More than Patient Care: UF Health Archer Family Health Care Celebrates 20th Anniversary
For 20 years, health care has just been the starting point of the practice’s involvement in the community.
When the Calloway family moved to the small, rural town of Archer, Florida, 11 years ago, mother, Dominique, was in search of a primary care provider for herself and her four children. Thinking there was no closer option than Gainesville, Calloway heard from a friend about a great clinic right in her community.
She decided to check it out. The Calloways have been patients at UF Health Archer Family Health Care, or AFHC, the College of Nursing’s nurse-led primary care practice, ever since.
Calloway feels that she and her family are more than just patients. After going to AFHC for about one year, a staff member approached her near the holidays and asked what her plans were. Calloway admitted she was worried about being able to afford gifts for the children.
“All of a sudden, they came to my house bearing gifts for me and the kids,” she said. “That Christmas, they made it so special because I did not know what I was going to do to fulfill the kids’ wishes for Christmas. It just so happens that they were my little personal angels. I love them for that.”
For 20 years, the AFHC team has believed providing health care is just the starting point of the practice’s involvement in the community. Adopting families for Christmas, sponsoring youth sports teams, participating in events and hosting health fairs are just a few examples of how the practice has helped shape the community over the years. College of Nursing students also receive one-of-a-kind education there through clinical and volunteer experiences.
“Our team is an integral part of health care in this community,” said Denise Schentrup, DNP, APRN, FAANP, associate dean for clinical affairs and the AFHC practice director. “We have been taking care of the community for many years, and it really shows in the way our staff and providers care for our patients. They remember the patients, they remember details about their family, and they really make them feel like they are at home when they come here.”
Answering the community's call
AFHC's founding director M. Dee Williams (center) with Archer community members at the ribbon-cutting ceremony for the practice's new building in 2007.
Although College of Nursing community health students and faculty were present in Archer schools and senior centers for decades prior, AFHC was established in 2001 after a resident spoke up about the need for primary care in the community. Instrumental in its establishment were College of Nursing administrators Kathleen Ann Long, PhD, RN,
FAAN, dean emeritus, and M. Dee Williams, PhD, RN, then-executive associate dean and associate dean for clinical affairs, who retired in 2013 and 2014, respectively.
During the practice’s first year, a full-time office manager and a full-time family nurse practitioner were hired, and 900 patients were seen in the “little house” — a 1,200-square foot rental property. Fast forward 20 years, and the practice has expanded to about 5,000 patient visits a year, with four nurse practitioners and five staff members in a
5,000-square-foot custom-designed modular building in “downtown” Archer.
Long, who was the dean of the college when the clinic was established, said Williams was the engine that made AFHC work, doing everything from punch lists when moving into the facility, lobbying for funding, presenting the nurse-led practice model at the national level, to engaging the local community.
“Archer Family Health Care was extraordinary in the way they used creative techniques, innovation and commitment to make it work,” Long said. “It is unique in that it has lasted. I know of many rural health, primary care and nurse-led clinics that work for a couple years, and then they falter. To have this 20th anniversary in Archer is very special. It speaks to the commitment to being there and doing what is needed.”
Patients of AFHC are primarily lower-income and uninsured, and, therefore, are charged using a sliding fee scale. More than 40% of the practice’s patients lack health
insurance coverage, but AFHC providers and staff are committed to a patient-centered approach to care and building better relationships between the patient and the care team.
In addition, AFHC was designated a Rural Health Clinic in 2012, which allows the practice to offer increased access to care and receive enhanced reimbursement rates for Medicare and Medicaid services.
“Our reach goes beyond just Archer and the southwest part of Alachua County,” Schentrup said. “We see patients from Levy County, Marion County and Gilchrist County. In those areas, there’s really limited health care, so the patients are able to come here and receive care, as opposed to driving to Gainesville when their resources are very limited.”
Treated like family
The AFHC team often honors National Rural Health Day with matching T-shirts. Photo from 2019.
While the AFHC team and space have grown over the last 20 years, the personalized care and feeling of being among family has remained.
“They want the best for you,” Calloway said. “They want you to be in the best health possible. They want to make sure you are OK, make sure you’re comfortable, make
sure you’re treated as family. The whole staff, everyone is so close. They have a way of lifting you up and making you feel better. And they have a way of making you smile.”
Schentrup has worked as a nurse practitioner at AFHC since 2005, serving in both the provider and administrative role. The impact of her patients on her life has been profound.
“Many of my patients have seen me since I started my clinical practice in 2005,” she said. “Not only have I had an impact on their lives, but they’ve also made an impact on mine. They ask about my family. They ask about my daughter, who is 13 years old, but she’s still the ‘baby’ because I walked around the clinic pregnant, and they remember that.”
