NACHC Year Ender Round Up

The year 2016 started with NACHC’s efforts to reach out across multimedia channels and share the compelling success of Community Health Centers.  We began our podcast series to showcase how health centers innovate, save health care costs, attract bipartisan support and confront the emerging public health crises of our times.  The podcasts help listeners gain insight from the frontline perspective about how health centers solve problems in their community — problems that so often are linked to preventable illnesses and chronic disease.  We featured a health center mobile van that is fighting an epidemic of tooth decay among children in Nevada, AIDS/HIV prevention in rural Iowa, and dealing with opioid addiction in West Virginia. These are our stories.

Health centers were also widely featured in the news media on various fronts.  Here is a breakdown of the year’s highlights:

An overwhelmingly bipartisan coalition of House and Senate lawmakers called on key subcommittee chairs  “to recognize health centers as providers of high quality, cost-effective primary care” and to ensure continued funding for a model of care that offers a “bipartisan solution to the primary care access problems” facing the U.S.   In an otherwise politically contentious election season, health centers drew a rare consensus on Capitol Hill as a successful health care solution [see NACHC release].  The media paid attention.

“I doubt there is any program that has delivered more in terms of saving both lives and taxpayer dollars over the course of over the last half century.”

Ricardo Guzman, NACHC Board Chair, The Hill newspaper, November 4, 2016

“Health centers treat patients for a fraction of the cost of one emergency room visit.  Health centers not only focus on illness prevention, they reach beyond the walls of the exam room to address the factors that actually cause poor health, such as homelessness, lack of nutrition, stress or unemployment. They are innovators in treating chronic conditions that are typically ignored until they become a costly illness.”

NACHC CEO and President Tom Van Coverden, The Pulse, a blog published by the Community Clinic Association of Los Angeles County, August 3, 2016

It was easy to make the case for supporting health centers because of their longstanding record of cost-savings, as evidenced by the published release of a landmark report on Medicaid savings at health centers (“Health Centers Save Medicaid 24 Percent, Health Leaders Media“).

The critical role that health centers play in addressing emerging public health threats, such as Zika, opioid addiction, and contaminated water in Flint, MI,  was also under the spotlight, as was their role in caring for growing numbers of veterans (see NACHC release).  In fact, new data showed that the number of health center patients who are veterans grew by 43 percent in less than a decade (from 2008 to 2015) to 305,000 from 214,000. Nearly 9 in 10 health centers serve veterans, who are able to access a wide range of services in addition to primary care.

Health center challenges in recruiting and retaining the workforce needed to meet the demand for care was also widely featured in the media:

“CHCs also innovate to recruit and retain staff members, especially family physicians. In an examination of recruitment needs at CHCs across the country, the NACHC report showed that family physicians are in greatest demand. Nearly 70 percent of CHCs had an open position for a family physician and 51 percent said their highest priority vacancy was for a family physician. Salary was ranked as the largest obstacle to recruitment and retention.”

AAFP News Now, March 23, 2016

Health centers also continued to prove they are innovators in health care. From embracing health information technology to integrating behavioral health care in order to provide patient centered care, health centers stood out. 

“This week, let us thank the dedicated professionals in our Community Health Centers who provide quality care at affordable prices. Let us build on their efforts to improve the well-being of our people and together continue working to bring about a stronger, healthier Nation for all.”-President Barack Obama,  National Health Center Week 2016 White House Proclamation.

We look forward to sharing the successes of 2017 in this blog. Stay tuned!

 

Fighting Opioid Addiction: An Update

It’s been a while since we updated you on the activities related to fighting opioid addiction — a task Community Health Centers are taking on with vigor and innovation. First, with $500 million in hand to fight the opioid epidemic, White House officials are moving quickly to get that money flowing to the hardest-hit states—and pushing local officials to spend the new dollars on treatment above other addiction-related initiatives. Earlier this week the President signed into law “The 21st Century Cures Act,” sweeping legislation that packages together various health policy provisions related to cancer research and the Federal Drug Administration (FDA) approval process for medications (including several provisions that are helpful to health centers that you can read about in more detail in this press release). But the law also funds mental health services and efforts to fight substance abuse.

