Where We Began and How Far We Have Come

CPHC 1985_1989 (00000002) GGCHC TodayTo measure how far we have come we first have to look at where Community Health Centers started 50 years ago. It began with a cause, and then an opportunity.  The cause was lack of access to basic healthcare among the poor, and the opportunity was President Lyndon B. Johnson’s major War on Poverty initiatives in the mid 1960s. Doctors Jack Geiger and Count Gibson, then affiliated with the Preventive Medicine Department at Tufts University School of Medicine, submitted proposals to the federal Office of Economic Opportunity to establish health centers in medically underserved urban and rural areas.  Funding for the first two “Neighborhood Health Centers” (as they were then called) – one in Boston, Massachusetts, and the other in Mound Bayou, Mississippi – was approved in 1965. The health center which opened its doors in Boston’s Dorchester neighborhood a few months later was Columbia Point Health Center. Establishing a health center in Columbia Point made sense for a lot of reasons. The Department of Preventive Medicine already had a longstanding relationship with the Columbia Point Housing Project in that neighborhood. Fourth year medical students  had been providing care to residents since 1954.  Also, the demand for care was overwhelming. According to the book, “Community Health Centers: A Movement and the People Who Made It Happen” (Bonnie Lefkowitz), even though the housing project was four miles from major hospitals, visits to them took an average of six hours, including travel and waiting time. Once the health center opened for business, as many as 200 patients per day received services.

Columbia Point also launched a local grassroots movement that saw eighteen more health centers established in Boston by 1971.  The collective success of these health centers in delivering healthcare services gained the notice of local and national leaders, including Massachusetts U.S. Senator Edward Kennedy. Now, 50 years later, the re-named Geiger Gibson Community Health Center is one of the founding members of the larger Harbor Health Services, Inc., which administers five Community Health Centers in three counties in eastern Massachusetts.

  “Clearly much has changed in 50 years but much has remained of the original ideas,” says Dan Driscoll, President and CEO of Harbor Health. Driscoll has been with Harbor Health for 38 years, and visited Columbia Point in its early days. “The vision that Jack Geiger and Count Gibson had for a ‘pre-payment plan’ to finance care has become a capitated arrangement for Medicaid patients. Their concept of community participation is now a fully empowered and legally responsible community board of directors. Geiger and Gibson always saw the health center mission as more than medical care. Today, those services include outreach using community residents, financial counseling, domestic violence advocacy, substance abuse treatment, medical – behavioral health integration, case management and the provision of career ladders for staff.”

Indeed, addressing the whole health of the person and the factors that may contribute to illness, rather, the social determinants of health, is one of the hallmarks of the health center movement and a key to its record of success in reducing healthcare costs, unnecessary hospitalizations and visits to the hospital emergency room. Harbor Health Services stays true to that mission and also continues to focus  resources on the needs of the local community. In addition to providing services to 27,000 patients, including  10,000 dental patients. Harbor Health also saw the need for delivering services to the growing numbers of elderly who were homebound. They offer an Elder Service Plan, which now cares for 450 people. They also run a Women Infant Children Nutrition Program for more than 3,000 women and their children.

 “The scope and size of the health center program nationally is most likely larger than either Jack Geiger and Count Gibson had dared hope for, but today the Columbia Point Health Center/Geiger Gibson Community Health Center remains, along with our rural cousin, Delta Health Center in Mound Bayou Mississippi, as lasting signs of the resiliency of the movement and its mission,” said Driscoll.

Help us celebrate the 50th anniversary throughout the month of June by telling us about your health center’s journey.