Many of the providers and staff at AFHC have been dedicated to the clinic for nearly the entire 20 years. Practice Manager Joan Newell- Walker, for example, began working at AFHC in 2004 and knows the ins-and-outs of the clinic’s operations, management and patients.
“Our team is much more than colleagues,” Schentrup said. “We are family. We laugh together and cry together. We celebrate birthdays and accomplishments with one
another; we support each other when one of us is having a particularly challenging time. Words cannot express what this team means to me.”
The nurse-led primary care setting is unique, but it is also crucial right now as the country works to meet the demands of a chronically ill, older population, said Anna
M. McDaniel, PhD, RN, FAAN, the College of Nursing’s current dean and the Linda Harman Aiken Professor.
“Nurses meeting the health care needs in the U.S. is the underlying theme of the National Academy of Medicine’s recent report to Congress on the future of nursing and how to achieve health equity in our country,” McDaniel said. “It’s very important to have the nursing perspective on how to keep people healthy.”
A helping hand
Chikako Alvarado reviews patient information in the lab at AFHC. Alvarado has been a licensed practical nurse at AFHC for 14 years.
Since its establishment, AFHC has relied on the philanthropic support of individuals and foundations, as well as grants from federal, state, local and private organizations.
Numerous grants from the Health Resources and Services Administration, or HRSA, an agency of the U.S. Department of Health and Human Services, have sustained the clinic through the years. In addition, the Health Care For All Fund was established at the college in 2001 by generous donors and continues to receive funding to support the practice.
Peter and Eileen Maren, as well as the Thomas H. Maren Foundation, have been significant financial supporters of AFHC since 2007. Peter Maren said they are passionate about rural health care, and AFHC serves a function in both providing access for a diverse population and introducing nursing students to the importance of rural health care.
Family nurse practitioner Ashley Kairalla (right), DNP, APRN, FNP-BC, oversees DNP student Meiyu Dong during a patient exam at AFHC.
“When you look back and you see what you’ve been able to do by supporting the clinic, it gives you a very positive feeling,” Maren said. “This clinic is an exciting opportunity to get into philanthropy and to help a population that sorely needs help.”
Because AFHC serves an underinsured population, the patient revenues can never meet the practice’s expenses, McDaniel said. The only way to maintain financial viability is through grants, philanthropy and donors. Clinic and college faculty and staff are constantly looking for ways to supplement with grants and donations.
“We wouldn’t have been able to do it — we wouldn’t have been able to start the clinic and certainly not able to maintain it for 20 years — without the generosity of our donors,” she said. “I hope they take pride in what we have done and what we continue to do, and I hope they know how much we appreciate it, as do the many patients we see.”
In the next 20 years
DNP student Anthonia Rich examines Traveon Calloway, who has been a patient at AFHC for 11 years.
Although many other primary care practices temporarily closed during the COVID-19 pandemic, AFHC remained open, with new safety measures in place. Telehealth appointments became and remain a way for particularly isolated and vulnerable patients to be seen. In May, AFHC began administering free COVID-19 vaccinations to patients and the community.
Recent expanded services and hours have provided more access and opportunities for patients. For example, through a grant from the Children’s Trust of Alachua County, the practice also expanded its children’s services, including offering free sports physicals. After-hours appointments are also now available for those unable to make it to the practice during regular business hours.
In September, AFHC received an HRSA-funded opportunity to increase vaccine confidence in the community. Funds from this grant will support increasing community outreach to decrease the fear of vaccines and, in turn, improve vaccine rates (see page 8).
In the next 20 years, McDaniel and Schentrup agree that they would like to see even more expanded services at AFHC, as well as a new building to replace the current modular building that continues to require extensive repairs.
“In the next 20 years, I would like to see us be able to expand our services to the community,” Schentrup said. “I’d like us to have a new brick-and-mortar building in order to increase the number of providers we have and expand the services we provide to the community.”
McDaniel said financial stability of the practice is essential in order to continue to meet the greatest needs of the most deserving patients. AFHC is unique in its longevity and commitment to making sure patients feel comfortable at the practice, despite their resources.
“Everybody at the College of Nursing — not just me — is very proud of Archer Family Health Care,” McDaniel said. “It is a place where we serve the underserved, and that’s an important value of the nursing profession. It’s a place where our students have a different kind of clinical exposure than they get in an inpatient setting. Our faculty have opportunities to maintain their skills and clinical practice. It’s everything an academic nurse-managed clinic is supposed to be.”
