More than doctor visits, a $30 million Kansas City, Kansas, clinic plan comes with a hopefully better neighborhood

Takeaways:

• Vibrant Health in Kansas City, Kansas, is raising $30 million to build a new clinic in one of the county’s poorest neighborhoods.
• The nonprofit has formed a community development corporation, hoping to spark more economic development in the area.
• Vibrant’s revenue has jumped 200% in five years, matching a national trend among federally qualified health clinics.

For a year, Vibrant Health has drafted plans for a $30 million building in Kansas City, Kansas, to bring in health care and kickstart a poor neighborhood.

The project reflects an evolving health care ecosystem where clinics cash in on the idea that some people get healthier or live longer not because of the doctors they can afford or the exercise they get, but because of social factors beyond a physician’s control.

Fast-growing nonprofit Vibrant Health treats 20,000 patients a year in Wyandotte County already. Now it envisions a 50,000-square-foot building on a vacant stretch of land north of Parallel Parkway near 13th Street.

Vibrant wants the new building to house primary care, dental and behavioral health clinics and a low-cost pharmacy.

In addition, it hopes to lease space in the new building to other service providers, to help meet basic needs in the area. Vibrant has also formed a community development corporation in hopes of spurring further investment in the surrounding neighborhood.

“This is one piece of land that is currently empty,” said Patrick Sallee, Vibrant’s president and CEO, “that we believe can add some energy and be a potential catalyst for other things down Parallel Parkway.”

Vibrant resembles other clinics with special designation — and added funding — from the federal government. It is taking on growing responsibility for low-income patients as the federal government bets that getting more poor people needed health care and social support early will lead to less costly care in the long run.

Especially in underserved areas like the northeast Kansas City, Kansas, neighborhood where Vibrant hopes to build its new clinic, residents’ health turns on social factors ranging from difficulty finding healthy food or affordable housing to income and education disparities.

Roughly a fifth of the area’s residents live below the poverty level. About one in four didn’t graduate from high school. And more than a quarter reported their health was poor to fair. The U.S. Department of Agriculture classifies the area as a food desert where residents have limited access to healthy, affordable food.

And largely because of factors like that, people who live there have a life expectancy of 71.8 years , almost 13 years less than people living just to the south in Johnson County’s tony Westwood.

Increasingly, health care providers like Vibrant, a federally qualified health center, or FQHC, are stepping up to help address some of the disparities. That can mean providing more support services to patients or straight-up economic development like Vibrant hopes to do.

“Even if we provide world-class, quality care,” Sallee said, “we can only do so much if the environment people go back into is bad.”

Nozella Brown grew up in this part of northeast Kansas City, Kansas, before “urban renewal” razed houses, grocery stores closed and poverty seeped so deeply into the lives of the people left behind.

Like others connected to the area, Brown has seen outsiders come in before with investment plans and promises about turning the area around. They all seemed to stall.

“They come in like the great white hope and (say) ‘We’re saving you’,” said Brown, who holds a doctorate in education and spent her career working to improve food access in underserved communities. “Traditionally disinvested communities have been forced to accept whatever has been given to them by those with the money and the power.”

Even plans for developments in this part of the city that have come from government-led efforts have fizzled out.

In 2014, the Unified Government of Wyandotte County began discussing plans for a healthy campus — with a community center, grocery store and farmers market —  about a mile south of Vibrant’s planned development. Political changes have meant the plans, even the much-needed grocery store, haven’t materialized.

It’s understandable, then, Brown said, that residents in the area may be skeptical that Vibrant’s promises will end any differently. But as a member of an advisory council that Vibrant set up last year to give input into project plans, Brown said she is hopeful.

“Vibrant decided to listen,” she said. “There was a lot going on here — a lot of organizations, neighborhood groups that were doing good things with hardly any resources. And that’s key. … Vibrant was coming in to build on that and support that.”

Last year, Vibrant invited the advisory council to help decide how the new health care facility should look, what it should be called and which other tenants should be invited to move in and lease space.

The council draws membership from 18 neighborhood groups, churches and other nearby organizations. Members have taken trips to learn from developments in Oklahoma City and New Orleans. And they meet regularly to discuss the project, Brown said.

Vibrant, which came to life 34 years ago as a community health clinic staffed by volunteer doctors, plans to formally hand some future control to residents in the neighborhood. It’s setting up a community development corporation, a nonprofit controlled in part by people and organizations in the area the clinic is designed to serve.

Matthew Kleinmann, Vibrant’s director of community development, said the project will likely be structured so the community development corporation is the prime tenant in the building. Vibrant Health will own the building, Vibrant CDC will lease it as the prime tenant and then sublet it to Vibrant’s clinics and the other tenants who come in. Money made on rent will be funneled back into the community.

