Why Community Health Centers Could Be Key for People with Disabilities

/ January 7, 2020

By Emily Waitt

Community health centers are patient-centered, non-profit organizations that provide primary health care services to communities with limited access to health care. Community health centers are also known as Federally Qualified Health Centers because they must adhere to federal requirements regarding the services they offer, the quality of care they provide, and the cost of care to patients.

By mission and by statute, health centers provide care to everyone that comes through their doors regardless of whether or not they have health insurance or can afford to pay for care. Health centers offer a sliding fee discount program to ensure that cost doesn’t stop patients from taking charge of their health.

Health centers are located in areas of high need and are required to provide accessible hours and after-hours availability to meet the needs of their communities. They are truly patient-driven organizations because patients must compose the majority of members on their governing boards. For more information on what makes community health centers unique, check out the following video:  What is a community health center?

Community health centers provide services and programs that extend beyond the reaches of traditional medical care to address factors that shape the health of entire communities. Health centers provide comprehensive, integrated care that blends primary care with behavioral health care, dental care and non-medical services and supports all under one roof, at the same time. There are nearly 1,400 of these organizations across the country that serve 28 million patients.

Tennessee has 29 community health centers with around 200 sites in 72 of Tennessee’s 95 counties. Health centers are located in underserved urban and rural areas and act as the health care home for more than 422,000 patients per year. Health centers welcome all patients regardless of housing status, income or employment, health condition or disability, gender identity or expression, sexuality or sexual orientation, race, color or ethnicity, immigration or citizenship status.

Staff are trained to provide inclusive, sensitive and culturally appropriate care to all patients. Health centers treat patients across the lifespan and provide continuity of care that allows them to respond to their patients’ needs as those needs evolve over time.

Model of Care

Community health centers are connected by their mission and mandate, but each health center has its own unique characteristics. Health centers rely on teams of health care providers that may include physicians, nurses, physician assistants and nurse practitioners along with behavioral health providers and case workers. Teams coordinate care for patients and follow-up with more specialized care or services as needed. Care teams provide patient-centered care by engaging patients and their families as partners in health care decisions and care delivery. All health centers provide patient-centered care, but some health centers are designated as Patient-Centered Medical Homes. This designation recognizes health centers that provide coordinated, patient-centered care with an emphasis on quality improvement.

Health Center Services

All health centers must provide a core set of preventive and primary care and other supportive services that improve health care. Many health centers provide additional combinations of services or provide care that is targeted to certain populations. Health centers provide a wide array of services such as mental health care, substance use disorder treatment or dental care. Some health centers provide more specialized care like X-rays, lab services and pharmacy services. Certain health centers also offer programs that meet the needs of vulnerable populations, such as people experiencing homelessness or migrant and seasonal farmworkers.

One of Tennessee’s health center illustrates how health centers are equipped to address the needs of underserved populations. An East Tennessee health center operates a Developmental Center for adults with intellectual or developmental disabilities.  Programs through the Developmental Center serve two dozen individuals, some of whom participate in a residential program. Participants in the program can also receive vocational training and work for a variety of organizations and businesses. The Developmental Center seeks to create an environment where participants can achieve independence throughout everyday life and foster whole person health. Although the Developmental Center is unique to that one health center, all community health centers address factors outside of medical care that affect health and well-being.

Addressing Other Factors of Health

Along with primary health care, health centers offer programs and services that address the conditions in which people live, work and play that contribute to poor health in the first place. Health centers offer “enabling services,” which are non-clinical services that help support access to care and care delivery. Enabling services vary from one health center to another but can encompass child care, eligibility assistance, food banks or meals, parenting classes, and education and employment assistance. These services can break down barriers to care for patients and ensure that their physical, mental, emotional, and social needs are addressed, and they can thrive.

Health centers are successful at identifying and responding to the needs of their patients because they are connected to their communities. In addition to patient-majority boards, health center staff is often composed of members in the community. Health centers form strong relationships with other health care and social services organizations and leverage these partnerships to more effectively meet the needs of their patients. Deep community ties also allow health centers to respond to emerging public health threats such as an outbreak of the flu, the opioid crisis or natural disasters.

For more than 50 years, health centers have stood as examples of how investing in preventive and primary health care can improve the health of patients and strengthen communities. If you are interested in learning more about how to make a community health center home, check out the following resources:

I learned about the Tennessee Primary Care Association several months ago and had the privilege to meet with Terri Sabella, the chief executive officer of the association, and Libby Thurman, the chief external affairs officer. I was delighted to learn about this group and its desire to serve ALL patients in need of health care.

As many of you know, finding appropriate health care for adults with intellectual and developmental disabilities can be a daunting task, and I believe that many community health centers are striving to provide that care. I honestly knew very little about community health centers until our pediatrician suggested, after my son turned 18, that he would need to find a new health care provider. Because my son also needed a knowledgeable mental health provider, we chose Mercy Community Healthcare for his care, which provides integrated physical and behavioral health care. Although he still has private insurance through my employer and TennCare as an SSI recipient, we’ve chosen a community health center because of that focus on integrating physical and behavioral health. And we’ve been very happy with his care there. I hope that if you or your loved one needs health care, you’ll look at your local community health center as an option.

I want to thank Emily for writing about the mission of community health centers and their willingness to care for any patient who walks through their doors. If you have questions, you can email me at janet.shouse@vumc.org. Thanks for reading!

Emily Waitt smilingEmily Waitt, who has a master’s degree in public health, serves as the policy and advocacy coordinator at the Tennessee Primary Care Association, the membership organization for community health centers in Tennessee.

January 7, 2020

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