10 Sep
by Derrick Vander Waal
SIOUX CENTER, IOWA – Melissa O’Rourke has been a driving force behind Promise Community Health Center in Sioux Center since early dreaming about it began.
SIOUX CENTER, IOWA – Melissa O’Rourke has been a driving force behind Promise Community Health Center in Sioux Center since early dreaming about it began.
It was well over a decade ago, while advocating for under-served people in the region, when she started realizing the need in Sioux County for a community health center – a place that would provide access to care for people of all incomes, including those with no health insurance.
She recognized the cause while serving on the Center for Assistance, Service and Advocacy (CASA) Sioux County’s board during its early days and providing monthly free immigration legal assistance clinics. She saw the demand while working in the criminal justice system – both as a public defender attorney and as a prosecutor.
“We started having conversations about the need to provide access to health care for everyone – not just the privileged in our society,” O’Rourke said.
The informal talks about the idea to establish a community health center progressed into formal meetings that began in 2003. A steering committee and an initial board of directors was formed in 2006. O’Rourke said the team was committed to “a dream of quality, affordable health care accessible to all.”
That dream came to fruition when Promise – then named Greater Sioux Community Health Center – opened in July 2008 after receiving incubator funding from the Iowa Department of Public Health. Until 2012, Promise was recognized as a Federally Qualified Health Center Look-Alike. In June 2012, Promise received federal funding from the Health Resources and Services Administration and was designated as an official FQHC.
Through it all, O’Rourke played a key role. She was a mainstay on the board of directors until this summer when she and her husband, Joe Skoda, moved to rural Decorah in northeast Iowa. There, she will continue to work as a farm and agribusiness management specialist and attorney for Iowa State University Extension and Outreach.
“Promise CHC owes a debt of gratitude to Melissa,” said Nancy Dykstra, executive director of Promise. “As a founding member, Melissa donated hours of her time to drafting policies, bylaws, reviewing contracts and filing documents that were essential to establishing the organization. She believed in the mission, and she knew that the center did not have the financial resources to purchase these services, so she stepped up and provided what was needed. She never wanted credit or accolades, but her background and involvement at the board level was vital to guiding the organization’s development.”
With O’Rourke’s direct involvement with Promise coming to a close, she reflected recently on her many years of volunteer service with the organization:
Q: Why were you interested and willing to serve on the Promise board all these years?
A: Everyone needs a ministry, and in a way, I guess this community health center became mine. One of my favorite texts is Matthew 25:34-40 – where those who enter into the kingdom of heaven are told, “For I was hungry and you gave me something to eat . . . I was sick and you looked after me . . .” And they ask, “Lord, when did we do these things?” And the response is, “Whatever you did for one of the least of my brothers and sisters, you did it for me.” Jesus didn’t tell us to take care of the sick if they have money and health insurance and if you can make a profit doing it. It’s shameful that in the world’s richest country, people go without health care because they happen to be poor or uninsured. . .
As time went by, the community health center has stayed on track and moved ahead to provide health care services accessible to all. . . The board, the staff and community members have worked together to continue to build on the early vision. That’s been very gratifying to me, and I guess that’s why I wanted to continue to serve.
Q: As you reflect on Promise’s history, what have been the most exciting progressions you’ve seen through the years?
A: There have been many exciting days. I will never forget the day when we heard that we were going to receive incubator funding from the state of Iowa and that we would actually start to move forward, remodel an old bowling alley and open our doors to provide health care.
Another exciting time was when we were working on a plan to provide oral health care – it was invigorating to go door-to-door throughout the region, calling on individuals and businesses to ask for their support, making a presentation in Des Moines to Delta Dental to receive some initial funding, having Sen. Tom Harkin visit us to see the reality of our oral health-care center.
But I have to say that one of the most important decisions we made before even opening the doors was that we would provide prenatal and birth services to families in our region based on the research that many women were going without such care prior to the existence of Promise. It’s amazing that we annually have over 100 babies born to mothers who received their prenatal care at Promise – many of whom would have received no prenatal care but for our existence. This year, we expect that at least 40 women will give birth at home through the home birth services provided by the certified nurse midwives and staff employed by Promise.
