Changing the Lives of Low-Income Individuals/Families in Bandera County

Grant Information
Categories	Healthcare
Location	Texas
Cycle Year	2022

Organization Information
Organization Name (provided by applicant)	Arthur Nagel Community Clinic
Organization Name (provided by automatic EIN validation)	The arthur nagel community clinic inc.
EIN	77-0697361
Website	https://nagelclinic.org/

Contact Information
Contact Name	Mr. Chuck Lutke
Phone	8307963448
E-mail	chuck@nagelclinic.org
Address	P.O. Box 519 Bandera TX 78003

Additional Information
Used for	Our programs have expanded over the years, and now include not only Primary Care, but also Mind Body Spirit counseling, Prescription Assistance, RiskBusters healthy lifestyle support, wellness exams, Elder Care, Dermatology, cancer screenings, nutrition and exercise classes. Funds will be used for patient care supplies, medical equipment, staffing, and specialist treatment referrals for the vulnerable, low-income men, women, and children we serve, ensuring their lives and those of their families are changed by the ability to maintain their health in the midst of the numerous other challenges they face.
Benefits	For low-income individuals and families living in rural Bandera County, their lives are plagued by job loss, financial concerns with rising inflation, child care challenges, and lack of education, to name but a few. Often, health care concerns are the last to be addressed due to lack of transportation and/or lack of finances. As the only no-cost community clinic in Bandera County, the Nagel Clinic provides life-changing health care services to this vulnerable population – all in support of ensuring that long-term adverse health consequences are minimized for the most vulnerable individuals and families in rural Bandera County.
Proposal Description	The mission of the Nagel Clinic is: to improve Bandera County health by providing medical care to eligible residents and promoting health education. Founded in Bandera, Texas in 2008 by Texas Hill Country businessman Arthur W. Nagel and other concerned, community-minded friends, the Nagel Clinic remains the only 501(c)(3), nonprofit health care provider of its kind in the 800-square-mile, rural county. The Nagel Clinic offers no-cost primary and preventive health care for low-income, medically underserved rural Bandera County individuals and families, ages 12 and older, who live at or below 250% of the Federal Poverty Level (15% of Bandera County’s 23,000 residents). Core programs and services for fiscal (calendar) 2022 include: Primary Care is our cornerstone program, and these appointments are the first all patients have with the Clinic. Professional doctors and staff respond to illness or injury, perform general health assessments including screenings, health promotion, and maintenance, and offer patient education and counseling. Patients are referred to internal and external programs and services when specialized care is deemed appropriate. Well-Woman Program encompasses a variety of services: comprehensive physical evaluations; pregnancy tests and birth control advice; screening for and treatment of STIs, cervical, breast, skin and colon cancers; and treatment and prevention of diabetes, heart disease, and hypertension. Referrals for in-house Mind Body Spirit (formerly Integrated Behavioral Health) counseling are made as deemed necessary. Men’s Health programs include PSA prostate cancer testing and screenings for skin, colon, and testicular cancer. If necessary, providers make diabetes treatment and prevention recommendations, screening for heart disease and cholesterol, and recommendations for in-house Mind Body Spirit (formerly Integrated Behavioral Health) counseling. RiskBusters, our popular preventive health education program, is designed to help reduce health risks and chronic illnesses by promoting healthy eating, exercising, and smoking cessation. Through this award-winning program, patients, and the community can participate in healthy lifestyle classes, nutrition-rich cooking demonstrations, and cardio-focused exercise classes. RiskBusters also provides wellness information at community health fairs and events. The Mind Body Spirit (formerly Integrated Behavioral Health) program addresses underlying mental, behavioral, and/or substance abuse issues that may be exacerbating or contributing to physical health care problems. Patients are referred to the program after a Primary Care visit, followed by a PHQ9 questionnaire. Due to demand, in 2018 the IBH Department expanded services to three days a week. We anticipate that, due to the stress of the ongoing COVID-19 pandemic, these services will become even more relevant as we navigate 2022 with in-person as well as computer-enabled telehealth visits. New for 2023, the program will offer group therapy in addition to individual. The Elder Care program focuses on issues for patients aged 60+ years, including fall prevention, cognitive impairment screening, sleep issues, and medication management, as well as general mental health, diet, and exercise programs in addition to IBH referrals. Prescription Assistance links pharmaceutical company products with patients who need no-cost or dramatically discounted medications, mostly in the treatment of hypertension and diabetes. The Clinic neither stores nor dispenses narcotics. The T.E.E.N. (Thought, Emotion, Exercise, Nutrition) program is facilitated each summer by a Mind Body Spirit counselor who addresses physical and mental health issues teens face today. These issues may include coping with pandemic stress, depression due to disrupted school attendance, as well as financial upheaval that has disproportionately affected low-income families. Throughout last year, the Nagel Clinic opened its doors to 492 unduplicated individuals who came to the Clinic for 3,207 appointments and received a total of 5,497 distinct health care services, or 11.2 distinct services per patient. The 2021 totals for patient services exceeded our goal by 25% – while we saw fewer unduplicated patients in 2021 versus 2020, we provided more services to those patients in 2021 than we did in 2020. Of the 2021 unduplicated patients, 101 were new patients. Our patients are presenting with more multiple health issues. Whether these issues were exacerbated by neglect in previous years or developed during the societal disruptions of the COVID-19 pandemic, the number of distinct services provided per patient rose 40% from 7 in 2019 to 11.2 in 2021. Many of these were mental health related. As a result, our Integrated Behavioral Health (IBH) program was rebranded to Body Mind Spirit, to mitigate perceived stigmas of mental health counseling, provide an immediate relationship within the three areas directly in the name, and introduce a spiritual component for those patients with a history of religious tradition who want to address this in therapy. An increase in encounters in our Elder Care Program told us patients age 60+ who were most at risk from COVID-19 exposure preferred not to visit the Clinic before vaccines were returning 2021. We are also adding a new social determinants of health questionnaire to our application for services in 2022. Our programs help educate patients about the importance of a healthy lifestyle in preventing and treating disease and maintaining long-term health. Our ultimate goal is to positively affect the entire county’s overall health.