To the Editor:

What we have been waiting to hear, and a little more: Hilltown Health is opening telephone business in November, and will begin providing medical service to patients in December. Hannay Reels has made a $10,000 donation to help HH cover costs for early service, and the region has been designated as a “Medically Underserved Area” by the federal government.

Details below, some of them complicated.

— 1. Jill Martin, nurse practitioner, is announcing that on Friday, Nov. 1, Hilltown Health will open phone lines in its office in 1772 Helderberg Trail. As of that day, staff members will be available to receive calls from prospective patients. They will tell callers how to get their medical records from current providers, and will begin scheduling office visits. The number to call is: 518-872-0009;

— 2. Hilltown Health, PLLC will begin providing medical services on Dec. 2. One-hundred-and-fifty-eight days after our community meeting, we will have a medical office operating once again in the Helderbergs. The office will be small at first — perhaps five staff, including Jill and Jane Snyder, who is coming back from retirement to help get things going — but there are plans to ramp up as the patient population grows;

— 3. Here is a problem — with a solution — that we will see in early days. It is necessary that HH be accredited by every single health insurance plan that provides coverage for potential HH patients. This is a long and tedious task; each health insurance plan has a different process and different criteria. There is no “standard” format each plan requires its owand it is unlikely that HH will be on board with every plan by Dec. 2. If HH is not accredited by a plan, the plan will not pay HH for services.

We are nonetheless halfway through the accreditation work: HH has been accredited by Capital District Physicians Health Plan, and is close to being accredited by Medicare and Medicaid. These insurances cover more than 50 percent of the anticipated patient population.

But how can HH be paid for services if a patient’s particular insurance plan does approve HH as of Dec. 2? How can HH be open to everyone in the Helderbergs on Dec. 2?

Solution: Until a patient’s health insurance accredits HH, patients may pay HH directly. HH has not set the cost of an office visit yet, but it is likely to be about $50. These payments will cover only about half of HH’s actual costs, but they will allow HH to do two things: open on Dec. 2, and open to everyone, no matter what insurance they have.

Once the patient’s health insurance accredits HH, the fee will be whatever the plan’s normal co-pay is; until then, though, everyone will be able to establish a medical record and schedule services with HH;

— 4. Here is another problem — with a Helderberg solution — that we will see in the early days: What about patients who can’t afford the $50?

On Wednesday, Oct. 2, Jill described the problems involved in paying for medical service to financially-stressed patients to Eric Hannay and Elaine Gruener of Hannay Reels Inc. Hannay notified Jill within 30 minutes of the discussion that Hannay’s Charitable Committee would make $10,000 available — $10,000 that will be, in effect, a donation from our largest local employer to neighbors in need of health care.

It will allow HH to extend service to patients whose health plans have not yet accredited HH, or who simply do not have the money to generate a full co-pay.

Hannay Reels is extraordinary in so many ways: It is a multi-generational, family-owned American manufacturing company; it is and has always been located in the rural town where it was founded; and it employs 175 local residents who compete successfully in an international industrial business.

Its place in the Capital District charitable community is legendary. And now it has become a major partner in the creation of locally-owned and directed primary medical care in the Helderbergs. This donation will allow Hilltown Health to offer primary medical care to every Helderberg resident from the very first day. “Grateful” may not be a big enough word;

— 5. Again on Wednesday, we were notified by the New York State Department of Health that the Helderberg Region has received designation as a “Medically Underserved Area.” This designation was one of our early goals.

The MUA designation will give HH two specific options for consideration in the future. The first is to recruit foreign medical professionals — including MDs — who would become eligible to apply for a J-1 Visa Waiver to work at Hilltown Health.

The second is that HH is now eligible to apply for additional federal designation as a “Rural Health Clinic.” Each option will require close study by HH in the coming year — there are pros and cons — but the important thing is that the options are now available.

There are a lot of people to thank for this success: All of you who petitioned our political representatives, those representatives themselves — most importantly, Congressman Paul Tonko and his staff members, Colleen Williams and Marilyn Smith — the Berne Town Board, which unanimously requested that the state’s Department of Health make application for the designation, and Dr. Robert Martiniano, whose office researched and submitted the application on behalf of the health department.

I’m sure I’ve left people out, and if so, I apologize, because to get this done in 157 days is simply amazing; and

— 6.  Finally: On Oct. 4, Jill participated in a discussion on rural broadband coverage with Congressman Tonko and Federal Communications Commissioner Commissioner Jessica Rosenworcel. Jill was chosen because of the relationship with the congressman’s office that has developed over the past four months, and she was able to speak generally of broadband access problems in the Helderbergs, and of the specific impact on medical care.

That’s enough for now. This must be like offering you a drink of water from a fire hose. Please email me questions, and I will try to get answers.  And thank you: Without the many, many contributions made by so many of you over the past four months, we would not now be on the absolute brink of restoring locally-owned, locally-directed primary medical care to the Helderbergs.

Raymond Schimmer

Berne

Editor’s note: Raymond Schimmer, an emergency medical technician volunteering with the Berne ambulance squad, also worked in the vitalist program, which used a video feed and proxies to visit homebound patients. When the Berne doctor’s office was closed this summer, Schimmer volunteered to assist Nurse Practitioner Jill Martin as she established the Hilltown Health primary care medical clinic.