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Celebrating 20 Years of Caring

On December 1, 2003, CCCHC was awarded grant funding to become a Federally Qualified Health Center. With now over 110 employees, four health centers, and five school-based clinics in the communities of Beulah, Hazen, Center, and Killdeer, CCCHC is celebrating their 20-year Anniversary!

Navigating the Healthcare Seas:The 20-Year Journey of Coal Country Community Health Center

By: Aaron Garman, MD – CCCHC Medical Director


The landscape of healthcare organizations is continually evolving, adapting to the shifting tides of the industry. Recent examples, such as the acquisition of Mid Dakota Clinic by Essentia, illustrate the constant change and the growing pressure to expand and adapt. Even rural healthcare providers are not immune to these transformations, facing their own unique challenges and opportunities. This essay traces the inspiring journey of Coal Country Community Health Center (CCCHC) over the past two decades, reflecting on the organization's inception, evolution, and its unwavering commitment to its primary guiding principle: the best interests of the patients it serves.

Inception and Early Challenges

Dr. Aaron Garman, a fresh graduate from a residency program, embarked on a journey to serve the community in August 1999. At that time, he joined the "new clinic" in the area, Med Center One, a tertiary care facility in Bismarck. The clinic had a modest staff of nine dedicated individuals, led by Teresa Klipfel, the manager. These early days were marked by hard work, enthusiasm, and the shared mission of providing quality healthcare to the local community.

During the late 1990s, Bismarck-based healthcare organizations like Med Center One and St. Alexius Medical Center, operating with Sakakawea Medical Center, were major players in the region's healthcare landscape. A clash between these titans shaped the healthcare scene for several years. However, Med Center One's struggles, leading to the impending closure of ten rural clinics, created pressure for CCCHC to explore alternative options.

Dr. Garman and Carla Anderson, the regional manager from Med Center One overseeing the clinic, shared a common concern for rural healthcare. Carla's passion for serving rural patients was contagious. Together, they proposed the idea of the clinic becoming a Federally Qualified Health Center (FQHC), aligning it with the mission to prioritize patients' best interests. Med Center One's leadership agreed to support this transition, hiring a grant writer, Jane Bruggeman, to assist in the grant application process.

In December 2003, CCCHC was awarded the grant to become an FQHC, marking the beginning of a new chapter in the organization's history.

The Road to Independence

With the grant secured, the arduous task of establishing the foundation for CCCHC's independence began. The Board was formed, and a new clinic name was chosen. Med Center One's decision to withhold computer system access posed a significant challenge, but the dedicated employees of CCCHC met it head-on, adapting to new systems and working tirelessly to ensure a smooth transition.

Overcoming Challenges and Prioritizing Patients

Since its inception, CCCHC has faced numerous challenges. However, its commitment to providing the best possible patient care has remained unwavering. The Board members of CCCHC have played an essential role in providing strong leadership throughout the organization's journey. Despite seeing five CEOs in its short 20 years, CCCHC's dedication to its mission has allowed it to grow rapidly, serving around 9,000 unique patients across four formal clinic sites and three school-based sites.

CCCHC has been a pioneer in providing virtual care to enhance access for all patients. The organization's focus on value-based care has earned it recognition not only within the state but also on a national level, particularly for its screening efforts. The dedication and excellence of its employees have propelled CCCHC from a small team of nine to an organization with over 110 employees.


As Coal Country Community Health Center celebrates its 20th anniversary, it stands as a testament to the power of dedication, perseverance, and an unwavering commitment to the best interests of the patients it serves. The journey from a small clinic to a thriving healthcare provider has been marked by challenges and triumphs. With a dedicated Board, visionary leadership, and a passionate team, CCCHC has maintained its course, following the North Star of excellence in care for its family, friends, and communities. The legacy of CCCHC is a reminder of the remarkable impact a collective commitment to patient care can have on a community. Happy 20 years, CCCHC, and here's to many more years of service and success in rural healthcare.