Community care: Health center seeks funding from county commission

By WHITNEY BERMES  for the Ravalli Republic | Dec 25, 2010

Karen Tinney makes her feelings about Sapphire Community Health Center quite clear.

"We could not afford health care if it weren't for the Sapphire clinic," she said.

Between Tinney, 52, and her husband Kent, 53, the Darby couple works four jobs. Karen owns a sewing, alteration and quilting business. Kent is starting a traditional archery shop and the two both manage a lodge.

But neither have health insurance. And getting coverage has proved impossible for the two, both of whom are diabetic.

"What we found out was that as soon as you write down that you're diabetic ... we don't even get the denial letter part," Tinney said. "They won't return your phone calls or e-mail you back."

"I probably put in 10 or 12 applications," she continued, "and we were not able to find any health insurance at any price."

Over the past five years, the Tinneys have been uninsured. Their life has been a steady stream of scrimping and saving just to have every dollar taken by medical needs.

"One small health incident and the money's all gone," she said.

So when the sliding-scale Sapphire Medical Center, located on North Third Street in Hamilton, opened its doors in February, the Tinneys jumped at the chance to receive primary health care that fit into their budget.

"We have gotten outstanding care," she said. "I'm very, very impressed with the care Sapphire provides."

Tinney is quick to point out that the service she received at Sapphire has been life-saving for her husband in particular.

Through Sapphire, the couple both had colonoscopies. Tinney's husband had a pre-cancerous lesion that he was able to get removed.

"We would have never been able to pay and afford that," she said.

Tinney's husband also suffered a heart attack six weeks ago

"We were kind of blown off by the first health care provider we went to with the heart attack," Karen said.

But Sapphire's Dr. Phil Haggerty sent Kent's test results into a hospital in Missoula.

"Because of Dr. Haggerty, we got a phone call from Missoula that said he needs to come up here immediately for an angiogram," Tinney said. "It's because of Dr. Haggerty and the clinic and the follow-up care and the completeness of the care they gave that my husband got treatment that was critical for him."

Despite having limited free time, Tinney recently joined Sapphire's nine-member board with the sole goal of figuring how to keep Sapphire up and running.

"It's so important that I'm taking what little bit of time I can find and try to help," she said.

Tinney joins the rest of the clinic in asking for funding from Ravalli County.

Last week, Sapphire staff made their case before the county commissioners, asking for help in funding a $100,000 shortfall the clinic is facing for next summer.

It costs Sapphire about $50,000 a month to operate, said Commissioner Carlotta Grandstaff, who is one Sapphire's founders. The center will be facing two months of no funding during July and August of next year. They are hoping to receive a federal grant that wouldn't kick in until September, Grandstaff said.

A continuation of last week's meeting will be held on Tuesday, Dec. 27 at 11:30 a.m. in the commissioners' meeting room to decide on funding for the center. The commission asked Sapphire to come up with a contract, stating exactly how any funds would be spent.

At last week's meeting, Haggerty said the clinic, which opened its doors in February, has seen 520 patients, accounting for 1,193 visits.

"The need for our service is incredible," Haggerty told the commissioners. "Our target patient population has more difficult and more advanced medical conditions than what you'd see at a regular health care practice."

Sapphire is asking for money that would come from the county's Payment In Lieu of Taxes reserves, which currently holds about $388,000, Grandstaff said.

Commission chairman Greg Chilcott said he worried that the services provided at Sapphire were redundant to what the county public health department already provides.

"I'm really concerned with this $100,000 and how we justify this to the taxpayers," he said. "The redundancy of the provision of services is not efficient."

Tinney emphatically disagreed with that sentiment, however.

"I think that was something that showed maybe not a good familiarity," she said. "You cannot go to public health and have a nurse practitioner or a physician assistant or a doctor examine you, make a diagnosis and prescribe anything.

"Public health doesn't have that at all. Period."

Grandstaff pointed out that public health provides health care for child and maternal health, family planning as well as immunizations.

Sapphire, she said, is a primary care facility intended to prevent small health problems from becoming larger.

Commissioner Jim Rokosch also disagreed with Chilcott, saying that the services are not redundant but are a missing, complementary piece of health care in the Bitterroot Valley.

Grandstaff said that Sapphire is letting the commission know what its shortfall is, but isn't necessarily asking for the entire $100,000.

For a regular patient like Tinney, that seems like a small price to pay.

"What is more important than the health of your citizens so they can be productive, so they can be working, so that they can be paying taxes? I'm not sure what is more important than that."

Reach reporter Whitney Bermes at 363-3300 or

Sapphire Community Health