Ten years ago, when the last private practice physician traded a Cloverdale shingle for a Kaiser office, the small rural clinic known as Alexander Valley Healthcare became the only primary care provider between Healdsburg and Ukiah.
Since then, from this modest single story, T-shaped structure on the corner of South Cloverdale Boulevard and Tarman Drive, a small team of medical professionals has struggled to keep up with the demand, even as the state has pared back its health care funding.
But a new era is about to begin for this unique North Coast lifeline, putting it in the same league as the far larger Santa Rosa Community Health Centers, the Petaluma Health Center and the West County Health Centers.
This year, after 18 years as a rural health center, Alexander Valley Healthcare was declared a federally qualified health center, a crucial designation that comes with an enhanced Medicare and Medicaid reimbursement. It also means hundreds of thousands of dollars in federal health care grants.
Since the Bush Administration, the federal government has poured billions of dollars into building up the nation's community clinic infrastructure.
Part of the Redwood Community Health Coalition, Alexander Valley Healthcare is the last of the coalition's qualifying community clinics to receive the federal status.
"We're not the orphan anymore," said Deborah Howell, Alexander Valley Healthcare's CEO, who becomes visibly giddy when thinking about the future of the clinic.
"It's huge," she said. "We can maintain health care in this community. Without this grant we might not have been able to stay open. That's how big this is."
The Cloverdale clinic became incorporated as a rural health center in 1995. When Howell joined the clinic 12 years ago, she said, there were five physicians practicing in town. The last one left in 2006.
Seven months ago, when Bertha Herndon and her husband moved to Cloverdale from Waterloo, Ill., she immediately began looking for a primary care doctor to help manage her diabetes. She has had the disease for 30 years and has an insulin pump that requires her to have frequent consultations with a doctor.
Eager to avoid driving to Santa Rosa, Herndon searched her iPad and found Ann Luke, a nurse practitioner at the Cloverdale health center.
"I'm very happy, Ann has been so wonderful," Herndon said during an appointment at the clinic last week.
Most other Sonoma County health centers historically have served uninsured and low-income patients, but Alexander Valley Healthcare also serves a large number of insured patients.
Herndon is insured by Anthem Blue Cross through her husband's Santa Rosa employer, and is one of about 640 patients at Alexander Valley Healthcare who are covered by private insurance, Howell said.
That's 16 percent of the clinic's 4,000 patients. An additional 24 percent are covered by Medicare, 36 percent have Medi-Cal insurance (California's Medicaid program) and 24 percent are uninsured.
The federal designation, announced last month, brings $733,000 for the first 14 months and $650,000 each year thereafter. The funds will be used to expand services for uninsured and under-insured patients.
Among other things, the money will allow the health center to greatly expand doctors' hours and hire another registered nurse, a licensed clinical social worker, a substance abuse counselor and a dentist and dental support staff. The health center was forced to shutter its adult dental services in 2009 because of state budget cuts.