A Health Center Leader Under the Spotlight at SOTUS

Cedric Rowland

Cedric Rowland

President Obama’s final State of the Union (SOTU) address tonight is a special one for the health center community.  A representative from a Chicago area Community Health Center will be accompanying First Lady Michelle Obama in her guest box. Cedric Rowland is a passionate Lead Navigator at  Near North Health Service Corporation (Near North), a health center which has served uninsured and underserved populations across the Chicagoland area for more than 50 years. He is passionate about connecting people to insurance coverage options under the Affordable Care Act (ACA).  As Lead Navigator, Rowland works with consumers to find the best plans available at a price they can afford. Affordable Care Act navigators help consumers across the country take advantage of the benefits of the landmark law. In addition to enrolling more than 500 consumers since the inception of the ACA, Rowland’s role in the ACA’s success can be seen in the story of Stephanie Lucas. Ms. Lucas suffers from diabetes and at one point did not qualify for Medicaid, but Rowland worked hard to help Lucas transition to a Marketplace plan that met her needs and let her continue seeing her doctor at a price she could afford. It is this story that drew the notice of the White House and  resulted in his invitation to the SOTU, and no small amount of local media attention [see news story].

Thanks for your hard work and passion on behalf of the medically underserved and uninsured, Cedric. You make us proud.

 

Postcard from Rhode Island — A Community Approach to Target Victims of Domestic Violence

Every so often we hear about health centers collaborating with other organizations to solve a problem.  In a previous blog post we wrote about efforts by health centers and Boston to respond to victims of trauma.   Now, in Rhode Island, we learned about a similar collaboration, only this time it is to reach out to victims of domestic violence.  Thanks to a grant from FUTURES Without Violence, an organization dedicated to empowering organizations and people to end violence against women and children around the globe,  Thundermist Health Center and Sojourner House, a comprehensive domestic violence agency, have joined forces.  These organizations may sound like unlikely allies, until one considers that domestic violence is not just a private family matter, but also a public health issue.   According to the Centers for Disease Control,  on average, 24 people per minute are victims of rape, physical violence, or stalking by an intimate partner.

Thundermist will focus on offering patients health education and harm reduction strategies.  Sojourner House will help with safety planning and support services. FUTURES Without Violence will add in technical assistance, training, and resources.   For Thundermist, this is a health issue that demands an immediate community approach.

“In 2013, there were 407 arrests due to domestic violence in Woonsocket.  This is the highest rate in the state when accounting for population size, and we believe a vast underestimate of the true rate,”said Chuck Jones, Thundermist’s president and CEO.  “We see a great opportunity to integrate intimate partner violence (IPV) screening into our practice.  We recognize that Woonsocket is deeply impacted by IPV, and that strengthening our existing partnership with Sojourner House will have a positive impact on staff, our patients, and our community.”

Help for domestic violence victims is just one of the many social services Community Health Centers can offer patients. The services at Thundermist alone range from primary medical care and dental care to adherence counseling for HIV-positive patients and even a Trans* Health Access Team which works to improve access to culturally and clinically competent healthcare for the trans community.

Firehouse Clinic Opens in California

U.S. Rep. Eric Swalwell at the FHC press conference.

U.S. Rep. Eric Swalwell at the FHC press conference.

FHC2

FHC in Hayward, CA,

A firehouse clinic is such a good idea it has us wondering–  why aren’t there more of them? The Firehouse Clinic  (FHC)  recently opened its doors in Hayward, CA, east of San Francisco.  The health center represents an innovative collaboration of the Hayward Fire Department, Tiburcio Vasquez Health Center (under the direction of CEO David. B, Vliet), Acute Care Hospitals, and Alameda County Health Care Services Agency.  FHC is a full-service primary and preventive care clinic co-located on the grounds of a newly constructed fire station in South Hayward.   Over 3,800 patient visits are projected for the first year and will likely keep going.  Most would agree that it makes sense in healthcare to shift patients away from more costly and crowded emergency rooms to be treated in a primary care setting.  And nationally nearly 40 percent of emergency department visits among the general population are primary care sensitive in nature and thus even preventable, according to a NACHC fact sheet.

“We need primary care services that are open at the right time, accessible to the people we serve, doing things that they need,” explained Hayward Fire Chief Garrett Contreras to the ContraCosta Times in a recent interview.

Common visits to the FHC include: Ear, nose and throat infections,  urinary tract infections,  asthma,  bacterial pneumonia,  hypertension,  cold and flu symptoms,  tuberculosis tests,  blood pressure checks and wound care, conditions that, all too often, are inappropriately and more expensively treated in an emergency room.   FHC plans to add dental services later this year.

