Serving Rural Communities

On National Rural Health Day we join others in celebrating the rural communities that are served by so many Community Health Centers while also raising awareness about the unique challenges rural communities face in accessing healthcare.

1447946247According to the Federal Office of Rural Health Policy (FORHP) 57 million people, 1 in 5 Americans, live in rural communities. Rural populations experience many of the same barriers to healthcare that affect underserved communities nationally, such as cost, language, and transportation. However, the geographic isolation  that comes with the territory of rural living, and fewer healthcare resources, can exacerbate these strains.

People who live in rural areas often face challenges in gaining access to affordable primary care — largely because of where they live and the scarcity of healthcare options. In fact, 37 percent of rural residents do not have access to a primary care physician due to local shortages of such physicians, compared to 21 percent of urban residents (according to NACHC fact sheet on rural health from 2013). Only nine percent of all physicians practice in rural settings. Compared to their urban or suburban counterparts, rural residents, especially rural elderly residents, are less likely to visit a primary or ambulatory care provider.

However, health centers can remove some of those barriers to care. Community, Migrant, Homeless, and Public Housing Health Centers make up one of the largest systems of care for rural America, and are frequently the only source of primary and preventive services in their communities. About 54 percent of health centers are located in rural areas and they serve more than 1 in 7 US rural residents.

Research shows that health centers have compiled a record of success in providing access to care, along with improved health outcomes and generated healthcare savings in both urban and rural communities.  That is why it is important to  grow and expand the reach of health centers in rural communities — with better access to preventive care,  rural populations will experience better health and reduced chronic disease.

Health Centers can play key role in addressing the Social Determinants of Health

Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity

Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity

Every day it seems there is a  new study about healthcare documenting costs or what does or doesn’t work. But a new issue brief from Kaiser Commission on Medicaid and the Uninsured really caught our eye. The brief entitled, “Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity,” documents the shift toward a broader approach in healthcare that “that addresses social, economic, and environmental factors that influence health.” Opportunities fostered with the help of the Affordable Care Act (ACA)  have enhanced the focus on prevention and community health, and have led to initiatives at the local, state and national level to address the social determinants of health. The brief also notes:

“Community health centers (CHCs) can play a key role in addressing social determinants of health given that they serve at-risk and underserved communities with broad needs. CHCs have a long history of meeting both the clinical and non-clinical needs of the patients they serve and collaborating with community and social support services. Building on this role, the National Association for Community Health Centers, in partnership with the Association of Asian Pacific Community Health Organizations, the Oregon Primary Care Association, and the Institute for Alternative Futures, recently launched a new program to implement, test, and promote a national standardized patient risk assessment protocol to assess and address patients’ social determinants of health.”

Health centers have addressed the social determinants of health virtually since their inception. But now the philosophy is catching on. For the past 15 years there has also been a “Health in All Policies” approach in healthcare that sensibly looks at impact on population health much in the way that we assess the impact of policies on the environment. Decision-makers across sectors and policy areas can collaboratively assess how actions and decisions in multiple sectors affect health, and engage partners and stakeholders to work together to improve and sustain better health in diverse populations.

We’ll keep you posted on new data and updates as they happen on this blog.


Veterans Gain Access to Care at Health Centers

Health & Wellness Center, Inc. Eufaula, OK

Health & Wellness Center, Inc. Eufaula, OK

We’re always on the lookout for stories about how health centers are serving special populations.  On this Veterans Day we found one in eastern Oklahoma.  The Health & Wellness Center, a health center with locations in Stigler, Eufaula, Checotah, Wilburton, Sallisaw, and Poteau, Ok, is now open for business for veterans [see local news article]. Health & Wellness the largest rural health center in the state, serving over 23,000 patients at seven locations in six different counties.  In addition to offering affordable medical services, the health center also provides dental, mental health, optometry and pharmacy services.  Now veterans can not only get care at the center, they will also have special designated parking spaces at the health center for easier access to services.

“It is an honor to serve the veterans in our area who have made the sacrifices for our country that enable us to live in a free country,” said Teresa Huggins, Chief Executive Officer The Health & Wellness Center, Inc.  “We honor and respect these men and women, and hope that our gesture of remembrance reminds them of what they mean to us.”                   

Federal legislation passed last year is changing how veterans can access care in their local communities.  Veterans who live more than 40 miles from a VA facility, or who are forced to wait more than 30 days for an appointment, can now be seen at a local health center. As a result, more health centers are reaching out to veterans who need easier access to care.  The Health & Wellness Center is one of 400 Community Health Center organizations with a contract to serve veterans, according to estimates by the National Association of Community Health Centers (NACHC). More than 300,000 veterans depend on health centers for their care, a number that is expected to increase in the coming years.

Community Health Centers were launched 50 years ago as part of President Lyndon Johnson’s War on Poverty. Today, they serve over 24 million people, or 1 in 14 Americans, and save the U.S. healthcare system more than $24 billion a year through effective patient care that reduces the need for hospitalizations and emergency room visits.

To learn more about The Health & Wellness Center, please

Outreach and Enrollment Kicks Off November 1

open-for-business-badge-180x150Outreach and Enrollment open season approaches yet again, along with autumn leaves and Christmas decorations.  This is the third open season, which starts on Sunday, November 1.  As we’ve reported in a previous blog post, Community Health Centers have been key partners in connecting people and communities with coverage.  They  also have a long and rich history of outreach to communities and people, and have the networks on the ground to get the job done.  They have hired  an estimated 19,000  outreach and enrollment assistance workers, held trainings, and launched  a host of creative and engaging outreach events across the country at libraries, health fairs, supermarkets, churches, and in their own waiting rooms.

