WILLSBORO With many people expected to weigh the costs of fuel, food, and medicine this winter, its often health care that gets cut from household budgets. Fortunately, there are options available for people in need. The Smith House, a health clinic in Willsboro, wants to make sure people in need of medical care and prescriptions dont go without because of fear they cant afford it. Since 2006 the clinic has operated as a Federally Qualified Health Center (FQHC). This means that it is designed to operate as a safety net provider in an underserved area. Because of that status, the Smith House can offer services and medication to patients who might not otherwise be able to afford them. The clinic charges for services on a sliding fee scale based on patients family income and size. Also, deductibles for Medicare patients are waived. We want people to know there are options, said Smith House Executive Director Robin Pierce. In addition, they also provide 340B pharmacy programs which help to make drugs more affordable. Its a tremendous asset, especially to people who are uninsured, said Pierce. It allows us to purchase the drugs at a lower rate than retail can. Those savings are passed on to patients with a similar sliding fee scale applied to pharmaceutical costs. Recognizing that some people are hesitant in divulging information about their income, the Smith House has taken steps to ensure confidentiality. We ask you to sit down with a third party, said Pierce. We want people to feel comfortable sharing that data. Though there is currently no physician on staff at the Smith House, a team of physicians assistants and nurses can offer a host of preventative primary care services. Pierce said that, while many people insist on seeing a doctor, mid-level providers are essential for caring for people in underserved areas like Essex County. By affiliating with and making referrals to other health care services in the area, she hopes the Smith House can assist people with getting the help they need in desperate times. Its about doing whats best for our community, Pierce said, we want to work with the town and our pharmacy to make things easier on people.