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.

Connecting Veterans with Health Center Jobs

Community Health Centers serve more than 260,000 of America’s Veterans. Yet, did you know that they are also engaged as part of a joint initiative launched by the White House and the U.S. Department of Health and Human Services to hire more Veterans, and to help returning servicemen and women transition into civilian life?

Health centers provide a wide range of employment opportunities for Veterans. Veterans have skills and experience that are a good match for health centers. They also bring a sense of mission and commitment to the community. In fact health centers report a 50 percent higher retention rate for Veteran employees.

To help health centers establish a Veteran hiring strategy NACHC has created a toolkit entitled Making the Connection and Continuing to Serve: A Veteran Hiring Toolkit for Community Health Centers and Veterans.  In the toolkit health centers will find information on creating a Veteran friendly workplace, the benefits of hiring Veterans, finding Veteran candidates and creating a strategy for hiring Veterans. The toolkit is also helpful to Veterans. It contains information for them on how their military experience translates to jobs in the health centers and where to find available jobs.

To learn more about the Hiring our Veterans Initiative click here. You can download the toolkit here.

Patients First

PCMH snapshotTo mark the 50th anniversary of the Community Health Center Program we are using the month of May to spotlight the various ways health centers operate as Patient Centered Medical Homes (PCMH). We found a good example in Colorado, where Peak Vista Community Health Centers has been spotlighted in the journal Health Elevations, published by the Colorado Health Foundation.

The article, authored by Kelly Dwyer, describes how each morning “small teams of primary care doctors, nurses, medical aides, behavioral therapists, and care managers” gather to discuss which patients are coming in and review their reports and check off which lab or diagnostic tests need to happen. “This is integrated care at work,”  writes Dwyer. “Peak Vista is defying perceptions of beleaguered clinics scrambling to merely keep up with demand and is instead leading the integration revolution through better design.”

We admit we’ve written about Peak Vista before on this blog when they received PCMH recognition. We are writing about them again because their work demonstrates how patients experience the “patients first” approach of PCMH. For instance, Dwyer writes:

A fair share of Peak Vista’s patients and their families miss work without pay to get to the doctor’s office. Some ride the bus to get there, which makes it convenient to schedule back-to-back visits with the dentist and pediatrician, for example.  A team-based approach to care allows primary care providers to intervene the moment they recognize a behavioral or dental issue. “When you get emotional outpouring from a patient, you have a way to say, ‘I can help with that,’” said pediatrician Barbara Divish, MD, who makes frequent “warm handoffs” to a pediatric psychologist on-site. Peak Vista’s behavioral care providers typically spend 10 to 15 minutes with patients on those handoff visits, then schedule longer follow-up visits if needed. Patients are more likely to see a dentist or therapist on the spot than they are to follow through on a referral at a different office and possibly weeks later.

The health center has also invested in areas that improve efficiency, as well as the patient experience, such a electronic health records and care coordination, strategic changes that has reduced wait systems and enrolled people into insurance coverage.   Staffing investments also paved the way for care teams that help patients and providers “connect what is disconnected.” For instance, the staff at Peak Vista also recognized that parents with multiple children may have difficulties accessing care, especially when they can’t find a baby-sitter.  Solution?  Open a drop-in child care room for healthy siblings, a move which cut the health center’s no-show rate.

Every day health centers prove in communities that a system of care exists where innovation is shaped around the patient experience and geared toward better outcomes.  Tell us how your health center is making patients first  and we’ll write about it on this blog.


Stage 4, How Did We End Up Here?

This blog was originally published in the Huffington Post as part of a series of posts raising awareness of National Women’s Health Week. 

womenshealth (3)My mother, the certified nursing assistant (CNA), has stage four breast cancer. She has tumors in her breast, on her hip and on her skull. The tumor on her hip is what bothers her the most because it’s painful to do just about anything. My siblings and I are working to get her the care she needs and if her treatment works and she changes her lifestyle a bit she could live long enough to see her grandkids graduate from high school. But she will never be completely healthy again.

How did we even end up here? We have no history of breast cancer in our family. My mother is a healthcare provider, I work in the healthcare industry, and my sister — with whom she lives — is very aware of the importance of staying healthy with regular care. How does someone like my mother — who often worked with terminal cancer patients — slip through the cracks, with no diagnoses until stage four? Simple — she ignored what was happening to her body. She ignored it until she could not ignore it anymore. She did not have health insurance and she was afraid. That’s the reality. My mother has — until this point — lived every day taking care of others as an occupation and caring for her family but not herself, often rationalizing that she didn’t want to be a bother to her grown children. Instead she pretended nothing was wrong until she could bear the pain in her hip no longer and tumor in her chest was visible to the naked eye.

After an official diagnosis my mother’s survival rate now stands at 22 percent. And so begins our journey of navigating the health system to confront a host of problems that include terminal cancer, coupled with arthritis and high blood pressure. At first I was angry, not just at her for not taking care of herself but also at a system that made it difficult for her to do so because she was uninsured. Then sadness slowly crept in. Here’s a woman who came to the United States from Honduras by herself in her early 20s, who raised three productive members of society, who received her CNA license in her 50s and now must fight for her life because she didn’t make time for a simple, routine exam and skipped out on a mammogram for over five years. She may not be around for my daughter’s first birthday or my nephew’s first day of school. There may not be visits to abuela’s house for Mother’s Day and Christmas. When my daughter is older I may only have stories and photos of her in my mother’s arms as an infant to share. All of those milestones and memories she could make in the future are now more uncertain than ever.

Women are strong, but not superhuman. We need to take time to care for ourselves and go to our healthcare provider for regular check-ups. We can’t be there for our loved ones if we can’t even be there for ourselves, mentally and physically. This year take the National Women’s Health Week Pledge, and learn the steps you can take at any age to be your healthiest you.

If lack of resources or coverage are keeping you from getting your check-up, visit your local Community Health Center. Community Health Centers provide quality preventative and primary healthcare regardless of ability to pay. The care is affordable and offered at a sliding scale fee. You can access a range of preventive healthcare services all under one roof — from cervical and breast cancer screenings to health education and assistance with signing up for health coverage. Best of all, a health center is a healthcare home, a place to return on a regular basis for continuous care.

Life can be tough enough without the added stress an illness can bring. We matter. We mean something to all the people we touch including our friends, and family so we shouldn’t ignore our health.