The focus on this public health crisis could not come at a more urgent time.  As we noted in a previous blog post, the U.S. Surgeon General’s office reports that one in seven people in the United States is expected to develop a substance use disorder at some point, but only 1 in 10 will receive treatment.  Meanwhile, nearly 80 Americans die every day from an opioid overdose.   In West Virginia, also known as “ground zero” for the epidemic, the numbers are far more startling.   Louise Reese, CEO of the West Virginia Primary Care Association, recently described it this way in an op-ed published in the Charleston Gazette-Mail:

“A high unemployment rate, a disproportionate share of manual labor jobs with high injury rates — in addition to aggressive marketing by pharmaceutical companies — all have contributed to our state’s vulnerability. We have paid dearly. West Virginia claims 32 overdose deaths per 100,000 people, nearly triple the national average in 2015.”

Reese goes on to describe efforts the state’s health centers are launching in collaboration with local partners to address every aspect of the crisis, including its direct impact on families and children.

“Health centers are forging partnerships with state and local organizations, schools, churches, the mental health community, pharmacies and law enforcement because we recognize we can all be more effective when we work together. We are developing approaches aimed at helping families and children affected by addiction. A case in point is Handle with Care, a program implemented by the West Virginia Center for Children’s Justice, to support children in school who have experienced a traumatic event. West Virginia health centers operate 143 school-based health centers and are in a position to support this program with additional behavioral health services. Health center providers will be participating in an interactive web-based system called Project Echo to receive consultation from specialists on evidence-based treatments for chronic pain management and opioid addiction.”

You can also listen to our podcast on opioid addiction, featuring Reese and journalist/author Sam Quinones by visiting this link.

 

A Note about the Tennessee Wildfires

Courtesy: Tennessee Highway Patrol

Courtesy: Tennessee Highway Patrol

The call to help can come at the unlikeliest times, but that never stops a Community Health Center from stepping forward.  This was the case in eastern Tennessee, where last week a massive blaze forced thousands from their homes and claimed 14 lives.    Cherokee Health Systems, which cares for over 65,000 residents who live in the affected area, swung into action.   In a dispatch to colleagues and friends in the health center community, Dennis Freeman, CEO of Cherokee Health Systems,  describes what happened:

“The flames were still raging across our beloved Smoky Mountains when Julia Pearce, Cherokee’s Regional Vice President, leapt into action. Julia, always at the ready to advocate for those in need, began to organize our efforts to reach out and care for the residents and vacationers whose lives would be forever impacted by the wildfires. Within a matter of hours Cherokee staff began calling, emailing texting. ‘What can I do to help?” Shouldn’t we be on site?’

Whipped by the near hurricane force winds the fire took a greater toll than initially anticipated. Hundreds of homes burned to the ground, 14 people lost their lives and a few still remain missing. It will be months before some businesses re-open. There will be a lingering financial impact on many families for many years. Of greater significance, the emotional forces of trauma will affect the health and well-being of some for the rest of their lives.

As soon as the Gatlinburg shelter opened for the evacuees and those suddenly homeless, Cherokee staff were there. We have been on site every day since and will be until everyone finds a place to go. Matt Tillery, Cherokee’s Director of Community Services, coordinates these activities and is in active collaboration with the Red Cross, the local hospital and other health and human service agencies. Matt reports our assistance has been welcomed. In a recent email Matt wrote, ‘I’m inspired by the resiliency and tenacity of the survivors just as much as I am by the compassion and willingness of our Cherokee team members.’

Gatlinburg Strong. Tennessee Tough.”

Freeman also thanked  the host of volunteer interpreters and therapists on his staff who came forward to help traumatized residents on the ground.

“The quick response to the wildfires by Cherokee Health Systems very clearly demonstrates the vital role that Community Health Centers play in their communities,” said Kathy Wood-Dobbins, CEO of the Tennessee Primary Care Association.  “Our health centers impact the lives of individuals and communities every day, both within their clinics and beyond their walls. I am proud that we are willing and ready to serve our neighbors any time there’s a need.”

 

 

 

 

World AIDS Day and Beyond: How Health Centers Help

wad2016-instagram-square-1081x1081_cropToday is World AIDS Day and we are taking a moment to highlight the work Community Health Centers are doing to reduce the incidence of HIV and care for people living with HIV.

