And It’s a Wrap (Almost)

Carolyn McClanahan, NACHC 2017 Policy & Issues Forum

The 2017 NACHC Policy and Issues Forum EXPO 

Another great day at the NACHC 2017 Policy and Issues Forum. Today’s sessions were chock full of information. And did we mention the record attendance? It has been standing room only in the General Session, which today featured Forbes columnist and physician Carolyn McClanahan whose column this week about Community Health Centers was spot on! We also heard remarks from Jim Macrae, Acting Administrator of the Health Resources and Services Administration (HRSA) . Macrae offered up some powerful statistics about the work health centers are doing, particularly in the area of behavioral health services and integrating it with primary care. He noted that “51 percent of Community Health Center patients are screened for depression,” compared to only 4 percent of other private providers. In fact, primary care is increasingly becoming the gateway to behavioral health services in the health center world. According to federal data, depression and anxiety were cited as the fourth and sixth reason why a patient visited a health center. Macrae also underscored the value of the health center model of having patient majority governing boards, which gives health centers a bit of a “leg up” in meeting the needs of their communities. He also fielded a lot of questions from health center professionals about a host of issues facing their health centers — and for that we are always grateful. Getting first hand information from HRSA is invaluable to health centers, who travel from far-flung places to attend this conference and hear about policies and regulations that impact their health center’s operations.

Another great reason to attend the NACHC P&I is the EXPO hall, which features scores of exhibitors from the health care industry. And have we mentioned the education sessions? There were sessions on all kinds of topics — workforce, payment reform, advocacy and addressing the social determinants of health.

One more General Session to go!

Day Two of the 2017 NACHC P & I

NACHC Staff on Hill Day

Today nearly 3,000 health center leaders in attendance at the NACHC 2017 P & I descended upon Capitol Hill and made their case to decision-makers about the importance of preserving and strengthening the Health Center Program. Of particular concern to health centers far and wide is the looming primary care funding cliff, which will result in a 70 percent cut in funding to health centers (and an estimated 9 million patients losing care) if Congress does not address it by October 1, 2017.  The media spotlight on this issue has helped put some wind in the sails of these advocates.  In a column posted today in Forbes, Carolyn McClanahan, MD,  urged congressional lawmakers to extend funding for health centers for another five years, arguing that:


“CHCs currently serve about 25 million patients, mostly low income individuals. In addition to medical care, many provide dental and mental health care. They do this very efficiently and the care they provide saves the rest of us billions of dollars annually. It costs less than $1,000 per patient per year to provide all this care. This is astounding.”

Modern Healthcare reporter Virgil Dickson also took note of the funding cliff in an article about the Capitol Hill briefing which featured two health center leaders [see earlier blog post].

Attendees at the 2017 NACHC Policy and Issues Forum

The best part of advocacy day is reading all of the positive buzz and seeing photos on Twitter (follow the hashtag #nachcpi17 or #ValueCHCs).  Scheduled for later today at the Newseum is a reception that will honor the grassroots advocacy champs who have outdone themselves rallying support for health centers.

For those that stayed behind today there were a host of interesting education sessions to attend. We stopped by the session “Expanding the Ability of Health Centers to Serve Veterans Through Coordinated Systems of Care,” and heard amazing stories about the work health centers are doing to care for veterans — using mobile vans to bring affordable dental health to veterans in New Jersey, or transitioning homeless veterans to housing in Hawaii.

There was also a session focused on the various strategies health centers use to address the social determinants of health in their own communities, and a “Twitter 101” session to bring health centers up-to-date in the age of social media.  These are only a few highlights of numerous and well-attended sessions that took place starting at 8:30 this morning.

Stay tuned for tomorrow’s post to keep you up to date about what is happening at the 2017 NACHC P & I.



Day One of the NACHC Policy and Issues Forum

The Hon. Tom Daschle & the Hon. Michael Leavitt with NACHC President and CEO Tom Van Coverden and NACHC Board members: Ricardo Guzman (Chair), Jim Luisi (Chair-Elect) and Yvonne Davis (Consumer/Board Member Representative)

Left to Right: Ricardo Guzman, NACHC Board Chair, Jim Luisi (Board Chair Elect), John Gressman, and NACHC President and CEO Tom Van Coverden.