“It’s a commitment to sharing power,” Kleinmann said. “You don’t have to look far to find projects, including clinics, where they design the building and they show it to the community and say, ‘This is what we’re doing.’ … We would like to do it differently and actually invite the community to learn alongside us.”

Vibrant Health began as Turner House Clinic in 1990, founded by a group of volunteer doctors. In the beginning, Turner House cared for uninsured children and mothers in one neighborhood. In the three decades since, one clinic has grown to four and Vibrant’s patients range from pediatric to geriatric. They get  primary and dental care and behavioral health services. Vibrant also operates a pharmacy that can sell patients medications at cost.

Dr. Sandra Stites, Vibrant’s chief medical officer, remembered one patient who came to Vibrant after being handed a prescription at a nearby emergency room that would have cost $500 to fill. But at Vibrant’s 340B -designated pharmacy, the patient got it for $40.

“There are just stories and stories, again and again, about the impact it has when you don’t have to choose between buying food and medication,” she said.

Turner House became Vibrant Health in 2018, when it merged with three other Wyandotte County clinics, including one operated by The University of Kansas Health System , a Wyandotte County neighbor.

In 2019, Vibrant got its FQHC designation, which entitles Vibrant to higher Medicaid reimbursement rates than other providers and also additional financial support from the federal government.

With passage of the Affordable Care Act in 2010, financial support increased. FQHCs got just over $2 billion from the federal government in 2010. By last year, federal funding had grown to close to $6 billion.

Congress has doled out about $1.7 billion a year. But another pot of money, established with the ACA as the Community Health Center Fund, has increased significantly, and now accounts for about 70% of the federal money being funneled to FQHCs. Community Health Center Fund support reached $3.9 billion in 2023, up from $1 billion in 2011, the first year it was allocated.

Dr. Steven Stites, chief medical officer at The University of Kansas Health System, was on the board of Turner House when the original FQHC was formed. It only made sense, he said, for the community clinics in Wyandotte County to go after the federal money.

“We weren’t leveraging the dollars,” said Stites, who is married to Vibrant’s Sandra Stites. “So we had these rather balkanized safety-net clinics, all of which had a good heart ….  The need was much greater than anyone of those clinics could afford.”

Since Congress began increasing federal funding, FQHCs have become an increasingly significant part of the health care landscape. In 2022, 1,370 FQHCs provided care to 30.5 million people, the majority covered by Medicaid and 45% whose incomes fell at or below the federal poverty level.

Because Vibrant is a newer FQHC, its federal grant only covers about 2% of its budget. The organization relies on philanthropy and its heftier Medicaid reimbursement rates to cover costs. By 2022, Vibrant’s revenue had jumped to $17.3 million, a 200% climb from 2018. That increase came in part from taking over a pediatric care clinic operated by Children’s Mercy that year. Vibrant acquired another nonprofit clinic in 2023.

FQHCs in Kansas City are spreading rapidly. During the same five-year period, 2018  to 2022, Swope Health, Kansas City’s largest FQHC, reported a 43% jump in revenue to just under $80 million. KC Care’s revenue increased 150% to $35.5 million and Samuel U. Rodgers Health Center reported an increase of 34% to $28.6 million.

In exchange for financial support , FQHCs agree to treat anyone — insured or not — who walks through the door and agree to offer a sliding payment scale to make care more affordable to uninsured patients. Services go beyond basic care. FQHCs also offer patients social support, like transportation and dental and mental health services. Often, they also help patients sign up for safety-net services like Medicaid or deal with housing struggles.

At Vibrant, all of those services are on the table. The vast majority of patients live at 200% of the federal poverty level or below, 32% are uninsured, 56% have Medicaid and 62% are best served in languages other than English — mostly Spanish, but also around 20 others.

Vibrant has an option with the county on the property at 13th and Parallel, where it hopes to start building in early 2025. Sallee said the new facility could open in the second quarter of 2026.

But first, the organization has $30 million to raise. Vibrant is also hoping to raise an additional $20 million for other capital improvements and operational costs. So far, the Hall Family Foundation has committed $5 million to the project. And Vibrant leaders are hopeful the project will get $4 million through a federal earmark.

If plans come together, Brown said it could make all the difference to her old neighborhood. She still remembers it as a place where children played outside and shopping, churches and schools were within walking distance.

“We all know that everyone deserves a nice health care facility,” Brown said. “And we all want equity. But we also know that within our country that’s just not true — and it’s definitely not true in our county. But this is an opportunity, with all of the complexities and all of the risks involved, to say, ‘We’re going to do this differently.’”

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