NEW PORT RICHEY — Mike Coy had been waking up nauseated and in pain every morning for about a year. One morning during the week of Thanksgiving, when he was unable to move, his mother called an ambulance to take him to Morton Plant North Bay Hospital for tests.
Kidney cancer, the doctor said.
"I was scared (to death)," the 40-year-old swimming pool repairman said. "I'm self-employed and don't have insurance. I didn't even have a primary care physician."
A nurse recommended Premier Community HealthCare Group across the street behind the hospital. Coy went and was examined by Dr. Peter Obesso, the family practice physician. Obesso gave him prescriptions for free or low-cost meds. He also knew a good urologist, who removed Coy's left kidney in March without charge.
Coy says he owes his life to the staff at Premier, a nonprofit primary care clinic that has seen 2,589 patients since it opened last year on the county's west side. The clinic has operated locations in east Pasco since 1979.
"I love the people at Premier," Coy said. "I used to give those people chocolate. They really helped me."
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Premier began 31 years ago when a group of east Pasco residents realized that migrant workers needed medical help, especially when it came to prenatal care.
The clinic had offices in Dade City and Zephyrhills and has expanded from pediatrics, family health and obstetrics to include mental health care for children, dental care and diabetic management.
But executives were aware of a growing need on the county's west side. An analysis a few years back showed that west Pasco's uninsured and underinsured face huge problems when looking for affordable care. The only options were Good Samaritan Clinic, which won't accept Medicaid, and Healing Hands, a faith-based clinic that opens only the first three Tuesday evenings of each month and struggles to stay open.
The clinic applied for federal grants for several years to open a west Pasco location but was unsuccessful.
"We kept getting beat out by states like Montana," said Sue Hutson, the organization's marketing director.
But when federal stimulus money became available last year, Premier moved up on the priority list.
The practice, which received $1.2 million, was one of 126 clinics nationwide to receive an award from the new allocations earmarked for health care center expansions. The amount represents about a third of its budget.
Three months after being notified of the award, the clinic opened in a yellow stucco building at 3363 Forest Ave. behind North Bay Hospital.
"We've been bombarded since day one," said Sandy Beach, the clinic's office manager. "Patients came in so sick, some with Stage 4 cancer needing transplants. They were postponing care."
Or they were waiting until things got so bad they were forced to go to a hospital emergency room. Then they had nowhere to go for followup care.
"The ER is not a medical home," Beach said.
Across the street, North Bay's ER started seeing fewer regular visitors.
"Premier has had a profound effect on the ER," said John Couris, who was the hospital's administrator when Premier opened the new clinic. He helped work out a lease agreement with Premier for its building.
"What that means to me is if they get roughly 2,100 seen in the first year, that's huge," said Couris, who now is chief executive officer of Jupiter Medical Center in South Florida. "That might not be the 2,100 who aren't going to the ER but it's probably safe to assume those patients who came to the ER first and got referred to Premier aren't coming back to the ER."
Premier's goal is to be that medical home, a term used by those in the health care industry to describe the place a patient goes for routine checkups and treatment of illnesses before they become catastrophic.
"We provide high-quality services that emphasize primary care and wellness so that families can stay healthy and out of hospitals," said Kim Schuknecht, the clinic's CEO.
The clinic accepts all patients regardless of whether they have insurance. Those without pay discounted rates on a sliding fee scale based on household size and income. The lowest fee is $20, though the agency has provided a number of payment options to make sure no one who needs help gets turned away.
To operate, the clinic relies on a mix of payments from private insurance, Medicaid and discounted patient fees.
In February, 85 percent of the west Pasco clinic's patients were uninsured. That number has since dropped to 72 percent.
"We've seen people come in who said, 'I've always had insurance all my life,' " said Viva Casler, the clinic's registered nurse practitioner.
The clinic wants more insured patients and is doing more to let people know its benefits.
"We're a one-stop shop," said Hutson. For example, an entire family can get medical care at the same time even though one may be on Florida KidCare and the other may be on adult Medicaid or another plan or may lack insurance. Some practices cap the number of patients they see who have a certain insurance plan; Premier does not.
The clinic also works closely with school nurses who can refer families and small businesses who can't afford to offer insurance or whose employees must go through a waiting period before health coverage begins.
The clinic also is working to offer dental care in west Pasco at the Mike Fasano Hurricane Shelter in Hudson, where it plans to open an additional clinic this fall.
Recent statistics released by the Suncoast Health Council showed Pasco with only 33 licensed dentists per 100,000 residents compared with the state's overall figure of 62.6.
"We get at least one call a week from people who are ill and who reached out to us because don't have access to health care," said Fasano, the state senator for whom the shelter is named. "Premier has done an outstanding job."
Fasano, who is on staff at Florida Hospital Zephyrhills, praised it and North Bay, both nonprofit hospitals, for working with Premier and helping the needy gain access to care.
"I'd like to see the for-profit hospitals get more involved," he said. "For every patient who doesn't sit in the ER and goes to Premier, it saves taxpayer money."
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Cancer survivor Mike Coy is among those who no longer has to go to the ER.
He does his followups with the urologist who agreed to see him and at Premier. When he gets sick, he'll have a place to go. He said he also referred a friend who is on disability.
Three weeks ago, he visited Dr. Obesso and brought along his 17-year-old son.
"He talked to my son and said, 'Your dad's going to be just fine. He'll live to be 90 if he does what I say.' As we left, my son said, 'You know that doctor, he's pretty cool.' "
Lisa Buie can be reached at (813) 909-4604 firstname.lastname@example.org.