Yesterday was the first official day of the 2017 NACHC Policy and Issues Forum and a record crowd (standing room only) was treated to an abundance of wisdom during the Opening General Session. Let’s break it down. First, there were the remarks by former U.S. Senate Majority Leader Tom Daschle and Michael Leavitt, the former Governor from the State of Utah and the former Secretary of Health and Human Services. Daschle reminded attendees about what health centers bring to the table, despite the contentious political atmosphere in Washington, in terms of a mission and vision. He said, “What you bring to the table is something very rare. Despite the polarization, you continue to generate a bipartisan consensus and you must be very proud.”  Daschle also spoke optimistically about the possibilities for health centers as Congress continues to debate funding for health care programs in the coming months, but he also advised health center leaders to think beyond the debate now and into the future.

“We have been debating health care for 100 years,” Daschle said.  “You are already making history and have been at it for 52 years. You can make history in 2017.  We need to start talking about becoming a high performing health care system.  You are already credited with creating public/private partnerships valued at 3 trillion dollars.”

Leavitt also followed along the same themes of health centers reaching toward a vision and a future, saying “Community Health Centers have to go from being a safety net to becoming the foundation of primary care.”  He also made the assessment that the winners in the ongoing effort to fix health care by Congress will be “the ones who deliver quality care at a lower price. Health centers do that, and you also have the moral advantage. And you have the stories. All Community Health Centers that I have spoken with have a story of people who saw a need and decided to do something about it. And all of those stories were unique.”

Another golden moment of the day was the NACHC Outstanding Achievement Award presentation to John Gressman, President and Chief Executive Officer of the San Francisco Community Clinic Consortium.  NACHC Board Chair Ricardo Guzman in presenting the award noted Gressman’s 30 years of service in the Community Health Center Movement and now, sadly, his decision to retire after running a “dynamic network with a reputation for quality care.” Upon receiving the award, Gressman stepped up to the microphone and spoke from the heart.  He recalled how as a college student in West Virginia he was called to Appalachia to do a needs assessment for a health center. He said, “I remember interviewing people who were suffering from Black Lung Disease because they were miners, amputees who suffered from diabetes and women who ate clay because they were pregnant.”

Gressman described how that experience informed his tenure as a health center veteran and health center advocate at the state and federal level.

“Thank you for letting me stand on your shoulders,” he told the audience who gave him a standing ovation.  “Thank you for trusting me with your patients, your soul, and your vision.”

Stay tuned for our report on Day 2 of the NACHC P & I — we have grassroots advocates awards and a host of exciting events to write about!


The NACHC 2017 P & I is Here!

From left to right: Julie Wood, MD, AAFP; Kemi Alli, MD, Henry J Austin; Brenda Johnson, La Clinica

The NACHC 2017 Policy and Issues Forum is about to start and we could not be more excited.  More than 2,500 Community Health Center leaders from around the country have signed up to attend this national gathering, including a record number of consumers [see media advisory]. The policy conference began today with a panel discussion on Capitol Hill on the topic “Primary Care: High-Value Care for Underserved Communities.” The discussion is part of a series hosted by NACHC, the National Coalition on Health Care, AAFP, the American College of Physicians, and the American Osteopathic Association, groups that are part of the larger National Coalition on Health Care. In their remarks the panel of experts made the case that primary care must become a national health policy priority, underscoring that the U.S. spends only 4 to 8 percent on primary care, compared to an average of 12 percent among other industrialized countries, each of which spends substantially less on health care overall than the U.S.

Two Community Health Center leaders presented on the panel, Kemi Alli, MD, a pediatrician with Henry J. Austin Community Health Center in Trenton, NJ. Also, Brenda Johnson, with La Clinica, in Medford, OR.

Dr. Alli described the range of comprehensive primary care services that her health center provides for patients (adult medicine, pediatrics, gynecology, dental, nutrition, social services and heatlth education) explaining, “A whole healthy human being is a happy human being. We try to provide as many services as we possibly can because our patients are vulnerable and disenfranchised.”

She also described the value of integrating primary care and behavioral health care “at the same point of touch in a trauma informed system.”

Brenda Johnson of La Clinica shared how the state’s efforts to expand Medicaid and coordinate care has saved the federal and state government $1.4 billion in Medicaid costs since 2012.  But even more compelling was her description to a captive audience about how her health center “knits together” a host of service providers that connect patients not just to good care, but better housing, a living wage employment and higher education, as well as coordinated care to address behavioral health and substance abuse.

