By Micah Clemens

Last night, President Obama delivered his third State of the Union address, outlining his priorities for the country in the coming year. Many of the themes the President raised — for instance coming together in a “common purpose and common effort” could easily describe the spirit of the Community Health Center movement.  The President also talked about the erosion of economic security among the middle class and the need for job creation, particularly among veterans who are coming home.

NACHC’s President and CEO Tom Van Coverden responded to the President’s speech, and highlighted what health centers are doing to in these areas, such as lowering health care costs, expanding access, and creating jobs — with a special emphasis on hiring veterans:

Community Health Centers are proud of their role in providing the jobless and uninsured with a quality health care home. We are also proud to carry out the Obama Administration’s challenge to hire 8,000 veterans – approximately one veteran per health center site – over the next three years. But we can do more. We can lend our leadership and experience to build a stronger primary care foundation that delivers both excellence and lower health care costs, helping to put our fiscal house in order.

Ask the White House questions about health care policy in 2012

The President has also made members of his administration available to directly answer questions from the American people about the different subjects in the State of the Union. On Friday, they will hold an open Q&A on health policy on Twitter:

Friday, January 27 1:00-2:00 p.m. (EST) Jeanne Lambrew, Deputy Assistant to the President for Health Policy and Nick Papas, Assistant Press Secretary, will answer questions on Twitter directed to the hashtag #WHchat. You can follow the conversation through the @WHlive Twitter Account at that time as well. Be sure to include the #FQHC hashtag when asking questions about health centers!

See the State of the Union address here and read Tom Van Coverden’s full statement here.

By Amy Simmons Farber

Rev. Martin Luther King once said, ‘’Of all the forms of inequality, injustice in health care is the most shocking and inhumane.’’  These words are often repeated among the dedicated people who work at Community Health Centers in all corners of America because it appropriately describes their mission: to ensure access to affordable care for all people, not just a few.

Some health center leaders are marking January 16th by celebrating the legacy of Martin Luther King through special events.  NACHC’s Community HealthCorps, for example, is observing The Corporation for National and Community Service’s Day of Service, with a variety events around the country. Check out the blog posts by Commuinty HealthCorps members that highlight what’s going on in Maine and Washington state (see local news story in Yakima, WA about a scheduled peace march).  So far we’ve tracked Day of Service events in 13 states, and the District of Columbia, where Community HealthCorps members and health centers are choosing to ”Make it a Day On, Not a Day Off,” in the spirit of public service.  To view a listing of events visit the Community HealthCorps page.

Mark Your Calendars!

By Micah Clemens

The Office of Disease Prevention and Health Promotion at HHS has recently released the 2012 calendar of National Health Observances. Many of these days, weeks, and months align closely with the efforts of Community Health Centers to promote wellness and preventative care. Many are also covered to varying degrees by local and national media, so they are great opportunities for Community Health Centers to show their value in educating the public about preventative care and wellness.

National Health Center Week Poster (for 2011)

We encourage you to take a look through the calendar now and see what your health center can plan to do throughout the year. It’s important to also communicate about these events — so let your local news outlets know what you’re doing. Often, local broadcast, print and online journalists look for ways to add a local angle to a national story, so make your health center and event that local angle.

In addition to the observances on the calendar, remember to mark National Health Center Week, which is from August 5-11 in 2012.

Remember to check out NACHC’s Media Toolkit for Health Centers for sample press releases for many of these observances.

By Micah Clemens

The Piedmont Health’s Prospect Hill Community Health Center was the first Community Health Center in North Carolina, serving residents since 1970. To meet the demand in the area, Piedmont Health expanded to five other health centers service surrounding counties. They recently held an open house for their new facility in Caswell County to raise awareness about their services — an event that attracted local press, small business owners, and long-time patients.

Senator Kay Hagan visits Prospect Hill Community Health Center for National Health Center Week 2011

According to The News of Orange County’s article about the open house, Piedmont’s patients span the economic spectrum.  Some are self-employed, or work for small businesses that don’t carry insurance, or simply are underinsured and unable to access regular primary care.  That’s where Piedmont comes in.  The health center has created partnerships with small business owners through local chambers of commerce in what could be the wave of the future for primary care.

“Some think health centers are only for low-income people,” [Delores Ramsey, a Piedmont Health Board member from Hurdle Mills] said. “Health centers across the nation offer care on a sliding-fee scale to assure that everyone has access regardless of their income or insurance. But, the truth is that there are no income limits on who can use the center. Most private insurance plans are accepted, as well as Medicare and Medicaid.”

