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Appalachian Community Health Centers to Open After Delays


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By Margaret Williams

This story first appeared in Carolina Public Press and is published by N.C. Health News through a content-sharing agreement.

Initially scheduled to open in Asheville last fall, Western North Carolina’s newest community health center has seen substantial delays, but the facility’s director says he expects it to open Feb. 8.

Nic Apostoleris is director of the new Appalachian Mountain Community Health Centers. Photo credit:

Nic Apostoleris is director of the new Appalachian Mountain Community Health Centers. Photo credit:

Appalachian Mountain Community Health Centers, awarded a $704,167 federal grant last May, had been scheduled for a September 2015 opening.

“Delays on our end [came from] trying to nail down contracts [and] doing this the right way,” director Nic Apostoleris told Carolina Public Press in October when the center was only a few weeks behind.

That same month, representatives of the U.S. Health Resources and Services Administration, which oversees such health centers, visited Asheville and “provided training and technical assistance,” Apostoleris said.

Some regional leaders of other health centers saw the visit as a sign that HRSA was investigating the new organization or at least scrutinizing its progress more closely, in part because of its close ties with a major hospital, Mission Health, and the Mountain Area Health Education Center, as Carolina Public Press reported Oct. 19.

After a two-year process, Appalachian Mountain had been awarded status as a federally qualified health center – independent nonprofit organizations that provide care to “medically underserved populations/areas or special medically underserved populations comprised of migrant and seasonal farmworkers, the homeless or residents of public housing,” according to HRSA guidelines.

“Since approval [in May], we’ve been working to iron out the details,” Apostoleris said, responding to the criticism. Some of the 16 sites listed in Appalachian Mountain’s federal application were dropped from its plans, he said. Others were still being negotiated.

“What we all want is to do this the exact right way,” Apostoleris said.

As the new year arrived, none of Appalachian Mountain’s proposed sites had been opened.

Asked about the nature of the fall 2015 visit to Asheville and the reason for the delay, HRSA spokesperson Elizabeth Senerchia said the agency “utilizes a variety of methods to monitor health-center program grantees throughout the year to support continued compliance with program requirements.”

The agency can’t comment on progress at a specific health center, she said.

“We also work to identify areas where technical assistance might be beneficial (and work) with grantees to resolve identified issues while also focusing on continuity of service so that people in the communities the health centers serve can continue to receive high quality primary care.”

A few weeks into 2016, Apostoleris reported, “Now it’s coming, and it’s real. We’re opening on Feb. 8.”

He also said, “It’s been a difficult birth process.”

Appalachian Mountain will launch services at 7 McDowell St., a location selected and prepared with cooperation with MAHEC and the Asheville Buncombe Community Christian Ministry, he explained. The new access point, or NAP, will be named after Dr. Dale Fell, a former chief medical officer at Mission Health, MAHEC board member and longtime healthcare advocate in the region.

Despite other delays along the way, “we’re getting it right,” Apostoleris said. “We’re ready to go.”

He emphasized the regional need for affordable care, Appalachian Mountain’s independence as a health organization and the community-based mission of aiding the underserved. He’s assembled “a good clinical team” for the Dale Fell Health Center, he said, and he’s close to announcing satellite locations in the region.

Jeff Heck, director of MAHEC, helped establish Appalachian Mountain. MAHEC is continuing its collaboration with the new organization, he said.

Mission spokesperson Susan Dunlap said the hospital isn’t aware of “any change of status [for] Appalachian Mountain Community Health Centers.” Nor is there “any change regarding Mission Health’s involvement with the new health center.”

Appalachian Mountain will help “expand access to critically needed services in Western North Carolina,” she said.

Apostoleris, the former interim chief operating officer of a community health center in Massachusetts, had served as board president for the National Health Care for the Homeless Council. He’s used his experience to “rework” Appalachian Mountain’s model “and align the details with what community health centers are supposed to do,” he said.

The Dale Fell clinic will complement other local organizations that help the homeless, and new access points across the region will help those who need affordable care, Apostoleris said.

“We’ve made a lot of progress [on Dale Fell and satellite locations]. This is a starting line.”

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