Jim Macrae, Acting Administrator of the Health Resources and Services Administration notes, “As open enrollment starts again, health centers will continue to play a critical role in educating and enrolling members of their communities in health insurance coverage. To date, health centers have assisted over 12 million people in their efforts to find health insurance coverage. This November, health centers will once again be on the front-lines as more and more community members are turning to them to find out about affordable health insurance options.”

With two previous open seasons behind them, health centers have also streamlined their processes and fixed some kinks.   A NACHC survey of health centers last spring revealed that 84 percent of respondents said the second open enrollment season met or exceeded expectations in terms of total enrollment assists, and that there were fewer problems.   And there is a lot of optimism and excitement this go around as health centers are already lighting up social media with photos and flyers sporting the #Heretohelp hashtag.

Is your health center doing some special to get out the word about open season? Tell us and we’ll write about it on this blog.




Community HealthCorps® Brings Financial-Health Literacy into Focus

Guest post by Anastasia Sonneman, Communication/Public Engagement Program Specialist NACHC-Community HealthCorps

Over a third of U.S. adults—77 million people—have difficulty with common health tasks, such as following directions on a prescription drug label or adhering to a childhood immunization schedule, according to the Office of Prevention and Health Promotion at the Department of Health and Human Services. The vast complexity of the U.S. healthcare system can be challenging for many to navigate and understand, and too often, it is the people who need care the most who fall through the cracks.

SFCCC-picThat is why Community HealthCorps® is taking action.

“When about nine in ten Americans lack proficiency in health literacy—including how to use their health insurance–and 43 million have overdue medical debt, emphasizing financial-health literacy as a focus area for Community HealthCorps® was a necessary choice,” says Gerrard Jolly, Community HealthCorps® National Director.

As the bridge between the national service and Community Health Center movement, Community HealthCorps® places full-time AmeriCorps members into Community Health Centers so they can expand their reach to people who need access to care. With a primary aim of reducing barriers related to social determinants of health, the role of Community HealthCorps® AmeriCorps members is to address the most pressing needs of the nation’s medically underserved, in this case connecting the dots between a patient’s health-related decisions and their finances.

Grace Hill Teen Awareness Health Fair-Women's Health Danielle Schroeder (2)Throughout the past two years, Community HealthCorps® AmeriCorps members have integrated financial-health education as a part of their service activities, such as in health insurance enrollment, health outreach, and emergency room diversion initiatives. So far, the approach is working. Over 75% of the 27,000 patients served by Community HealthCorps® AmeriCorps members reported at least a 20% improvement in their financial-health knowledge. A story from the Community HealthCorps® team in Texas illustrates how this service can truly impact a patient’s life:

“At the Heart of Texas Community Health Center, all Community HealthCorps® AmeriCorps members become Certified Application Counselors for the Health Insurance Marketplace. Often times, patients come into the health center completely misunderstanding how to apply for health insurance on their own. Members spend a lot of time explaining the importance of health care coverage and how to apply. In one particular instance, a Member spent four hours over the course of several appointments helping a patient set up an email address, fill out the Marketplace application, and submit her first payment. Throughout these visits, the Member reviewed CMS’ “From Coverage to Care: A Roadmap to Better Care and a Healthier You” pamphlet to provide education about the financial impacts of becoming newly insured and how to utilize the health insurance benefits effectively. After engaging with the Member and becoming newly insured, the patient reported a 70% increase in their financial-health literacy.”

AltaMed - DSC03352Community HealthCorps® has also partnered with the Consumer Financial Protection Bureau (CFPB) to help develop program training and education in the area of financial-health literacy. Through this partnership, Community HealthCorps® was selected as one of the first national partners to introduce “Your Money, Your Goals,” CFPB’s new financial management toolkit focused on empowering patients to set financial goals, save for medical emergencies, and properly deal with medical debt. Community HealthCorps® AmeriCorps members use the toolkit as a resource to teach patients about financial-health information. In Michigan, for instance,  Cherry Health’s Community HealthCorps® AmeriCorps members use the “Your Money, Your Goals” toolkit to reach different patient populations that include veterans and their families, children aging out of foster care, and ex-offenders transitioning out of the criminal justice system. The Community HealthCorps® team with the Institute of Rural Health at Idaho State University uses the toolkit to assist homeless patients with creating a budget because local housing organizations require one for applicants for assisted housing.

Focusing on financial-health literacy as a part of the Community HealthCorps® service experience not only provides AmeriCorps members with a more holistic lens of patient needs beyond the walls of traditional medicine, it also helps them gain a new perspective on reaching positive health outcomes with the patients they serve. Chantal Berry, who served with the 2014-2015 San Francisco Community Consortium Clinic Community HealthCorps® team, sheds light on how this link impacted her patient interactions:

“It has been a joy to develop a connection with families as their immediate contact for…finding access to health care, financial stability, and so much more. I am beginning to realize that this is the connection I want to make with patients and clients—a well-rounded look at their cultural background, lifestyle choices, and health care needs in order to make the right turn in a positive direction together.”