MOUNT VERNON — On Thursday, the Knox County Commissioners paved the way for the health department to realize a long-held goal: providing dental services to the eastern part of the county.
“We have the opportunity to obtain a dental practice in Danville,” said Health Commissioner Julie Miller. “Legally, the [Knox County] Board of Health cannot purchase an asset like that, so we approached the commissioners to do that for us.”
The commissioners approved purchasing the Medicaid practice of Aaron Lerg, DDS, at 706 S. Market St. The real estate purchase price is $130,000. The price for the practice assets, which include furniture, equipment, and accounts receivables, is $282,500.
“The commissioners are the borrowing authority, but the payments will be paid by the health department,” explained County Administrator Jason Booth.
Lane Belangia, chief operating officer for the Knox County Community Health Center, said that according to law, the health department cannot purchase property, but it can acquire property. The purchase arrangement with the commissioners is similar to a lease-to-own agreement.
When the loan is paid off, the county will sell the property to the health department. Under such agreements, the selling price is typically $1.
Belangia said it will be a 10-year loan with an annual payment of around $36,000. Although he anticipates the health department will pay off the loan early, the longer term allows time for Medicaid reimbursement to catch up with provision of services. With the credentialing and billing process, it can take up to one year before the department sees any revenue from its dental services.
The federally qualified community health center, operating under Knox Public Health, began providing medical services in Danville in February 2019. From the start, the goal has been to expand services to include dental as well.
“We are excited about the opportunity to provide dental services in Danville for the under-served community,” said Miller.
“We also hope to bring additional services to the Amish community out there, such as affordable dentures,” said Belangia, who worked with Lerg for about a year to acquire the practice.
“Dr. Lerg and Dr. Glibert developed that practice to provide low-cost dental care. The reimbursement model of Medicaid makes it very hard for providers to continue to operate with such low reimbursement,” said Belangia. “Down the road, Dr. Lerg potentially selling the practice worried us. He wanted us to have the opportunity first.
“The decision was really to keep that clinic operational and bring it under the umbrella of the community health center,” he continued. “The community health center receives federal funding so that those with no insurance or Medicaid have guaranteed care the same as those with other insurance.”
The practice sees about 3,000 patients a year.
Belangia plans to work with Lerg to retain some of his staff members in the clinic. A new dentist relocating to the county will provide services.
“Federally qualified health centers attract providers because the provider can come to us and work because of guaranteed loan repayment,” said Belangia.
Dr. John Cheek, the oral surgeon for the health department, will have a dedicated schedule in Danville, something which Belangia said is greatly needed.
“People drive from 2 ½ hours way to see him because there are no oral surgeons who are willing to see Medicaid patients,” he said.
Belangia expects the board of health to formally approve the purchase agreement at its December meeting. He anticipates seeing patients within the first two weeks of January.