Q: What are some of the biggest challenges that the health center has had to overcome?
A: Two things come to mind. I clearly a remember a time frame when the state of Iowa incubator funding was discontinued, and we had not yet been successful in obtaining our federally qualified health care status and funding. We continued to exist based on what clients could pay, donations and what insurance and Medicaid payment we could garner. We had some very generous donors, and things turned around for us, but it was a challenging time.
Second, we have had a continuous challenge with the unwillingness of some to understand the role of a community health center, and this is not uncommon for CHCs. However, we continue to hope that sometime there will be better understanding that people have the right to make choices about their health care, and that by working in a cooperative spirit, the entire community will benefit.
Q: How would you assess the overall health of Promise right now?
A: Right now, the overall health of the center is excellent. We continue to build a strong leadership team, board of directors, and a strong contingent of providers and support staff. Our strategic planning continues to guide us, and we look to the future to expand services and maintain and build the quality health care the center provides.
Q: What do you foresee for the future of Promise?
A: The Promise Birth Center. My biggest regret is that I will not be on the board when the Promise Birth Center is established. Unfortunately, we had a setback when the Iowa Health Care Facilities Council allowed themselves to be persuaded by the contingent of opposition from this region who do not understand that women and families have the right to access the kind of birth experience that is right for them.
Women want the opportunity to have births attended by qualified, certified nurse midwives, and right now the only way they can have that experience in our region is through a home birth. But that might not work for everyone, and a freestanding birth center staffed by CNMs should be an option. . . Promise will reapply, and the day with come that families in our region will have the option to choose a birth experience attended by a nurse midwife in a freestanding birth center. For now, those who can will continue to have that experience in their homes.
Q: Overall, what has the experience of serving on the Promise board been like for you?
A: Serving Promise has given me the opportunity, over and over again, to believe that a few people with a dream, building a team and working toward goals, can make a huge difference in the well-being of individuals, families and the community. Of course, there have been moments of frustration and concern, but perseverance and persistence, maintaining focus on our goals, has allowed me to see the real results of improved lives for those we serve.
Q: Is there anything else you would like to add?
A: Community health centers are patient-centered, and I encourage the board and leadership to maintain that focus – keep focusing on the people we serve, their needs and their choices, and Promise will continue to make a difference in the lives of others.
Promise Community Health Center, headquartered in Sioux Center, is the only Federally Qualified Health Center in the far northwest corner of Iowa. Promise provides medical, dental, prenatal and behavioral health services. To learn more, visit www.promisechc.org.
ABOUT MELISSA:
Melissa O’Rourke works as a farm and agribusiness management specialist for Iowa State University Extension and Outreach. She is licensed as an attorney in Iowa and South Dakota and previously served as a public defender and as the county attorney for Sioux County.
She and her husband, Joe Skorda, have been married for 35 years and lived the last 16 years in Sioux County. They recently moved to rural Decorah, where O’Rourke will continue in her role with the Extension. They have three sons and five grandchildren. They raised registered Toggenburg dairy goats for 22 years.
O’Rourke is interested in traveling, writing and photography. She also is a Master Gardener.
BEHIND THE NAME:
Promise Community Health Center originally went by the name Greater Sioux Community Health Center but changed the name in 2012.
Melissa O’Rourke played a key part during many discussions about a name change.
The original name resulted in some confusion with Siouxland Community Health Center in Sioux City. Plus, O’Rourke said the name did not exemplify what Promise does.
“Somewhere along the way I was thinking about the commitment that was made when we started talking about a community health center – a promise that we made to the community that we would provide quality, affordable and accessible health care services to all,” O’Rourke said. “And that word ‘promise’ just said it to me – that we made a promise, and we needed to continue to focus on and keep that promise now and in the years ahead.”
She also encourages people to remember the word “community” in the name because “a community is a group of people who live together and support one another.”
“We promise to be a community that supports the health care needs of all,” O’Rourke said.