Working Towards Equality in Healthcare

Thirty years ago, in 1985, MTV was four years old, the FDA approved the first blood test for HIV/AIDS and the Report of the Secretary’s Task Force on Black and Minority Health—commonly known as the “Heckler Report” was released. The landmark report was named after then Health and Human Services (HHS) Secretary Margaret Heckler and marked the first effort by the U.S. government to conduct a comprehensive study of racial and ethnic minority health.

Progress on the minority health is difficult to measure. Health disparities still remain a national problem, but Community Health Centers, a bright spot in the health system, with their unique model of care and 50 years of experience, continue to make great strides towards addressing these complicated issues. By recognizing that each community is one of a kind and has its own set of social determinants of health to contend with, health centers work not just for the community they serve, but alongside it. Patient majority governing  boards have helped direct important resources to the community where it is most needed.  And the mission of health centers, which began during President Lyndon Johnson’s War on Poverty, has been to not only prevent illness, but address the factors that cause it.

2-pager-infographicThe wisdom behind this mission was eloquently captured not long ago by Howard K. Koh, MD, MPH, Former HHS Assistant Secretary for Health at the NACHC CHI last year: “You know better than anybody that health is much more than an interaction in a provider’s office,” he said.   “Health starts where people live, labor, learn, play and pray. That’s what the social determinants of health is all about. And [health centers] got that right from the beginning.”

Whether it’s helping a patient manage their diabetes by providing nutrition and fitness classes, or  helping a community get to their appointments by providing much needed transportation, health centers go beyond their four walls to provide some equality in health in over 9,200 locations across the country. They are also a provider of jobs in their local communities and save the health system money while also generating $26.5 billion a year in total local economic activity.  Just look at the numbers:

  • C-_Users_mmballantyne_Desktop_SpecPops62 percent of health center patients are members of racial and ethnic minority groups
  • Health centers serve:
    • 1 in 15 Americans (23 million people)
    • More than 860,000 migrant/seasonal/agricultural workers and their families
    • Over 1.1 million homeless persons, including those who are on the street, in a shelter or in transition
    • More than 475,000 school-based health center patients including children who might otherwise miss school or not receive the care they need

Despite some progress in ending health disparities the work is not yet done and health centers will continue to play a crucial role in addressing the healthcare needs of the most vulnerable and underserved populations.  As part of the 50th Anniversary celebration, we are trying to showcase examples of health centers carrying out their mission with innovation and spirit  on this blog. If your health center is doing just that, let us know, and we will write about it on this blog.

Four Generations Under The Roof of One Health Center in North Carolina

Today’s blog post comes to us courtesy of our friends at  Piedmont Health Services in Carrboro, NC: 

Melba Jones, a patient at Carrboro Community Health Center, in Carrboro, NC

Melba Jones, a patient at Carrboro Community Health Center, in Carrboro, NC

Saying that Melba Jones is part of the patient family at the Carrboro Community Health Center is an understatement.  The 83-year-old Chapel Hill resident has been a patient at the center as long as it has been there, and she used to work there. Four generations of her family are also part of the Carrboro Community Health Center family. Jones has three sons and five daughters. She also has 10 grandchildren and eight great-grandchildren. Most of her children, grandchildren and great-grandchildren are patients at the Carrboro Community Health Center. Jones said she simply has no reason to go anywhere else.

“I really think I get quicker service at the health center,” she said. “There’s not a long waiting period and it’s close to where I live.”

Jones said she gets personalized treatment at the health center. She said she likes the center’s environment; it has a smaller staff that works with fewer patients than other medical facilities.  Jones also appreciates the fact that the Carrboro Community Health Center – like all of the centers in the Piedmont Health network – charges patients according to their ability to pay and provides care regardless of ability to pay.

“Why pay much more for care?” Jones said.

Jones also worked as a certified nursing assistant, also known as a CNA, for almost 25 years, including time spent as a CNA at the Carrboro Community Health Center. She retired in 2010. Most of Jones’ daughters are now also certified nursing assistants.

“I had a lot of compassion for people,” Jones said. “I really liked it. I figured someone might have to take care of me.”

Jones, a life-long resident of the Carrboro/Chapel Hill area, was a patient of the Carrboro Community Health Center when it was one of three centers that started Orange-Chatham Comprehensive Health Services, Incorporated in 1970. After 45 years, the Carrboro Community Health Center still provides quality health care to its patients.