 

In Bridgeport a Humble Start with a Big Finish

982 East main StreetIn Connecticut nearly 40 years ago Optimus Health Care, Inc. (formally known as Bridgeport Community Health Center) was founded by a group of civic-minded individuals committed to the goal of starting a healthcare home in their neighborhood. It was not going to be easy.   The site was located in an apartment house where pigeons were roosting in the top floor.  The Community Action Agency, Action for Bridgeport Community Development (ABCD), was one of the the organizers, along with a part-time chiropractor, who later became the Executive Director.   There were only nine people on staff,  including three nurses and three part-time physicians.  Somehow, they made it work.  And it worked because the demand for care was so great.   Bridgeport in the 1970s was struggling in the throes of the industrial decline.  There were few jobs, and growing numbers of working poor.  Up until that point the only local health clinic was located in the hospital.  Options for affordable care were few, especially for the surrounding Latino community.

“We were a storefront operation when I started back in 1983,” recalls Optimus CEO Ludwig Spinelli in a video which documents how the health center started.   Gradually, the health center grew and expanded its services to include pediatric, behavioral health, dental, health education, Health Care for the Homeless, and even naturopathic/alternative medicine.  “We look at the whole person and if any piece of the primary care needs to be addressed, we address it,” said Spinelli.

Optimus Health Care, Inc., has come along way since starting in an apartment house in 1976.  Today, there are 22 licensed sites in four cities,  a staff of nearly 400, and more than 52,000 patients.  “Optimus is the Latin word for the best,” said Spinelli.  “We do provide the best model of care and we prove it every day.”

 

 

 

How Far We Have Come: Post Card from Oregon

Virginia Garcia

Virginia Garcia

Cornelius Children's Day_6-17-13 071 (00000002)

Children’s Day at the Cornelius Wellness Center

Throughout June we are marking the 50th anniversary of the Community Health Center Movement by focusing on the theme of “How Far We Have Come.”  A movement and mission often start with a story about people coming together around a common, simple goal, and building something beyond their wildest dreams.  Such a story brought us to Cornelius, Ore, where Virginia Garcia Memorial Health Center (VGMHC) began in the unlikeliest of all places — a three car garage.  But where VGMHC started to provide care is not as important as why:  the death of a child that could have been prevented with timely access to care. In 1975, beautiful six-year old Virginia Garcia and her farmworker parents traveled from their home in Mission, Texas to California and Oregon to work in the fields. Along the way Virginia cut her foot, and by the time they reached Oregon it had become infected.  Economic, language and cultural barriers to healthcare, prevented her family from seeking care when they desperately needed it.  Virginia died on Father’s Day  while her own father was working in the fields.  Determined to never let such a tragedy happen again, the community built a healthcare home for people in need, including migrant seasonal farmworkers.  Not only has VGMHC endured over the years,  but the health center is also cutting edge when it comes to healthcare delivery.

VGMHC has 16 sites, including a brand new Wellness Center that is state-of-the-art, with a parking lot that has charging stations for hybrid cars.  The health center now serves 40, 000 patients, more than half of which live in poverty. Nineteen percent of their patients are still migrant or seasonal farmworkers, and nearly half are under 21 years of age.  Yet, VGMHC is a fully integrated Patient Centered Medical/Health Home that provides excellent healthcare services to the insured and uninsured alike.

“Virginia Garcia is here to provide the best care to those who need it most,” said CEO Gil Munoz.  “We at Virginia Garcia are not only keeping up with the innovations in healthcare today, but we’re also becoming the model for care. We are finding new ways every day to help keep our patients healthy, including new payment methodologies, team-based care and wellness classes. It’s amazing to see how far we’ve come!”

Not only has the health center come a long way, so has VGMHC staffer Maria Loredo, who was recently honored with the Legacy Award by the Northwest Regional Primary Care Association’s Legacy Award for her career of service to the most underserved populations.  The Legacy award is for an individual who has dedicated his or her career to solving the problems of health, poverty and human rights and who has contributed toward the mission and recognition of community and migrant health centers in the Northwest region. Maria herself came to Oregon as the child of migrant farmworker parents and earned a college degree.  At VGMHC she started with medical records and worked her way up to become Chief Operating Officer of the health center.