In addition to medical services, including follow-ups to emergency room visits, the FHC is also focused on population health services, such as navigating patients to the best insurance program available and to a medical home for chronic care, if necessary. Medical staff will also provide referrals to specialty and behavioral health care, and provide discharge follow-up for residents in a defined geography within 48 hours of discharge from Acute Care.

So why hasn’t anyone thought of this before?  We asked Lori Baptista, Director of Policy at Tiburcio Vasquez Health Center, Inc.   “The FHC is the first of its kind in California, and to our knowledge, this particular model is the first of its kind in the nation as well,” she explained.   “This model—which has since gone through a few iterations–was first conceived by Alameda County Health Care Services Agency Director (ACHCSA) Alex Briscoe and as this idea was an innovative, out-of-box concept,  it required bringing together many different partners, government agencies, unions, and other entities throughout the county.  The final project has generated a great deal of national, state, and local interest and excitement–and it is ACHCA’s plan, as well as that of TVHC, the city of Hayward and other healthcare stakeholders throughout the county to replicate this model in the years ahead.”

We hope so.

 

Going Beyond the Walls of HealthCare in Oregon

As we’ve written many times, Community Health Centers have been around for 50 years, yet the different ways they address community health are not widely known by the general public.  The conventional wisdom is that healthcare begins and ends in a doctor’s office.  Health centers prove that wrong every day. But how do we show that?  We found a good example at  Rogue Community Health in Jackson County, Oregon.  The health center teamed up with actor Patrick Duffy to produce a new video that shows exactly how healthcare can transform lives.  Both Duffy and his wife are supporters of Rogue Community Health.  In the eight-minute video, narrated by Duffy, we learn how the health center has touched the lives of their patients, not by just fixing what’s wrong in the exam room, but by solving the problems and challenges that patients face beyond the health center — homelessness, drug addiction, unemployment, etc.  As Duffy notes, “Poverty has consequences on health” for individuals and communities.  We learn how Rogue’s clinicians and staff are using the team approach to coordinate care and integrate services tailored to each patient.  We learn how Rogue helped treat longtime homeless patient, James.  Rogue helped managed James’ prescription drugs to ensure the correct dosage and helped link him to housing and other services to help him stay off the street.

We also learn about Tom, a single dad with two young children, including a newborn. Thanks to Rogue, Tom and his family are not only getting regular healthcare, but also support services, such as formula, diapers, job assistance and regular weekly progress check-ins from a Community Health Worker.  By getting the help he needs, Tom, a recovering addict, can focus on the needs of his family and the future.

Rogue Community Health has been in the business of community health for some time.  Established in 1972 by concerned community residents, the organization now provides affordable primary, preventive, pharmacy, dental and behavioral healthcare services in Ashland, Butte Falls, Medford, Prospect and White City, Oregon, and School-Based Health Centers at Eagle Point and Ashland High Schools, and Butte Falls and Prospect Charter Schools.  Rogue is part of a national network of health centers which are community directed and patient-driven.  There is no one-size fits all approach, no cookie-cutter type treatment plans.  Just a caring team of clinicians and staff on a mission not just to treat illness before it happens, but to address the root cause of illness that lie in wait.

Postcard from Massachusetts: Workforce Readiness in Modern Healthcare

We’re using the holiday time to catch up on news stories that may have escaped notice.  Here’s a headline from our friends at the Massachusetts League of Community Health Centers: “Med School Grads Are Not Prepared for Modern Healthcare” in the Bay State. As part of a daylong symposium last month celebrating the 50th anniversary of Community Health Centers, Mass League surveyed organization policymakers, health center leaders, advocates, and staff and found that primary care providers coming out of medical school today are not adequately trained for the new model of delivering care.

Since the 2006 health care reform, the state’s health centers have been actively engaged in transforming their care approach to the more team-based, patient-centric model that is now a cornerstone of the Patient Protection and Affordable Care Act (ACA), according to the Mass League press release.  While Massachusetts health centers have found early success with the transformation to this new approach, which moves from a single provider care model to integrated clinical teams focused on patient care coordination, there remains “a slow and difficult cultural shift for care providers, particularly physicians.”

“We’re making great progress, but it’s clear that medical schools have not adjusted their training approach to address issues of team coordination, process improvement, patient engagement and better use of technology – all of which are basic requirements in practicing primary care in the post-ACA era,” explained Antonia McGuire, Board Chair of the Massachusetts League of Community Health Centers and President and CEO of the Edward M. Kennedy Community Health Center in Worcester. “Medical schools should draw upon the community-based expertise of health centers in developing their curricula and training programs in primary care.”

“Community health center residency programs are an untapped resource for our nation’s medical schools, which are responsible for adequately preparing our future primary care providers for the modern healthcare system,” said James W. Hunt, Jr., President and CEO, Massachusetts League of Community Health Centers.