VERO BEACH — On a recent Friday morning, several patients sat in cushy chairs in the waiting room of the Whole Family Health Center, on 37th Place, drinking freshly brewed coffee and talking.
The center, founded by infectious disease physician and internist Gerald Pierone, is the most recent to open in Vero Beach and offer a variety of mental and physical healthcare services under one roof to people who can’t otherwise afford healthcare.
Because the caseload is growing by 40 to 50 people a month, the center has recently taken over the offices next door, where saws and sanders whirr during renovation.
“These are good people at this clinic. They treat you so nice here. I give them a 10 for nice,” said patient Earl Willingham.
“They also get a 10 for thoroughness as well as kindness. They do it all here. They treat you for more than one issue and it means a lot to get that in one place,” said patient Beverly Greene.
Those comments are at the core of what motivated Pierone, who has an extensive private practice in both infectious disease and facial aesthetics, to start the combined primary care and behavioral healthcare clinic in the first place: a belief that integrated care was the best way to help patients who can’t afford to pay for healthcare.
“How could we better serve than to help someone with physical issues, who also has headaches because her kid is in jail, than by having a primary care physician and a psychologist here to see her?” asked Pierone.
“If you’re down on your luck, why should you have to go to a yucky clinic and sit in a plastic chair?” he added. “Why not go to a nice place where people are nice to you?”
A few months after Whole Family opened in Vero in the spring of 2013, the Centers for Disease Control and Prevention sponsored a conference to explore integrated healthcare and look at the best way to deliver it.
To that end, physicians and public health administrators from all around the country discussed what would work best.
Their conclusion was exactly what Pierone was doing: “Providing patient-centered medical homes” where “a physician leads a medical team that coordinates all aspects of preventive, acute and chronic needs” including “integrating public health and behavioral health with clinic care” at one location.
Treasure Coast Community Health, Pierone is quick to point out, also offers integrated healthcare services in Vero Beach.
It is, however, a nonprofit that employs physicians, while Pierone, a private physician with separate successful practices, is the driving force behind Whole Family.
Treasure Coast Community Health, which is much larger than the Whole Family Health Center, served 14,000 patients last year, while the family center served 1,500.
Along with a difference in size, the two providers differ because TCCH offers adult and pediatric dental services, as well as substance abuse treatment services and sees many patients with insurance or who pay on a sliding scale, along with those who are indigent.
Whole Family Health Center, on the other hand, serves mostly indigent patients and has expanded its behavioral healthcare services to include pediatric psychiatry.
“We’re all the same in that we’re trying to be a force for good and increase access,” said Pierone.
Dennis Bartholomew, business director of Treasure Coast Community Health, agreed: “We’re pretty full all of the time, which suggests a need for another clinic.”
In the mid-1990s, Pierone founded an AIDS clinic in Fort Pierce and then opened a Vero extension in 2011. Because the families of his patients frequently asked where they could go for treatment for a variety of health services, he added primary care in Fort Pierce, then in Vero Beach.
The Whole Family Health Center now has a staff of 27 people, which includes doctors who are board-certified in internal medicine, infectious diseases, pediatrics and psychiatry and is continuing to grow by leaps and bounds.
A bell rings when someone enters the waiting room and “there is a constant sound of chimes,” said psychologist Rebecca Rustine, who often works through her lunch and stays late to see patients.
“It’s hard to turn away anyone with a mental crisis,” she said.
“The center is big on mental health,” said center board member Burton Lee, who purchased a van last summer to transport patients to the Whole Family Health Center.
Lee, a retired Sloan-Kettering oncologist and former Hospital District trustee, volunteered to be on the center board, he said, because both the center and the board “have so many wonderful, caring people.”
Whole Family Health Center board chairman Charles Cunningham, a retired General Motors executive, joined the board, he said, because he and his wife “are very concerned for the folks who can’t afford healthcare.”
He especially likes the fact that the center reaches out to the homeless by going to homeless centers and examining people.
“Because someone is homeless doesn’t mean they’re lazy or stupid. But for medical care they are too often the last on the list. If they want to get back on their feet, we’re here,” said Cunningham.
The clinic is funded by Medicaid reimbursement, which is much lower than private insurance or Medicare reimbursement.
It also gets money from a Ryan White grant and an Impact 100 grant. Also, a pharmacy on the property gets money from the federal 340b program, which helps immensely, said Pierone.
Currently, 70 percent of the services are for physical needs and 30 percent are for mental ailments. But those numbers are likely to shift as the center increases its ability to treat behavioral health in the county.
Lisa Kahle, program administrator of the Mental Health Collaborative, which coordinates mental healthcare services in the county and works with a task force to make them more effective, said she was thankful for the efforts of Whole Family Health, along with other key partners like TCCH, the Department of Health, New Horizons and others, for their help in developing pilot programs to measure the effectiveness of integrated healthcare.
Recently, a grant committee visited the Whole Family Health Center and a member asked Pierone why, when so many private-practice physicians are running away from treating people who can’t afford healthcare, he, his staff and his board were running toward them.
“Because they deserve this,” Pierone said.
