The friendly receptionist with strawberry blond hair and freckles gives the patients at the desk instructions in Spanish before sending them to fill out some paperwork.

Almost every sign at Mountainlands Community Health Center is posted in both English and Spanish, including the notice above the receptionist's head: "If you have been waiting for 15 minutes or more, please see the receptionist - Si ha estado por 15 minutos o mas, favor de ver a la receptionista," and the posters on dental care: "Be good to your teeth - Cuida tus dientes."

The clinic, located at 215 W. 100 North, Provo, provides low-cost medical, dental and mental health services to everyone, insured or not, English speaking or not.

On this Wednesday in early December, female physicians, nurses and medical assistants from Mexico, El Salvador, Brazil, Argentina, Chile and the United States bustle around the desk at the back nurses station, filling out charts, making phone calls - many in Spanish - sharing theories on men and squabbling over the hot topic of the day: the office holiday gift exchange, to be held at an international potluck.

"I knew it, someone's name is on here twice!" Cristina Larsen cried out.

Larsen was the nurse's station supervisor and mother hen for the day.

Inside the back laboratory room, she talked about the clinic as she prepared vaccinations for her next patient.

Most of Mountainlands' patients are uninsured, some are on Medicaid and the smallest proportion have some insurance, Larsen explained.

"The only difference is in the billing," Larsen said. "The care is the same for everybody."

About 50,000 people in Utah County don't have medical insurance.

Mountainlands offers a "sliding scale fee" system in which the cost of care for uninsured patients is determined by income level and size of family.

She abruptly darted out of the room to "give a shot to a screaming kid." Outside she greeted the patient, a young girl, immediately asking, "Do you speak English?"

Answering "no," the girl skipped down the hall, long brown ponytail swinging, and followed Larsen into a garland-trimmed exam room.

Larsen, who is half Brazilian and grew up in the United States, said the clinic is an extremely beneficial and important part of the local Hispanic community.

"Spanish people like to get close, they like people that listen," Larsen said. "They become our friends. The patients bring cookies and cakes to our doctors. They love that the doctors are returned missionaries that understand their culture and speak their language."

But staff members emphasized Mountainlands is not only a Hispanic clinic.

"It's a misconception," said Leto Quarles, one of Mountainlands' four family practice physicians. "We see a lot of Spanish speakers, but we take care of anybody. We have lots of patients from all over the world, not just Latin America. We are a great resource for anyone who's uninsured."

But it's not a free clinic either, staff insisted. In fact, a unique feature of the clinic's services is that they accept Medicaid - something fewer providers do these days, said Marilyn Tiffany, Mountainlands administrative assistant.

"No one else will take patients with Medicaid," Tiffany said. "We are happy to have Medicaid, and we are happy to have those that are insured too. We are happy to have everyone."

Tiffany works in a building across the parking lot from the main clinic. The administrative offices were moved there because the clinic grew so quickly, Larsen said as she marched across the slushy concrete.

Although physically detached and void of the active flurry of the clinic, the offices contain the same warmth and pride that radiates from the nurses's station.

It is there that they worry about maintaining funding - "hustling for funds," as Larsen calls it. Greg Parker, Mountainlands development director, is in charge of finding new funding for the clinic.

"The majority of the funding is through federal grants and the IHC [Intermountain Healthcare] but we want to attract more funding from private organizations," Park said.

One company that supports the clinic is Smith's Food and Drug on Freedom Boulevard. Through the Association of Utah Community Health Program, Smith's offers discounts on prescriptions to Mountainlands patients. Pharmacists also translate prescriptions into Spanish if needed.

Support from Smith's helps make health care a bigger priority in the community, said BYU student Francisco Kortman, who works as a translator for an English-speaking physician's assistant at the clinic.

Kortman, who was born in Costa Rica, said the clinic provides a place for Spanish-speaking patients in a way that they feel comfortable.

"By having good health care at the clinic, they are not scared to be treated for their maladies," Kortman said. "That's good for any healthy population." The environment of the clinic itself seems to be good for the population. Several of the employees said how much fun it is working at the clinic, and the affinity between staff members is tangible. That bond includes patients and even the pharmacists at the nearby Smith's store, Larsen said.

"We love and kiss and fight just like real family," Larsen said.

Copyright Brigham Young University 23 Jan 2006