BARRYVILLE, NY — An open house at the site of the new Highland Healthcare Initiative (HHI), held Thursday, January 22, offered community residents the chance to get a sneak peek at the facility, and to offer their input on what kinds of services should be offered therein. 

HHI is a project to bring a community health hub to Highland, spearheaded by Dr. Chris Dickey, a clinical associate professor of global and environmental health with New York University’s School of Global Public Health. It will renovate and operate out of the medical building formerly run by Richard and Cathy Daboul as River Valley Medical Services. 

Dickey aims to build a new kind of model for community health care with HHI, drawing on his experience establishing sustainable health care models in underserved areas around the globe. 

“We’ve been building this sustainable model, but we wanted to do it from the community outward, rather than have somebody like Garnet or NYU or another entity just impose a model on top of us, because those are not sustainable in my mind,” Dickey told a jam-packed crowd in the medical center’s former waiting room. 

Many of the community’s questions centered around the type of care that could be expected at the facility. 

Dickey said he did not see the HHI as being able to house a full-time primary care physician in Highland. “The bottom line is, in rural communities like ours, we can’t afford having a full-time primary care physician. No rural community can do that anymore.” What HHI could provide is access to resources such as primary care physicians, specialists, physicians’ assistants, nurses and community health workers, he said. 

Telemedicine could be a part of that model, Dickey said. However, the project would not be fully reliant on telemedicine: “We have to have a physical presence, periodically, of a person.”

HHI will work with the Highland Ambulance Service (HAS). HAS President Chris Tambini said one of the ways of having a physical presence could involve a community paramedic, someone on site who could interface with a remote doctor. 

While the facility itself might not have the resources of a traditional primary care center or urgent care center, the connections it fosters might make it easier for people to access the care they need. 

“The idea is that there’s a partnership, there’s a tandem of people that know you,” said Dickey. In other parts of the world, the model ends up relying on “a community health specialist who knows you, and they know your family, they know whatever diseases you might think about having, what medicine you’re on, they know when your kids are away, they know maybe when you don’t have enough food in your fridge—they know everything about you. Something changes, they know who to call to be able to help you, so you’re not on your own. The U.S. healthcare system puts all of the responsibility right now on the patient. It’s up to you that you have to go find it. You don’t have a partner like that now. And so for it to work we had to have partners. We need to have somebody who’s looking out for us.”

Project team members also mentioned HHI could provide such services as a preventative medicine; resources for senior health, mental health and substance abuse; and volunteer opportunities. However, they said, the process of building out HHI’s resources would be a slow one, informed by the needs of the community.

A community of support

Renovations to the facility will start shortly. According to the project team, expenses for the renovation are currently being OKed by New York State, which has supplied a $100,000 grant for that purpose, and renovations will start as soon as those expenses are approved. Dignitaries who gathered for the open house praised HHI’s mission and approach. 

Assembly member Paula Kay, who helped secure the New York State grant, said, “One of the things that I hear every single day when I’m in the district is, ‘We are so lacking in health care,’ especially in the western part of the district. So for all of you to put this together, to really find a solution to the problem, and do something here in Barryville, is incredible.”

Sullivan County Legislator Matt McPhillips said HHI was something that he and fellow legislator Catherine Scott talked about in their communities when they were running. “When you came to us with this idea, we both said, ‘Anything we can do to help,’ and I mean that, I want to adhere to that,” he said. 

“I really can’t think of another instance of a small town like this anywhere being willing to spearhead this like [supervisor John Pizzolato] has been,” McPhillips said.