The effort to establish a local clinic began at a Western North Carolina mental health care &dquo;summit&dquo; in Asheville in 2006.

The summit was organized by Jim Van Hecke, a Tryon resident who moved to the area in 1994 and served until 2003 as the executive director of Pavillon International, a non-profit residential center for the treatment of alcoholism and other drug addictions located in Sunny View.

During his 14 years in the addictions/recovery field Van Hecke says he became convinced that significant changes needed to be made in all aspects of the profession. He has served on numerous statewide commissions and work groups whose purpose was to improve the effective delivery of quality services.

Van Hecke currently is director of the Addiction Recovery Institute (ARI), a non-profit corporation that provides leadership training and professional development services to the mental health and substance abuse field.

After the summit in Asheville, Van Hecke and a group of Polk County citizens began studying ways to improve the delivery of services in Polk County. The Polk County Board of Commissioners, which by law provides $74,000 of &dquo;maintenance of effort&dquo; funds every year for mental health services, allocated $12,000 each of the past two years for the local study group&squo;s efforts.

Treating people in crisis

&dquo;It was decided that what Polk County really needs is a permanent, walk-in clinic,&dquo; Van Hecke said.

A non-profit corporation was formed, with the board consisting of Van Hecke as chairman, joined by Cameron Highsmith, St. Luke&squo;s Hospital chief executive, Sue Rhodes, head of Polk County Department of Social Services, Becky Collins, a retired nurse, Cathy Brooks, head of Smart Start, Bill Miller, superintendent of Polk County Schools, Trel Lowe of the Springs Health Center, and Corinne Gerwe, a therapist and member of the Saluda Health Center board.

The center they created, which will be called the Polk Wellness Center for short, will offer a range of services to those with mental health and substance abuse disorders, primarily targeting those who have no insurance or inadequate insurance.

One of the primary gaps the center will fill is treating people in crisis.

&dquo;We will be there to deal with crises during the day,&dquo; said Dr. Gordon Schneider, who will serve as the clinical director. Schneider received a BA from East Carolina, a masters degree from Appalachian State and a doctorate, all in psychology, from the University of Tennessee. Presently, he has a private practice, Lifespan Psychological Services in Columbus.

&dquo;The problem now,&dquo; Schneider said, &dquo;is that in a crisis, there is no one to see you, or they can&squo;t take that insurance, or you have to come back in two days. We will deal with them when they show up.&dquo;

An Asheville-based company, Families Together Inc., offers a mobile crisis team to respond to after-hours crises in an eight-county area including Polk.

Both services hope to prevent crisis patients from languishing in hospital emergency rooms, county jails, and to keep them from unnecessary commitments to the state&squo;s mental hospitals.

&dquo;Unmet needs cost everybody,&dquo; Van Hecke said. &dquo;If you don&squo;t deal with a chronic disease, it begets another chronic disease. The DSS, sheriff, and hospital all have horror stories of unmet needs. Anytime citizens are not being productive, they are not paying taxes and typically are using public services. Plus we simply have a moral responsibility to take care of everyone in a community.&dquo;

Cameron Highsmith, chief executive of St. Luke&squo;s Hospital, who serves as treasurer of the Community Health Center board, agreed. &bsp;

&dquo;The Wellness Center will give us a greatly needed resource, when more people are served before a health crisis occurs and costly emergency treatment can be avoided,&dquo; said Highsmith.

Primary care also offered

Using a &dquo;state of the art&dquo; model, the Polk Wellness Center will offer both primary care and mental health care. Dr. Jeffrey Viar DO of Foothills Medical Associates, a family practice, will serve as the center&squo;s medical director. Both Dr. Schneider and Dr. Viar, whose offices are in the same complex, will keep their private practices.

&dquo;The Polk Wellness Center will follow a wholistic perspective,&dquo; says Anne Marie Lester, the clinic&squo;s executive director. &dquo;We will use the integrated care model, which is state of the art, best practice.&dquo;

Lester has a masters in counseling from Florida State University and worked in Florida with child and family therapy, then served as an administrator for 15 years with programs for uninsured children and families. In this area, she has served as the leader of the local Wellness Coalition and created the Community Health Network to connect uninsured patients with a medical home in Polk, Henderson and Transylvania counties.

Dan Zorn, chief executive of Families Together Inc., said his company will partner with the Wellness Center, using its offices to offer case management and family-centered services. He praised the Polk Community Wellness Center plan to put primary care and mental health services together.

&dquo;We like to say the head is attached to the body,&dquo; Zorn said. &dquo;The physical and the psychological affect each other.&dquo;

In fact, Van Hecke said physical conditions and mental health disorders are often tied to one another.

