BETHEL — When Dr. Richard DeCarolis started working at the Bethel Family Health Center more than 20 years ago, the center mainly provided urgent care for people with bumps and bruises.

“We were seeing people for broken wrists, twisted ankles,” he said. “Most of them got their regular care in Norway.”

There was a regular turnover among providers at that time, said DeCarolis, with Physician’s Assistant Jan Whitworth the only stable presence.

He remembers asking some patients if they would consider becoming regular patients in Bethel, and they would answer, “I’ll just get used to you and you will leave.”

DeCarolis, along with Dr. Kevin Finley, who came to Bethel at the same time, proved those patients wrong. The two doctors are now fixtures at the center, and have been part of many changes that have taken place.

DeCarolis said much of the urgent care in the earlier years stemmed from ski injuries at Sunday River Ski Resort in Newry. But then the skiway established its own clinic to treat many of those injuries.

While that took some business away, he said, it also allowed the center to focus more on regular medical care.

“We became a more stable practice that way,” DeCarolis said.

In 1999, the health center became part of the statewide HealthReach Community Health Centers organization. Now it serves nearly 4,000 people from more than 25 towns, and in 2014 those people made more than 13,000 visits, according to information provided by HealthReach.

Bethel Family Health Center is a federally qualified health center, and therefore serves all members of the community, regardless of age, medical condition, or ability to pay, according to HealthReach. More than 370 patients take part in the Affordable Care program, which allows low-income patients to receive services at discounted prices. They may also qualify for assistance with paying for needed medications, and last year 62 patients received free prescriptions for a savings of $252,000.

The health center has also expanded its services to address behavioral health and substance abuse needs, and offers dental hygiene services for children two days a month. A social worker also provides help to patients to solve problems with medical expenses, obtaining medications, food, housing and transportation, as well as connect them to legal, elderly, behavioral health, disability and employment services. Telepsychiatry and care management are expected to be offered in the near future, according to HealthReach.

DeCarolis said it is very helpful to have Leslie Lufkin, a licensed clinical social worker, on site to talk to patients immediately, if needed. A doctor can say, “Let me get Leslie,” he said. “It’s a warm handoff. People can get help quitting smoking and changing other habits.”

He also said the presence of a social worker helps the staff with referrals into the mental health system, which can sometimes be difficult to navigate. “It’s fabulous to have someone who knows the agencies,” DeCarolis said.

The health center has also worked to develop a system to ensure provider availability and follow-up. “It allows primary care to do the best job it can do to keep patients well in between visits,” he said. “We hope patients notice they can get in in a reasonable amount of time.”

That was a challenge for a time over the past year, after Whitworth retired and Physician Assistant Mary Moses left the practice. But in recent months the center has added two staff members: Catherine Chamberlin, doctor of osteopathic medicine, who received her degree from the University of New England and is a graduate of Dartmouth College; and Kristen Waitt, a family nurse practitioner who graduated from a program at Vanderbilt University and has an undergraduate degree from Boston College.

Having the center fully staffed again, DeCarolis said, “is a load off our shoulders.” He also said it’s a benefit to have two female health providers again, which some women prefer.

Asked how the center is doing adapting to the Affordable Care Act, DeCarolis said,  “It hasn’t been difficult at all. Any time more people have more medical coverage, it’s better.”

He said there is more of an adjustment with changes to Medicare, which has eliminated payments for a traditional annual physical in favor of a “wellness visit,” which includes a detailed interview with patients to identify and reduce health risks. If something is indicated there for treatment, a specific appointment is then made for that purpose, DeCarolis said.

In addition to the center’s staff and service additions, the center is also looking to better serve patients in the future by reorganizing its building in order to provide more exam rooms.

“We’re finding it’s cramped with four exam rooms,” DeCarolis said. “We hope to do some redesign. It’s in the planning stages.”

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