“Piedmont Health has a health program with local chambers of commerce that offers care to many small business owners and employees who are looking for high-quality care at an affordable price,” said Sharon Sexton, director of the Caswell County Chamber of Commerce, who attended the open house. Both the Caswell and Roxboro Area Chambers of Commerce participate in the program.

U.S. Senator Kay Hagan visited Prospect Hill during National Health Center Week in 2011 to keynote the opening of the new facility.

By Phil Johnston, MD

Physician Phil Johnston was deeply affected by work with disadvantaged groups overseas as a medical student and in inner city Indianapolisas a resident in Family Medicine.  He followed this as a calling and has practiced for nearly 40 years at SoutheastHealthCenter, one of six Indianapolis HealthNet clinics.  NACHC invited Dr. Johnston to share some of his collection of stories about life as a health center doctor in two part series.  The patients names have been changed to protect their privacy:

The clinic where I began my practice was housed in what was once a Methodist Church. The church had followed the migration of its congregation to the suburbs and sold their old building to the neighborhood association for one dollar. A local grant of several hundred thousand dollars helped transform the old church into a passable medical space with eight examining rooms. For a few years, a mental health clinic occupied the third floor of our building; this relationship broadened my appreciation of the emotionally debilitating disease of schizophrenia.

A chronic disease that affects one’s perception of reality, schizophrenia often appears
with disturbing symptoms in late adolescence and early adulthood. Pervasive delusions,
disordered thinking, frightening auditory and visual hallucinations are among the spectrum of symptoms that drastically interfere with everyday life.

Two of my most endearing schizophrenic patients were a mother and daughter, Ava and Emily
Barnes who, at ages eighty one and fifty three lived together, sharing the peculiarities of their
illnesses. One day after they were leaving the examining room the daughter, Ava, took me aside and said, “I’ve been worried about Mom for a few months. She always sets an extra place at the table on Saturday evening because…” (and she hesitated a bit here), “she thinks Lawrence Welk is coming to dinner. She’d never put food on the plate before, but now she’s giving him a helping of everything! What can I do – she’s wasting a lot of food!”

I groped for an answer.

“Well, Ava, I suppose you should just plan on Mr. Welk’s portion being left-overs for you the next day…? And, perhaps you should tell your mother that Lawrence is eating dinner with another Champagne Lady tonight before the show.”

Although they were stable on their medications, Ava and Emily had a few recurring medical needs. For reasons that I have yet to discover, schizophrenia also seems to be associated with excessive toenail growth. Ava and Emily came in regularly every three months for podiatric care. They were both of such girth that they were unable to muster the strength and flexibility needed to trim their huge nails. Nail trimming was a peculiarly fulfilling diversion for me as a physician, but even with a pair of stout nail trimmers, the actual trimming was a hazardous occupation. My medical assistants soon learned to leave the room after dropping off the trimmers, fearful of being injured by a piece of nail that commonly ricocheted off the walls or ceiling in the heat of battle. I learned to be more cautious myself after one incident. I’d seen Ava and Emily for their respective trims early in the morning and drove home after finishing clinic hours to a fond hug from my wife. But she then pushed away and stared up at my head.

“What’s that in your hair?!” she asked, apprehensively. As I brushed my hand over my head, a sizeable chunk of Barnes toenail fell to the floor. In reflecting on the day, I wondered if anyone else had looked at my head closely enough to have detected what my wife saw instantly.

By Phil Johnston, MD

Physician Phil Johnston was deeply affected by work with disadvantaged groups overseas as a medical student and in inner city Indianapolisas a resident in Family Medicine.  He followed this as a calling and has practiced for nearly 40 years at SoutheastHealthCenter, one of six Indianapolis HealthNet clinics.  NACHC invited Dr. Johnston to share some of his collection of stories about life as a health center doctor in two part series.  The patients names have been changed to protect their privacy:

David McMillan became one of my patients against his will. He was a machine operator who had the misfortune of developing a cardiac problem that caused fainting spells. Tests showed that he had these spells from a cardiac arrhythmia – ventricular tachycardia. At that time there were few effective medical treatments for his condition.

David lost his job. He was depressed at the prospect of not being able to support his wife and family and faced the necessity of having to depend on food stamps and the stigma of welfare”- to get by. His fainting spells continued. Correcting his arrhythmia often required stays at the hospital. He was also given a drug which suppressed most of his fainting spells, but caused his skin to turn a dusky, silvery color. This added to his self consciousness and distress and didn’t restore what he most wanted – the independence and security of a respectable job.

