The wall decor no longer hung, the stacks of paperwork seemingly grew on the desk in the odd-shaped office space. A lonely helium balloon, given weeks before it actually meant anything, was losing its luster.
Rick Johnson isn't losing his, even as an important chapter in his life ends.
In November, the tall, 69-year-old will walk away from his job as CEO of River Hills Community Health Center. Though he's retiring from work life and ready to transition into something else, he can take solace in the fact that he has helped people for over 40 years, making sure they were cared for with professionalism.
"I've always been driven to make a difference in people's lives," Johnson said. "I've always kind of thrived in that helping environment. I like to try to make things better not only for the individuals, but for the communities they live in."
There from the beginning
River Hills has been in operation for almost 21 years, and Johnson has been the CEO for almost 16. But his fingerprints have always been on the health center.
Johnson recalled in 1998 he was asked to put together a group of community stakeholders, including current Ottumwa Mayor Tom Lazio, to discuss the possibility of building a federally qualified health center, a concept completely foreign to Johnson.
"We had this $650,000 earmark from a senator for this health center, and my response was, 'What's a federally qualified health center?'" said Johnson, who, at the time, was heading toward the end of a nearly three-decade career with the Iowa Department of Human Services. "So there were about 35 or 40 people and we discussed it, and they were like, 'If you don't think Ottumwa is interested in this, we're going to go down and offer it to Burlington.'
"I knew we had a lot of poverty in this part of the state, and there were a lot of folks who could benefit from access to quality health care."
The earmark had to be used for salaries and services, but everything moved quickly. Within two years, River Hills was in its building on Market Street, and then opened in November of 2000.
Johnson's involvement, however, did not end. He eventually was part of a downsizing at DHS in 2002, while serving on the River Hills board of directors. River Hills went through two CEOs in five years, and the board asked Johnson about his interest in taking over.
"I helped put it together, not knowing that I was ever going to work there. When I left DHS, I wanted to stay in southeast Iowa," Johnson said. "I was pretty invested with River Hills already."
Building a medical juggernaut
River Hills opened with 12 staff members; the staff is now closing in on 200.
"One thing of the things while I was on the board, we felt we really needed to try and start growing the program," Johnson said. "There were all these unmet needs, so I was pretty committed to that because we had a very small presence in Ottumwa, but yet we were responsible for eight counties.
"It's been really pretty challenging."
The work has paid off. The perk of a federally qualified health center is the sliding-fee scale for patients based on their gross income. Also, through federal Health Resources and Services Administration (HRSA) grants, River Hills has been able to extend its footprint into surrounding areas, building clinics and expanding services.
However, Johnson is the first to say he didn't do this by himself.
"Our greatest asset and our biggest value is our staff," he said. "They're very committed to providing quality care to for patients that we're entrusted to take care of.
"We've tried to market ourselves as being here for everyone," he said. "We have a very good payer mix, probably 35% on private insurance, 45 to 50% on Medicaid, 10% on Medicare and about 20% are sliding-fee patients that can't qualify for insurance for some reason."
Johnson said it was also important to build partnerships in communities the center serves, such as providing therapists to local school districts, and providing services to families served by First Resources, American Home Finding, etc.
"I think that's how you get a lot more buy-in and support from the community. You try and reach out and partner with people," Johnson said. "It becomes a win-win situation for everybody."
The last 15 years have seen the center's biggest growth. Not only have clinics opened in Centerville, Richland, Oskaloosa, Fairfield, etc., River Hills has expanded its dental services in Ottumwa, and offered obstetrics in Ottumwa, but it's also beefed up its behavioral health department.
Currently, there are 10 clinics covering five of the health center's eight counties.
"A lot of small organizations can't provide all the services they'd like to, so you need to partner. That's probably one of the most enjoyable parts of the last 16 years. It's one of the most gratifying parts of the job."
Turning the page
Johnson gave the River Hills board nine months' notice to find his successor, and plans are still being finalized in that regard. Whatever happens, Johnson will stay on as long as needed to make sure the transition is as seamless as possible.
"There's a lot of things that, you know, if I was 20 years younger and could stay in it for like 40 years, there'd be a lot of things I'd still like to see happen," Johnson said. "We built our two-story addition six years ago, and we can add a third story. Our behavioral therapists will need more room, and I'd like to see things like podiatry, optometry, chiropractic services added. Right now there isn't the space to do it."
Johnson is also one of the two finalists for mayor of Ottumwa, and currently holds a temporary seat on the city council. It's the first time he's ever held public office.
As for River Hills, he's excited about its future, from the present he's helped create.
"There will be all kinds of opportunities for continued growth in the next several years," he said. "I've kind of scratched the surface."