Please send us your stories about how far your health center has come and we’ll write about it on this blog and share it on social media using the  #CHC50 hashtag.

 

 

All Things Healthcare Update

We plan to continue blog postings about the 50th Anniversary for June focusing on the theme of “How Far We Have Come.” We will be looking at health centers that have made a long journey from humble beginnings, such as church basements, neighborhood storefronts or small trailers, into now dynamic health delivery systems showcasing what is possible in community health.  Telling those stories, we will recognize the vitality, commitment and perseverance of people in the Community Health Center Movement.  We will also show how health centers have moved public debate to change attitudes about primary care, prevention and the value of an accessible, quality community health system.

Tomorrow, precisely at 11:45 EST, the President will make a speech about healthcare and “offer a history” of where we have been, according to a widely distributed White House email.  The White House also released a healthcare timeline of key events. While there is no specific mention of Community Health Centers in the timeline, we were struck by a speech on the timeline given by President Lyndon Johnson on January 7, 1965 in an address to Congress.  He said, “We can and we must strive now to assure the availability of and accessibility to the best healthcare for all Americans, regardless of age or geography or economic status.” Certainly those words echo in the mission of health centers today, which serve anyone regardless of their insurance status and ability to pay.

We also note that the White House issued a report earlier this month focusing on the 22 states that have not expanded Medicaid and the impact on residents.  Among the most hard-hitting conclusions from the report is that 5,200 fewer people would die each year if these states had chosen to expand Medicaid.  Also 193,000 fewer people would  face catastrophic out-of-pocket medical costs in a typical year, and one million people would have a usual source of care.

These numbers are important for a many good reasons, not the least of which is that health centers and Medicaid have a longstanding history of saving lives and providing access to care. While Medicaid patients are only about 16 percent of the population, they represent 40 percent of health center patients. Health center Medicaid patients have fewer hospitalizations and visits to the ER. To learn more about health centers and Medicaid please visit this link.

In Tennessee Changing the Image of Community Health Centers

When a health center gains notice for their work, we always try to pay it forward. That is why we are focusing this week on Tennessee, where a feature article in the Knoxville News Sentinel highlighted the work of Cherokee Health Systems and Indian Mountain Clinic in Jellico, TN (operated by Dayspring Family Health Center). These are two health centers that are building relationships in the community and thinking “outside the box” when it comes to delivering integrated and continuous care. The result? These health centers are changing the way people view health centers.

“Over the years Community Health Centers have been known as the ‘poor peoples’ clinic,’ and I don’t think that’s the case anymore,”  Dr. Geogy Thomas, medical director at Indian Mountain told reporter Kristi Nelson. “Now they know us as the provider who will be at my bedside when I’m hurt or dying… We still do home visits.”

Indian Mountain serves a small community along the Kentucky border, and about half of the patient population relies on Medicaid and another 10 to 20 percent are uninsured, according to the article. Cherokee provides primary care and behavioral health services at 24 sites in 13 counties across east Tennessee. Forty percent of their patients are on Medicaid and 30 percent are uninsured. Yet, both health centers are providing a medical home for their patients and using innovative ways to care for patients. For instance, Cherokee was one of the first health centers in Tennessee to use an integrated health model where primary care and mental health services are provided in the same setting at the same time. Indian Mountain uses telemedicine to help prenatal patients with drug abuse issues, partnering with a high risk obstetric practice at the University of Tennessee Medical Center.

The article was also picked up by the blog, FierceHealthcare, which also mentioned the great work health centers are doing in California addressing the “whole health” of people, such as diet and nutrition:

California’s community health centers also have increasingly embraced a wellness-focused approach to patient care, the Public News Services reports. One nonprofit clinic organization offers a food bank, financial aid, legal aid and other social programs in addition to healthcare services at its locations, and another such organization includes a community garden, an exercise circuit, hiking trails and a playground at its clinics.

Stay tuned to more posts about how health centers are making a difference around the country.