Christ Community Health Services builds on legacy
Four founders’ perseverance gave birth to medical clinic in underserved area
By Jane Roberts, Daily MemphianUpdated: September 20, 2020 9:18 AM CT | Published: September20, 2020 4:00 AM CT
Shantelle Leatherwood has a megawatt smile anyway, but when she talks about Christ Community’s plans for South Third Street, her face glows with the fire of a CEO on a mission.
Every culture has a creation story, and 25 years ago, Christ Community Medical Clinic began in a small space at 3362 S. Third St., sandwiched between the Crystal Palace skating rink and offices leased by the state Department of Human Services.
From there, it has grown to a network of 11 health centers with a $46 million annual budget, up from about $2.5 million in 2000. In honor of its anniversary and how far it has come, Christ Community Health Services(CCHS) is investing $32 million to refurbish the 12-acre mall where it was born.
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By virtue of a gift from Belz Enterprises, Christ Community now owns the site. It is also the only tenant left.
With its connections to partners in the medical and education sphere in Memphis, CCHS intends to repurpose what is largely a vacant parking lot surrounded by a 1960s-era, one-story mall with services the community needs, including exercise and gathering spaces.
“We are planning to replace the existing health center on a portion of the 500-space parking lot that faces South Third Street. Our goal is to renovate the existing 90,000 square feet of mall space and use it for educational purposes,” Leatherwood said.
It also plans to build a second building, also facing South Third, for specialty medical and diagnostic services through partners it plans to attract, in part through subsidized rent.
“I’m working really hard so that we can break ground in this25th anniversary,” says Leatherwood, a 21-year employee who rose up through the ranks to become Christ Community’s first female CEO three years ago.
What it intends to build will stand as a tribute to the vision of its founders and the medical care for the poor they built, in the early years, through ledger sheets of red ink.
“As we replace that clinic, I just believe more strongly than ever it needs to reflect that. It needs to reflect the heart and dedication of our founders. And it should be unique; it should not look like any of our existing locations,” Leatherwood said.
The new clinic will have 24 exam rooms, a dental clinic three times larger than what currently exists, a behavioral health unit, and a separate counseling center, where Christ Community will offer individual and group counseling.
“That is one of the needs the community told us they wanted,” Leatherwood said.
The building will be sheathed in glass, and dotted with internal courtyards, art and community rooms, offering a quadrant of the city anchored by Third Street and Winchester Road. Even 25 years ago it was a neighborhood with few resources.
Christ Community is a federally qualified health center (FQHC),which means it is a federal tax-supported entity that serves patients up to200% of the poverty level in medically underserved parts of the nation.
Everyone pays some fee for the services they receive, based on income. People who are homeless are served free. Christ Community serves about1,500 homeless patients.
In 25 years, CCHS has grown to serve more than 56,000 patients. It is the largest FQHC in West Tennessee and the second-largest in the state behind Cherokee Health Systems.
It has 415 employees. CCHS physicians deliver more than 1,000babies a year at Baptist Women’s Hospital or Regional One Health because poor women who become pregnant nearly automatically qualify for Medicaid.
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Back in 1998, Burt Waller had just left his job as CEO of The Regional Medical Center at Memphis, now Regional One Health, when a member of the Christ Community board pulled him over at a Ridgeway High soccer game to gauge his interest in helping the fledgling and struggling nonprofit.
Waller agreed, but intended to stay only a year. A month earlier, his wife had started as one of the first nurse practitioners at Christ Community. He became its first executive director. He stayed 15 years.
“You know, we came to very quickly believe that this was the place God wanted us to be as well,” Waller said.
With its DNA nearly spelled out in its name, it would be no surprise that its founders were Christians determined to serve the poor, medically and spiritually.
The visionaries behind CCHS were four medical school graduates from Louisiana State University School of Medicine in New Orleans. They pledged to each other, even before they left for residencies, to serve God by running a clinic together in an underserved area.
The idea, over time, was that better health outcomes would measurably affect quality of life for the people of that community, even in other metrics.
One, Rick Donlon, came to University of Tennessee Health Science Center in Memphis for a residency in internal medicine and pediatrics.
“Maybe the most remarkable thing is that when we left New Orleans, we all dispersed,” Donlon said.
Because their residencies varied between two and four years, the hope was the clinic could start in 1993 when the first two were finished.
“They moved to Memphis even though we didn’t have anything todo. In our spare time, we tried looking for property, tried to talk to bankers, hospitals and other possible donors. Many times, it looked like it was going to die,” said Donlon, now an emergency room doctor at Saint Francis Hospital-Bartlett.
“We were unable to get it started until 1995. It was a multi-year, at times seemingly endless and frustrating struggle to get started. We were wet behind the ears and still in our residencies when we were trying to have these initial conversations.
“It taught me faith in God and perseverance,” Donlon said.
The other founders are Dr. David Pepperman, now at St. Jude Children’s Research Hospital; Dr. Karen Miller, who now practices in south Louisiana, and Dr. Stephen Besh, an oncologist at West Cancer Clinic.
None is still associated with Christ Community, although Donlon served as executive director until 2014. He left after a falling-out with the board of directors and went to lead Resurrection Health, also a health-based practice, which had three clinics here. When it failed in late 2018 due to finances and other issues, Cherokee took it over.
In the early 1990s, The Assisi Foundation gave the four doctors$75,000, which at that point, was the largest gift they had received after months and months of pounding on doors. In the spring of 1995, Baptist Memorial Health Care Foundation sensed an earnestness among the group, which had come seeking money. In a matter of days, the foundation found $200,000 to help. It also signed a $400,000 bank line of credit.
In September of that year, the Third Street clinic opened.