“We are all really lucky we can save peoples’ lives,” she said.  “We can talk about data, services but these are our neighbors.”

The services La Clinica offers such as nutrition/cooking classes, mindfulness classes, and personal development seminars, have changed the lives of the patients, and some of their success stories were featured in the discussion.

Lastly, we should also note that today’s panel discussion coincided with the release of a new NACHC report,“Strengthening the Safety Net: Community Health Centers on the Front Lines of American Health Care” makes the case that while the debate over insurance coverage is important, the question of ensuring access to high-quality, affordable care is equally important. Health centers have succeeded for decades in providing that care in some of America’s hardest to reach communities where there are few or no options for care.

A few of the report’s highlights:

  • Community Health Centers serve nearly 5 million more patients today than in 2010.
  • Behavioral health services have grown by 56 percent since 2010. Over 80 percent of health centers now offer behavioral services, such as mental health counseling and addiction-related services.
  • More than 76 percent of health centers offer oral health, and 40 percent offer pharmacy services.
  • More than half of health centers (55 percent) are located in rural areas, serving 13 million patients and in many cases are the only provider for hundreds of miles.
  • Health centers serve more than one in six Medicaid beneficiaries for less than two percent of the national Medicaid budget.
  • In terms of total costs of care, health centers save 24 percent per Medicaid patient and up to 30 percent per Medicare patient, when compared to patients cared for in other settings

You can read the press release by visiting this link.


The Challenges of Providing Equal Health Care Access to All

Today’s guest blog post is by Susan West Levine, CEO of Lowell Community Health Center in Massachusetts.  This article originally appeared in the March/April’17 issue of Merrimack Valley Magazine, Reprinted with permission from the publisher, 512 Media, Inc.

Photo Credit: Kevin Harkins

As CEO of Lowell Community Health Center (CHC), I am often asked just what a Community Health Center is. I tell people that a CHC is like any primary care provider, with one exception: We do not turn anyone away due to inability to pay.

Lowell CHC provides equal health care access to everyone in Greater Lowell. That means caring for patients who speak more than 40 languages, including some refugees who experienced torture and persecution. In nearby Lawrence, the Greater Lawrence Family Health Center focuses on the cultural needs and health concerns of a predominantly Latino population.

It is safe to say that no two CHCs look the same.

Lowell CHC accepts public and private insurance and earns 74 percent of our income from fees and services, raising the remaining 26 percent through contributions, grants and a small number of subcontracts. We also operate a pharmacy, which is open to patients and the general public, and partner with Circle Health/Lowell General Hospital to offer a full-service lab. These are amenities typically available in larger private practices. Both are on-site. Soon we will offer dental and vision services.

CHCs are not your typical health care providers. More than 88 percent of Lowell CHC patients earn less than 200 percent of the federal poverty level. Forty-six percent of our patients are best served in a language other than English, which is why we provide medical interpretation — a service not covered by insurance — in 28 languages. We also operate two full-service, school-based health centers, one at Lowell High School and another at Stoklosa Middle School, making it easier to assure that students have required vaccines and easy access to health care and behavioral health services.

Our patients often have complicated stories and involved medical needs. We might spend as much time making sure a patient has food and shelter as we do taking their vitals and gauging their physical health. And our community health workers are out in the community, visiting patients at home, screening people for diabetes or high blood pressure at health fairs, senior centers and during festivals and community events. Our behavioral health services provide prompt mental health care. By offering affordable health services to those who might otherwise visit hospital emergency rooms for routine care, CHCs reduce unnecessary and costly emergency room and hospital admissions.

Lowell CHC is a vital resource in our community, both as a health care provider serving 50,000 people annually and as an economic engine. The health center movement was launched 51 years ago, right here in Massachusetts, providing health care to all and creating jobs in communities where living-wage job opportunities were lacking. Lowell CHC is the 10th largest employer in the city of Lowell, providing jobs to nearly 400 people from throughout the Merrimack Valley.

So, what exactly is a Community Health Center? It’s a vital health care resource assuring that everyone — you, me, our neighbors and friends — has equal access to the kind of health care we all deserve.