Jones said hard work and personally relating to patients are important when helping people.

“Do your best to take care of people,” she said. “You’re there to take care of the patients. Those people are there to get the very best care they can get. They’re depending on you.”

As a patient at Carrboro Community Health Center, Jones said, Dr. Christopher Tobin has been one of her favorite doctors. “He was just like a family member,” she said. “He was just so kind and so sweet.”

Now, Jones enjoys spending time with her family. Along with the care she receives at Carrboro Community Health Center, gardening plays a major role in keeping her healthy.  “That’s my stress pill,” she laughed.

Note: The folks at Piedmont have established   Community Health Center Alumni Association (CHCAA), a nonprofit organization for current and former providers, staff, patients, donors, vendors, volunteers, interns and elected officials – anyone who has had a relationship with Community Health Centers. Staff, patients, elected officials, advocate and everyone that supports health centers are encouraged to sign up.  We signed up already! To learn more & register for membership,  visit:  http://chcalumni.org/.

A Mission and Patients Thrive in Omaha

CaptureEvery day in a community somewhere in America a health center makes a difference in someone’s life. We don’t have data or numbers to cite here, because the kind of impact we are writing about cannot be measured. What we do have are the stories, stories that we hear from our friends who are quietly carrying out the mission that started 50 years ago.

That’s what brought us to OneWorld Community Health Centers in Omaha, NE. We’ve always heard great things about OneWorld. Their clinics care for about 32,000 people, and operate from 10 locations around the city of Omaha — including four school-based health centers, and a mobile dental clinic. They also recently won the 2015 Business Excellence Award by the Greater Omaha Chamber of Commerce. But that’s not why we are writing about OneWorld. We are writing about them because they are making a difference in their patients’ lives beyond just delivering healthcare. And we would not know that but for this great video we found on their web site. In partnership with Community Alliance, OneWorld is addressing the comprehensive healthcare needs of patients battling mental illness. OneWorld and Community Alliance have providers in place at both healthcare centers – allowing for easy cooperation between healthcare and mental health providers. Patients do not need to make additional appointments or travel to multiple locations to have all of their needs met. But don’t take our word for it, watch the video and hear about it from the patients themselves.

Focusing on the Special Healthcare Needs of the Elderly

Our guest blogger today is Karen Scott, a Public Relations Specialist at A.T. Still University:

A patient at ATSU

A patient at ATSU

ATSU The Center for Advanced Oral Health

ATSU The Center for Advanced Oral Health

 

Arizona’s A.T. Still University of Health Sciences (ATSU), a longtime NACHC partner, is known for innovative curricula that prepare medical and dental students to work with underserved populations by embedding the students in Community Health Centers (CHCs) for large chunks of their education. What better way to get to know the types of patients they’ll care for and the team-based, medical-home settings in which they’ll do it?  The patients served by these CHCs are not the only underserved communities in the school’s sights. At The Center for Advanced Oral Health, one of four teaching dental clinics connected to ATSU’s Arizona School of Dentistry & Oral Health, changes are underway that will help a group not usually thought of as at risk: older adults.  

As the number of aging baby boomers grows, so does the number of people with Alzheimer’s disease and other complex medical conditions. According to the National Institute on Aging, there may already be as many as 5 million Americans 65 and older who suffer from Alzheimer’s, with the number doubling every five years after 65. It’s no surprise that Arizona, long a favorite retirement location for Americans, is fast becoming home to one of the country’s largest Alzheimer’s populations. The national Alzheimer’s Association reports that 120,000 Arizonans have the disease and projects that, between now and 2025, the state will have the second-highest growth rate in the country.

As the healthcare system scrambles to catch up, one of the areas often ignored is dental care. For older people with Alzheimer’s, other types of dementia, and complex physical conditions like cancer, cardiac disease, hemophilia and kidney disease, even run-of-the-mill dental procedures like fillings and cleanings, to say nothing of root canals, crowns, extractions and implants, require anesthesia. The trouble is, it’s not always readily available.

At ATSU’s Center for Advanced Oral Health, the number of affected patients already outstrips capacity. For every person receiving anesthesia (via a mobile cart), three are on the waiting list, and the waiting period is three months long. That’s a delay that can have “devastating effects on a patient’s overall health,” says Maureen Perry, DDS, MPA, a nationally known expert in special care dentistry who directs the clinic and is Associate Dean for Post-Doctoral Education at the dental school.

