More than eight years ago, community advocate Jean Purvis sat in my office at Butler Memorial Hospital, concerned about the future of health care.

Not that she was a prophet concerning health care reform. Her issue was a much more immediate one. It was one affecting every community in America: how the working poor would get basic health care services.

She had just returned from a visit to a Volunteers in Medicine (VIM) clinic in Hilton Head, S.C. — a clinic founded by a retired doctor and staffed by volunteer physicians, nurses and others.

And she had done her homework. She knew that low-income, unemployed people could access care through the medical assistance program and that everyone who needed care could get it through Butler Memorial Hospital’s emergency room, or the emergency room of almost any hospital.

But emergency care wasn’t the issue. And she knew that. What about primary care that would address working, low-income people’s health care needs before they became unbearable or painful — care that might keep people from having to access more expensive emergency care because the emergency was prevented through good primary, preventive care?

And what about access? And what about dental care?

She had come to learn how care is delivered and to figure out how care could be delivered in a community setting to those low-income working people who had no access to insurance.

Over the next several months, she and I and others — some retired as well as some current BMH doctors — explored how comprehensive primary care could be provided to low-income working people in Butler County. We visited another VIM clinic in Erie to find out how such a concept could work in a northern, industrial community. We talked with local physicians about what needs existed in our own community. We examined local data on how many people in Butler County needed such a service.

With retired physician Dr. Robert McKee’s guidance, the framework for a working clinic was established. And then Ken Bennett joined the team. A newly retired corporate head living in Slippery Rock, he brought a mix of business acumen and community concern to the table.

Under the Purvis/Bennett co-chairmanship, the Community Health Clinic of Butler County was born and opened to patients three years ago on Jan. 18. Its effects have been profound.

Butler County residents have had more than 6,000 visits and received care at the Community Health Clinic. Through the efforts of a largely volunteer staff of physicians, nurses, dentists, dietitians, social workers and a host of others — 150 in all — people who had no access to regular care to manage their health have it in Butler.

Diabetics can manage their disease and get the medications they need through the clinic. Those with dental problems can have them addressed before they become major problems that would either land them in the hospital’s emergency room or compromise other aspects of their health.

Television stations in Pittsburgh have come to witness it. When he was governor, Ed Rendell came to see it. Major foundations have helped to fund it. So have local community service organizations.

Long before Washington was attempting to address health care delivery through health care reform, ordinary people in Butler already were addressing it for the largest uninsured population in our community.

The Community Health Clinic of Butler County is a testimonial to the power of communities caring about themselves and, with strong, passionate leadership, doing what needs to be done.

The people of Butler County always have been good at that.

And that’s a good thing because, in Butler County, a population that might be disenfranchised almost everywhere else in America has been getting care for three years in the most appropriate and cost-effective way.

John J. Righetti, of Sewickley, is a former vice president of strategic relationship management for Butler Health System.