amazing,” Fox said. “I feel like I can call Archer Family Health Care at any time and they are always there to answer my questions. And it’s not just for the Archer community but many others in surrounding areas as well. We live out in the country so there are not so many resources.”
In addition, more private dollars are needed to offset costs of providing care to patients like James and Clarissa Green and Lillie Fox.
“Nurses are often the missing link for patient care for those who need it most,” Schentrup said. “It’s been shown that advanced practice nurses are more likely to provide care in rural and urban underserved areas than any other primary care provider. We want to continue to inspire nurses across the country and show that places like Archer Family Health Care can provide quality health care for those who most need it and otherwise could not receive it.”
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