&dquo;If you look at patients with substance abuse disorders, they almost all have some depression,&dquo; Van Hecke says. Another commonly co-occurring disorder is diabetes, Van Hecke said. The whole person needs to be treated. A person with a throbbing leg and depression needs both issues to be treated to get well.

Chronic diseases

The Community Wellness Center will base its mental health and substance use disorders treatment on the &dquo;recovery model,&dquo; Lester says. &dquo;That says, you can get well and be very functional. But you will always need support.&dquo; Some agencies offer mental health care on an &dquo;acute care&dquo; model, she says, where the idea is that you can fix the broken place and send the patient home cured.

But mental health and substance use disorders are considered by the American Medical Association to be chronic diseases, Van Hecke said.

&dquo;Statistics show that the longer you are in a therapeutic relationship, the better chance you&squo;ve got,&dquo; he said.

The Polk Wellness Center will offer a two-hour, drop-in clinic for support and skill-building every day. A nurse will check the physical health of those who attend.

In addition, the center will offer regular individual therapy sessions, structured group sessions and crisis services.

The staff will include Stan Bayne, a therapist who serves as a substance abuse counselor at Cooper Riis, Jim Nagi, a licensed clinical social worker who was formerly regional director for Family Preservation Services, and Catherine Miton, PhD, a nurse practitioner on the Pardee Hospital staff who will evaluate patients&squo; medicines one day a week.

There will also be a nurse and the center hopes soon to hire a &dquo;recovery coach,&dquo; Lester said.

The Wellness Center has an initial budget of $600,000, and has start-up funds already in place. The Polk Wellness Center was awarded Polk County&squo;s $74,000 in &dquo;maintenance of effort&dquo; (MOE) funds this year.

Family Preservation Services, located in the old Rutherford-Polk Mental Health offices next to Polk County Department of Social Services (DSS), had been receiving Polk&squo;s MOE funds to provide mental health services, but they did not apply this year.

Julie Snyder, regional director for Family Preservation&squo;s Polk office, said her agency knew the money would likely go to the new clinic this year.

Family Preservation Services, part of the Providence Service Corp. of Tucson, AZ, serves about 300 Polk County clients with community support services. Snyder said her agency fills a distinct niche and will collaborate with Polk Wellness Center. Family Preservation sends professionals out to work with clients, helping parents learn to raise their children and adults to care for themselves in their homes and workplaces.

&dquo;We are also staffing up to offer intensive in-home services to help prevent out-of-home placements,&dquo; Snyder said.

Everyone will be seen

In addition to working with Families Together and Family Preservation Services agencies, Van Hecke said the Polk Wellness Center will work with Pavillon, Cooper-Riis Healing Farm, the Mill Springs and Saluda health clinics, Steps to Hope and the Polk DSS. The center will also offer its offices for meetings of groups such as Al-Anon and Al-Teen.

In addition to the MOE funds, Polk Wellness received a $285,000 grant by the Western Highlands Network, the &dquo;local management entity&dquo; responsible for contracting mental health services in eight Western North Carolina counties.

Those start-up funds will be supplemented by fees for services.

Lester said the center will help clients find ways to pay, and is qualified to receive payments from Medicaid, Medicare and from Western Highlands Network, which administers state funds for the working poor, those who make too much to qualify for Medicaid but cannot afford private insurance.

&dquo;Anyone and everyone can be seen,&dquo; said Dr. Schneider. Those who have no other means of payment will be charged on a sliding scale.

To further ensure the clinic becomes sustainable financially, Van Hecke said he hopes the Polk Wellness Center will be approved as a Federally Qualified Health Center, a designation which would generate some annual federal grant funds. Lester said an application will be prepared this spring.

A clinical home

Lester said she knows there is a need for the center.

&dquo;I looked back and the old Rutherford Polk Mental Health Area Program was serving 1,100 people from Polk County. Western Highlands now serves 550. We know the other 550 haven&squo;t gotten well. These are chronic conditions. We need to give back to them a clinical home.&dquo;

Van Hecke has also been analyzing the numbers. &dquo;There are 3,500 people in Polk County with no health insurance. Of people who meet the addiction diagnosis, 83 percent get no treatment whatsoever.&dquo;

Keeping those numbers in mind, Van Hecke said he offers a sort of test when he speaks to local groups and asks all those in the audience with personal relationships with persons suffering mental health or substance use disorders to identify themselves. The majority of hands go up across the room every time.

&dquo;If ten percent of the average population meets the criteria for addiction, and 87 percent of those suffering from addiction get no help, that&squo;s 1,740 people in Polk County,&dquo; he said.

If, Van Hecke said, the Polk Wellness Center can help just 150 of those currently unserved people, considering that the average person has 40 regular contacts in the community, that&squo;s 6,000 community residents ‐ children, spouses, parents, neighbors ‐ whose lives would be touched by the increased treatment offered at Polk Wellness Center.