Later, Methodist Le Bonheur Healthcare and the LHS Foundation, which became the Urban Child Institute, also were supporters.
“If all those people hadn’t been willing to take a risk, it would never have started,” Waller said. “And it certainly wouldn’t have endured at Third Street all these years. The first five to seven years were really, really hard.”
Waller marvels at the coincidences that brought the four here.
“There was no connection to Memphis. None.”
Perhaps the biggest coincidence, he says, happened at a “health opportunities fair” in Nashville, where the members, still in residencies, happened to meet a staffer at the Shelby County Health Department.
“He chatted them up and pitched them on Memphis, and they literally said to the health department, ‘Look at all your health department data and tell us the geographic place in Memphis that has the greatest health problems and the least access and least presence of medical care,’” Waller said.
ZIP code 38109 was the response.
Today, 96% of the residents there are African American; the median household income is $30,103, according to Census data.
Belz Enterprises built the mall, which CCHS now intends to completely refurbish, in 1969 for Wells Department Store, a full-line discount store.
More than 25 years later, when the founders were looking for space, Wells was gone. But between Crystal Palace and the state offices, there was a single storefront, with about 9,000 square feet.
They took it.
For years, Waller said, Belz charged Christ Community rent that was “as close to free as you can imagine,” adding it was essentially what it cost to insure the space.
Belz later donated the 12-acres property to CCHS, a gift of $1.7million.
Filling community needs
Physicians who worked at Christ Community, even into the early2000s, were making 50% to 60% of what they could make in private practice, Waller said.
“It was always the case that they were making far less than they can earn elsewhere.”
That made recruiting doctors more difficult, except Waller noticed the people who wanted to work at Christ Community generally cared more about the mission.
Beverly Robinson grew up on Nonconnah, a few miles from the clinic.
The first time in her life that a doctor returned her call, it was a physician from the South Third Street clinic.
“I left my name and number; she called back the same day,” Robinson said. “They wanted to make sure that I asked all the questions I had. She had time to talk to me, and if my diabetes medicine wasn’t right, she would try to change it to get what I needed.”
Because of the way they are structured, FQHCs get extra funding to serve Medicare or Medicaid patients. For Dr. Scott Morris, CEO of the city’s other safety-net health care provider, Church Health, that makes it easy to refer patients to CCHS.
“We are eager to have Medicaid or TennCare patients be seen at Christ Community because their doctors are very well trained; they do a great job,” Morris said.
“We see people who are primarily working and uninsured. They see a lot of children who might have TennCare or the mothers of those children or people on disability.
“It’s a way everybody (health care providers) can be paid as opposed to the way we do it, where we are pretty much dependent on our doctors volunteering their time.
“We may look similar, but in reality, our operations are very different.”
Without Christ Community, Morris says, thousands of additional people in the Memphis area would be relying on emergency rooms for primary care.
“I’ve been around long enough to be able to tell you we had the void for many years, and no one was filling it. It requires people who are truly dedicated to care about the issues that are important within the most underserved community that we have. It can’t just be about giving out pills. You have to care deeply about the neighborhoods and the families you treat. Christ Community has demonstrated now for 25 years that they care deeply about the communities that they serve.”
He also says it has been able to grow because it is good at finding grants to cover startup costs.
About 70% of Christ Community’s annual budget comes from the fees its patents pay; 16% comes from state and federal grants.
“We can demonstrate a need,” Leatherwood said. “We can clearly articulate our plans. I tend to be very detailed when it comes to grant proposals and technical writing.”
She’s been CEO for three years. When she came, Christ Community had a 42% employee turnover rate, part of the residual fallout that happened when Donlon left the helm, she says.
Without its visionary leader, the organization floundered.
“For me coming into the role, it was just clarifying to everyone that we’re still on mission, and we’re still going to provide high-quality health care and in a consistent manner,” she says.
Today, employee turnover is 27%, still high, Leatherwood says, but heading in the right direction after she took steps to hear employee concerns, including leveling the pay of its underpaid nurse practitioners, who in some cases, got an increase of $10,000 to $15,000 a year.
“You think about mission-critical roles in the budget,” she said. “And then, you attempt to make it work.”
And as of January, its network includes Jackson, Tennessee. How the clinic there came to be is an insight into how Leatherwood leads.
“Jackson was not on our list for expansion. I mentioned that we just get busy doing what we’re doing, and sometimes opportunities come along that you have to stop and consider,” she says.
Leatherwood had gotten a call from Lisa Piercey, now commissioner of the Tennessee Health Department, in 2018 when she was executive vice president of West Tennessee Healthcare in Jackson. Piercey hoped to find someone who could help an older doctor in East Jackson trying to run a new, faith-based practice.
Leatherwood, who had her hands full running 10 centers in Memphis, plus strategizing the highest use of the Third Street property, couldn’t see it happening.
She and the chairman of the CCHS board went to Jackson to look the clinic over. Leatherwood was for it; the chairman less so, she says.
“I went to home to pray about it. The passage of scripture that really piqued my heart was “the harvest is plentiful, but the workers are few.”
“And at that point, I thought, ‘OK, this is speaking to me.”
When she looked deeper, she could see many of the Jackson patients were already coming to Christ Community in Memphis for care. There also was no FQHC in Jackson.
“So, then you start to wonder,” Leatherwood said, “where are the underserved individuals going?”
She made her case to the board, which ultimately gave a conditional green light based on her securing a federal expansion grant and a four-year financial commitment from West Tennessee Healthcare, giving the clinic time to build a Medicare patient base.
“It actually creates a pattern for more expansion,” Leatherwood says with a nod.
At least one clinic has already called, she says, looking for a suitor.