Several months after his last check up, I received a panicky call from the hospital. Mr. McMillan just checked out of the hospital where he had been on a monitored bed. The nurse reported that pulled off his chest leads and left. Later that week, Mr. McMillan appeared, quite alive, at my clinic. When I saw him, he had a sheepish look on his silvery face but was still stubbornly defiant about his behavior. Taking his history, I asked, “Mr. McMillan, the heart doctor called me about your leaving the hospital. You know how serious your condition is. You could have DIED! Why did you to leave the hospital under those circumstances?”

He replied, “I just got tired of people telling me what to do.”

As I imagined his perspective, I began to appreciate what it would be like to go into a food stamp office and be ordered, “Take this form and fill it out. Do you have your proof of income?” And, in the hospital, to be told, “No, Mr. McMillan, you cannot have that for lunch; it’s got too much sodium in it.” Or, “Yes, Mr. McMillan, we may have to try to cardiovert you again – yes, I know that’s painful…”

Mr. McMillan chaffed at the indignity of being in a hospital, especially when he didn’t have the anchor of a job to come back to.

Years later, I saw Mr. McMillan’s wife, long after he had succumbed to his heart problems. I recounted this event to her for the first time. Tears came to her eyes as she said, “Yes, my husband was a stubborn man. But he always did what he thought was right – and he was good to us!”

Tomorrow: Lawrence Welk Comes to Dinner

By Micah Clemens

The Unity Health Care Upper Cardozo Neighborhood Health Center sits on 14th Street in a changing community in Washington D.C. Unity’s President and CEO Vincent Keane described how people judged the building as “a great big concrete box” or “a classic expression of brutalism architecture.” The building itself is part of Washington D.C.’s history, built in 1969 on a lot destroyed by fire during the 1968 riots. Since then, it has served as a medical home for the community for over 40 years. As a result of the American Recovery and Reinvestment Act (ARRA), Unity Health Care received $12 million in federal funding to renovate its Upper Cardozo Health Center site and better meet the changing demographics and growing needs of the community. The renovated site opened this week in a ribbon-cutting ceremony attended by local leaders.

Upper Cardozo Neighborhood Health Center, Washington D.C.

“We Treat You Well”

At the ceremony, the medical director Dr. Luis Padilla, MD, explained what the new improvements will mean for patients. Along side primary care, Unity has integrated mental health services, specialty care, obstetrical care, and social services for their patients. It’s part of Unity’s mission statement — and pledge to patients — posted everywhere in the building: “We Treat You Well.”

Making Patients Part of a “Health Care Team”

Darryl

The most compelling speaker at the ceremony was a patient named Darryl who had been coming to Upper Cardozo to for debilitating fibromyalgia, chronic pain and chronic fatigue. Darryl said that his experience transcends the label of patient or client, saying, “I am a person who, here at Unity Health Care, is a part of my health care team.” Darryl underscored how he worked with his primary physician, physician’s assistant, and nurses to learn more about his condition, and various methods to treat it and manage the pain and symptoms.  Thanks to the help of Unity’s health care team, Darryl is mobile and not in a wheelchair.

Treating More Patients

Physician's Assistant and National Health Service Corps graduate Jessica Wallace

Administrative offices, which previously took up an entire floor, were moved downtown and replaced with more exam rooms. The increased capacity also allows providers to see more patients seeking walk-in appointments. In past years, the line for walk-in appointments would frequently wrap around the block. Upper Cardozo also has a dedicated staff of clinicians, including 10 graduates of the National Health Service Corps on staff.

The Value of Community Health Centers to the District of Columbia

D.C. Mayor Vincent Gray remarked that the entire Unity Health Care system of health centers helped reduce the need for new hospitals in the District of Columbia. Even though D.C. has the second-highest levels of health coverage for residents in the nation — 94% for adults and 97% for children, according to the Mayor — Unity’s Community Health Centers keep system-wide costs down by providing excellent primary care to thousands of residents who might otherwise end up in emergency rooms. Also attending was Washington’s Ward One Councilmember Jim Graham and Congresswoman Eleanor Holmes Norton.