But things are looking up. This summer, The Center will become Arizona’s first nonprofit community dental clinic with permanent dental anesthesia suites. Courtesy of a grant from the Phoenix-based Virginia G. Piper Charitable Trust, the clinic is creating two fully-equipped anesthesia suites and adding waiting and recovery areas specially designed to be oases of calm and comfort for older adults.

Opened in 2013, ATSU’s Center for Advanced Oral Health is Arizona’s first community dental clinic dedicated to what’s known as special care dentistry. The clinic is staffed with faculty members from the university’s Arizona School of Dentistry & Oral Health trained to care for patients with physical and cognitive challenges. They’re also expert at caring for people whose developmental challenges mean that even basic dental care can require a team of doctors rather than a solo practitioner. Before the 11,000-square-foot state-of-the-art clinic began operating, many Arizona residents with these conditions had to go outside the state for dental care. Others simply went without.

Like ATSU’s three other teaching clinics, The Center for Advanced Oral Health is both an out-patient treatment facility and a training center for ATSU’s post-doctoral dental residents and dental and medical students.

To learn more about dental care for older adults and about The Center for Advanced Oral Health at A.T. Still University of Health Sciences, click here or contact Dr. Maureen Perry at mperry@atsu.edu.

 

 

 

Finding Access to Care at School

Officials cut the ribbon to open the school based health center at Amistad Elementary School in Pasco, WA.  Officials cut the ribbon to open the school based health center at Amistad Elementary School in Pasco, WA.

Officials cut the ribbon to open the school based health center at Amistad Elementary School in Pasco, WA.

As part of our celebration of the 50th Anniversary of the Community Health Center Movement we are showcasing the unique ways that Community Health Centers deliver care to special populations. Among those populations are children, who all too often miss out on accessing primary care because of where they live, are uninsured or their families cannot afford care.  Thankfully, health centers can fill that gap, partnering students’ needs for a full range of age-appropriate healthcare services that typically include primary medical care, mental/behavioral healthcare, dental/oral health care, health education and promotion, substance abuse counseling, case management and nutrition education.  Nationally, school based health centers care for more than 475,000 patients and counting.

School-based health centers make sense for a lot of reasons, not the least of which is that children learn better because they are healthier.  That is why Tri-Cities Community Health, located in Washington state, recently launched two school based health clinics, one adjacent to an elementary school in Kennewick and the other is on the grounds of a middle school in Pasco.  “This is a way to provide easier access for children to receive necessary services, ranging from physicals, immunizations, preventive care and treatment of minor illnesses,” explained Tri-Cities Community Health CEO Al Cordova.

Most school based health centers operate on site, but in South Carolina, there is a school based health center  on wheels. Beaufort-Jasper-Hampton Comprehensive Health Services (BJHCHS) has just launched a new mobile health unit that travels around to Hampton County schools so students can get healthcare on the spot. The unit has two stations on board–one for medical exams and the other for dental care which aims to serve more than 850 students per year.

School based health centers are also catching on in rural California, according to a recent article in California Health Line.  There are 231 school-based health centers in the state, most were concentrated in urban areas but now rural towns, such Livingston, located in the Central Valley, are realizing the need.  At Livingston High School, for instance, in Merced County, more than 90 percent of students come from low-income working families. Access to care can pose a challenge for kids with both parents working at low-wage jobs. Livingston Community Health had an active relationship with the school and proposed a partnership as the next logical step.

“We have a lot of mental health issues, stressors from poverty,” explained principal Ralph Calderon to California Health Line.  “There are an inordinate amount of students with anxiety disorders that sometimes turn into full-blown panic attacks. These are things we want to try to get addressed.”  The article notes that Livingston High School is the smallest school in the district, but makes three times the number of ambulance calls as other high schools.

Federal support has helped boost the number of school based health centers in both rural and urban areas, and  for good reasons. Studies show that having a school-based health center improves attendance, reduces the dropout rate and hospitalizations. There are nearly 2,000 school-based health centers  that operate nationwide, according to the most recent National Assembly on School-Based Health Care census, and most are open every day school is in session.

To learn more visit this link at the Health Resources and Services Administration (HRSA).