The National HIV/AIDS Strategy for the United States: Updated to 2020 calls for the integration of high-quality HIV services in health centers and implementation of sustainable HIV testing and care coordination programs. Health centers are essentially on the front lines of HIV treatment and prevention, and making a difference. The number of health center patients receiving HIV testing has increased by 66 percent during 2010 and 2015, according to federal data.

Because the HIV/AIDS epidemic has disproportionately affected the medically underserved, health centers are uniquely positioned to provide comprehensive HIV prevention and treatment and are developing ways to continually improve their services to patients. They are integrating care management and coordination services to boost health outcomes, and are poised to make HIV screening part of a routine exam any patient receives. They are also trying to increase prescriptions of pre- (PrEP) and post- (nPEP) exposure prophylaxis for HIV to keep persons at risk of HIV from becoming infected. Health centers have begun training their expanded care teams to engage patients in discussions about their sexual health, specifically asking all patients about their sexual orientation and gender identity, and asking questions to better understand patient risk for HIV infection.

There are also resources for training and technical assistance. A case in point is the Denver Prevention Training Center (Denver PTC). The Denver PTC works with health centers and Primary Care Associations to assess and improve current HIV prevention services. One way they can do this is by working on routine HIV screening workflows and providing free consultation to help support or enhance a health center’s current HIV care coordination efforts.

Metro Community Provider Network in Colorado is one group using Denver PTC’s free services. Realizing the need to limit their providers’ time away from serving patients, they worked with Denver PTC to have them conduct PrEP trainings for all of their providers at six different clinics in a lunch and learn style to prepare providers for PrEP provision. The Denver PTC offers resources in formats easily accessible to busy clinicians, such as recorded webinars and online tools and have even developed flexible trainings such as onsite mentoring on their website, www.denverptc.org.

NACHC is partnering with Denver PTC to provide free HIV prevention capacity building services to health centers and PCAs. For more information on this service, contact Ashley Barrington at abarrington@nachc.com.  

Related Resources:

AIDS Education and Training Center

Taking Routine Histories of Sexual Health:  A System-Wide Approach for Health Centers

Upcoming Webinar:

Discover HIV Navigation Services: A New Model for Patient Navigation
December 15, 2016: 12:00pm – 1:30pm Eastern. Register.

Facing Addiction in America

sgr-reportU.S. Surgeon General Vivek Murthy, MD, has issued a groundbreaking report on America’s addiction crisis. The report concludes that millions of Americans suffer from alcoholism or addiction to legal and illegal drugs, but only a fraction are being treated. One in seven people in the United States is expected to develop a substance use disorder at some point, but only 1 in 10 will receive treatment, the report said. This is the first report of its kind from a surgeon general that addresses substance use disorders and the wider range of health problems associated with them. It could not come at a more critical time. More people died of drug overdoses in 2014 than any year on record. It is estimated that 79 Americans die every day from an opioid overdose. The report also underscores what many in the health center community are already saying: that addiction is a chronic brain disease, not a character flaw, and addressing the problem will require a cultural change in understanding.

The report also contains some startling numbers:  More people use prescription opioids than use tobacco. There are more people with substance use disorders than people with cancer. And substance use disorders are expensive, costing the U.S. more than $420 billion a year. Among the Surgeon General’s recommendations are that highly effective community-based prevention programs “should be widely implemented,” and that “full integration of the continuum of services for substance use disorders with the rest of health care could significantly improve the quality, effectiveness, and safety of all health care.”

As we’ve noted before in this blog, Community Health Centers have been fighting addiction in their communities for some time with a variety of approaches. Of late, opioid addiction has been a focus as health centers have seen their communities decimated by addiction to the drug.  Over 270 health centers also received $94 in federal funding to improve and expand the ways to treat opioid addiction in underserved populations. Many health centers are using these funds to innovate and expand services beyond medication assisted treatments to include pain management, counseling, group therapy, acupuncture, and holistic medicine.

Stay tuned for our next NACHC podcast, which will feature an interview with Louise Reese, CEO of the West Virginia Primary Care Association, a state which is at the epicenter of the nationwide opioid addiction epidemic.

Related posts:

A Health Center Writes a Book to Help Kids Understand Addiction

The New York Times Looks at Treating Opioid Addiction and Pain in West Virginia