The Upper Cardozo ribbon cutting, including Congresswoman Eleanor Holmes Norton, Mayor Vincent Gray, HRSA Deputy Administrator Dr. Marcia Brand, and Unity President and CEO, Vincent Keane

By Micah Clemens

Did you know that this week is National Influenza Vaccination Week and National Handwashing Awareness Week? Remember that newspapers, television and radio stations in your community often look to find a local angle on a national story. These National Health Observance Days/Weeks/Months are proven opportunities to share the value of your Community Health Center with events tied to preventative care or public health.  Health centers already are sharing their flu shot events on Facebook and Twitter.  And for folks who still haven’t had their flu shot yet, the Centers for Disease Control and Prevention has a Flu Finder site.  You can access it by visiting this link. 

Want to make a resolution for the New Year? When the National Health Information Center releases their calendar for 2012, browse through and see observances occur throughout the year and make a note in your calendar.  And don’t forget that National Health Center Week 2012 is August 5th through 11th.   Also please let us know what events you have coming up, including new site openings or ribbon cuttings – we love to share your good news and ideas.

By Micah Clemens

Community Health Centers in Washington State are joining together in a variety of ways to make a point about the value of health centers and the sad fact that state funding cuts that would make care for residents more expensive and hurt underserved populations across the state. In Yakima the effort drew notice from the local news:

About 100 people symbolically crowded into local hospital emergency rooms… hoping to point out that cuts to community health clinics would unfairly send more Yakima Valley residents to ERs where care is more expensive.

…three Community Health Centers — the Yakima Valley Farm Workers Clinic, Yakima Neighborhood Health Services and Community Health of Central Washington — rallied their staffs and patients to show what it would look like if people who depend on those centers had to instead go to one of Yakima’s two hospital emergency rooms for care.

“Now more than ever, it’s essential that people have access to the right care at the right time and the right place,” Dr. Mike Maples, CEO of Community Health of Central Washington, told the crowd.

The Emergency Room rally of 100 health center patients and staff members in Yakima, Washington. PHOTO BY GORDON KING/YAKIMA HERALD-REPUBLIC

According to the article in the Yakima Herald Republic  about the rally, current budget proposals in Washington State include the “elimination of the Basic Health Plan, the state subsidized health-care plan and Disability Lifeline, which provides medical assistance to disabled people with chronic conditions. Also slated for cuts are free or reduced-cost health-care programs for children like Apple Health for Kids, which was greatly expanded under [Washington Governor Christine] Gregoire to cover families above the poverty level of $22,350 for a family of four.”

Talking Directly to Lawmakers

Dr. Ned Hammar, MD

An article in the Spokesman-Review highlighted what Dr. Ned Hammer, MD from the Okanogan Community Health Center testified at the Washington State Capitol about what the proposed cuts would mean:

One person who finally managed to address the budget cuts was Ned Hammar, a family practice doctor at the Okanogan Community Health Center. He said the proposed cuts would be “devastating” to the center, which serves about 10,000 people from the surrounding counties. We’re sacrificing our future,” he said. “We’re giving up on a generation of our kids.”

Sharing the Value of Community Health Centers with the Public

The Daily News in Longview, Washington, has a wonderful profile of patients, administrators and providers at the Cowlitz Family Health Center. Be sure to check it out, as the reporter offered great context about the value a health center brings to people in the community.

NACHC Follows CHC State Funding Closely

Be sure to check out the forthcoming issue of Community Health Forum Magazine, which contains more details about state funding levels.

By Yvette Crenshaw

November marks American Diabetes Month and health centers are up for the challenge – as always to ensure that patients are getting screenings and finding ways to prevent the disease that affects 25.8 million children and adults in the United States. Throughout the month, health centers have been sharing tips and informational tools to help patients in their communities prevent the disease as well as help those currently diagnosed get proper treatment.

In a recent NACHC Press Release, Gary Wiltz, MD, President and CEO of Teche Action Clinic in Franklin, LA explained,

“We not only provide the screening, but also teach patients how to manage the disease with proper nutrition, exercise and regular testing.  The health center model is focused on quality, patient-centered, preventive care so that chronic diseases never reach the acute stage where the treatment is costlier and less effective.”

Health centers as an affordable option for Americans at risk for diabetes is increasingly gaining notice, particularly in tough economic times when more people are looking for affordable options for care.   A recent CNN online editorial noted,  ”In today’s economy, millions of people are becoming more and more reliant on America’s network of community clinics and health centers as their primary source of medical care, especially those who need daily medicine to survive…The data that have been collected from a recent survey of clinic partners have demonstrated that not only are the numbers of people relying on [health centers] escalating, but the number of people in need of medical attention for chronic disease, specifically diabetes, is growing.”

Sure enough, the numbers of diabetes patients are growing, as a survey by Direct Relief International recently noted.  Check out that report by visiting this link.