Forum outlines benefits, challenges to community health

A panel of health care professionals and elected officials
lauded the efficacy of community health centers even as they
decried the political process that threatens to undermine a system
that is one of the pillars of the Affordable Health Care Act of
2010 (ACA).
They were joined by Herb Schultz, director of U.S. Department of
Health and Human Services Region IX, who made his second trip to
Sonoma County in as many months to explain the finer points of the
ACA.
Dr. Mary Maddux-Gonzalez, chief medical officer of Redwood
Community Health Coalition (RCHC) and former Sonoma County Public
Health Division Director spoke about the challenges federally
qualified health centers (FQHC) are facing, reporting that over the
past 10 years, there has been a “dramatic increase” — more than 23
million — seen by FQHCs even as there has been a $600 million cut
in funding for health and nutrition programs for women, infants and
children.
In Sonoma County, almost 110,000 people receive care at
community health centers, according to a report released by the
National Association of Community Health Centers.
There are 6.6 million uninsured people in California — the
largest number in any U.S. state and 15 percent of the country’s
total — and almost 60 percent of the state’s uninsured are Latino,
according to the report.
“FQHC cuts don’t make sense,” Maddux-Gonzalez said, as FQHCs
offer “tremendous value and good care.”
Maddux-Gonzalez reported that non-emergency visits to hospital
emergency rooms cost taxpayers billions of dollars every year, but
that every dollar spent on community health center saves three
dollars in health care costs.
According to the report, since 2005, FQHCs in Sonoma County have
increased capacity to serve an additional 35,000 patients, and hope
to expand to provide primary care access to an additional 45,000
patients by 2014 as a result of health care reform.
But $11 billion in federal funding over five years included in
the ACA and intended to fund expansion of FQHCs is in danger of
being eliminated, jeopardizing local efforts to expand access to
primary care.
Carmela Castellano-Garcia, president and CEO of the California
Primary Care Association (CPCA), which oversees more than 800
non-profit community-based clinics, called the ACA the most
meaningful health care legislation since the advent of Medicare and
Medicaid, and will lead to “healthier people, communities and a
healthier nation.”
“Cost-effective medical homes are key to health care in this
nation,” she said.
Republicans proposed $1 billion in cuts, but that was reduced to
$600 million, she said. There were 350 new sites to be created, but
with budget cuts, that number has been reduced to 65, with only
“six or seven” of those to be built in California.
“That will hamper our ability to serve our communities,”
Castellano-Garcia said.
“It’s absolutely crucial to give your representatives real-world
examples what’s going on in communities,” she said. “Call your
member of congress and speak to the White House. We must be active
and win this fight for our seniors, our children and future
generations to assure affordable access to affordable health
care.”
Melanie Rinehart Van Tassell, Representative Mike Thompson’s
chief of staff, said that Thompson “has long supported community
health care” and that ACA has taken steps to ensure 95 percent of
Americans have insurance by 2014, to reduce deficits and to end
desultory insurance practices.
“They can no longer drop coverage when you get sick or deny
coverage to children,” she said.
Van Tassell added that funding used to build community health
care clinics will also help expand the workforce by creating jobs
for nurses, primary care physicians and educate more nurse faculty
to train more nurses.
Dr. Jason Cunningham, medical director of West County Health
Centers said that WCHC has “redesigned the clinic into a medical
home.”
“WCHC is something special. There’s something special about
treating a patient and not asking about insurance,” he said.
“There’s something about treating a patient with high blood
pressure and not telling them to keep their personal life out of
it. … There’s something special about diagnosing a woman with
breast cancer and letting her know that we can walk through it with
her.”
Cunningham said that U.S. health care is reactive and needs to
take a more proactive approach in order to improve outcomes and
reduce costs.
Schultz praised the work of FQHCs in Sonoma County as the
federal government celebrated community health week, adding that,
“The work in West County has been noticed in Washington.”
“I can’t think of any better place to be than in this
community,” he said. “The reason we are here today (is because) in
the ACA there is no more important delivery system or organization
than our community health centers.”
Schultz gave out his contact information and asked those present
to contact him with ideas and information to help HHS craft ACA
policy, which is being created over the course of several
years.
“The path to health care is coming into communities and working
together,” he said. “We can only be successful in the federal
government if we work with the communities we serve.”
For more information on the RCHC go to www.rchc.net; for the CPCA, go to
www.cpca.org, and for the Latino
Coalition for a Healthy California, go to www.lchc.org.