| COMING UP |
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Uniform Data System, Jan. 8, 9 QTS, Leadership Session, Feb. 27, 7:30 am - 1:30 pm QTS, Quality Institute, Feb. 27, 1:30 - 4 pm |
In this Issue
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Welcome to Senior Policy Coordinators Kimberly Keymer and Caleb Gilchrist. Welcome to Aza Nedhari, Project Specialist – AWI; and AWI Project Assistants Melissa Salinas and Kevin McNeill. Welcome to Cathy Morales, Director of Community Health Access and the AmeriCorps Community HealthCorp participants. Welcome to Linda Gardiner, RHIO Project Intern. |
| Medical Homes DC | |||
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| Policy and Advocacy | |||
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Standing Up. Speaking Out. |
 “From Tiny Acorns Mighty Oaks May Grow” I don’t remember where or when I first learned this little truism. Some English class during some school year, perhaps. I didn’t have the frame of reference then to truly appreciate this simple statement or that is seems to be the foundation for system reform, as I define it anyway. It resonated deeply just the other day with the announcement of La Clínica del Pueblo’s long awaited designation as a Federally Qualified Health Center. For those of you who may not know the lingo, an FQHC designation allows a community health center to qualify for a core operating grant, medical malpractice coverage, and an enhanced reimbursement rate through Medicaid – all funded through the federal government. It is a long, arduous, and highly competitive journey a health center must take. It is given to those centers who have demonstrated the deep need in the community for primary care and prevention services. Only those whose mission is to serve the poor, the uninsured, and other medically disenfranchised populations, who guarantee care to whomever comes through their door regardless of any ability to pay for services, are even considered. La Clínica joins four other sister organizations in DC who have been granted this critical designation: Unity Health Care, Inc., Columbia Road Health Services, Mary’s Center for Maternal and Child Care, and Community of Hope. Whitman-Walker Clinic was also recently designated as an FQHC “look a like” – which is an interim designation allowing for enhanced reimbursement through Medicaid, but none of the other supports for provision of care to medically needy populations. Ten years ago, when the primary care community for the underserved was just organizing, only one health organization was an FQHC and one was a “look-alike.” Those of us determined to establish a more secure place for primary care for the underserved heard more often than not from the feds that DC was not a good investment for federal money and the federal experience was that nothing much would come of any investment that was meant to improve the health of a very sick city. On the local level, there was either pure lack of knowledge of the good work hundreds of dedicated people and organizations were doing delivering health care – or just complete disinterest. We were the shadow health care system, hustlers for care for a large number of our citizens, the very poor, the working poor, the homeless, and immigrants who feared or could not afford to participate in conventional care – the “fringe” who fell between the cracks of DC’s approximately $8 billion health care delivery structure; not system mind you, structure. Entering our tenth year now as the organization representing those tireless survivors against major odds – the safety net primary care health centers, through their own tenacity, through some investment in facilities and operations through Medical Homes DC and navigating major mine fields – I can not only see the transformation from tiny acorn to mighty oak, but I am beginning to see enough growth to expect a forest and not just a few trees here and there. I have seen amazing signs of growth and witnessed the journey toward sustainability. So, I pause to celebrate in my mind one more step on the road to a high quality integrated system of community-based care … till my mind starts to list those hurdles still left to overcome to achieve our goal: $74 million in capital investment needed (we have $21 million). $8 million for implementation of electronic medical records in 10 community health centers (we have $5 million). $10 million for a Regional Health Information Organization (we have $6 million). $163 to provide a primary care visit (we get paid $65 – tops). This list includes just a few of the thoughts that run through my mind as obstacles standing in the way of system reform. It’s why the amazingly effective “mom and pop” model of health care I cut my teeth on, so eloquently laid out in the article below written by my former colleague from Community Medical Care, seems in danger of extinction if we do not persevere. Our newly sprouting “mighty oaks” are the last hope for humane, compassionate, patient-centered health care. While our goals of best business practices, quality assurance initiatives, performance improvement support, disease management collaboratives, and corporate compliance grind on and help us compete in the big supermarket health care system – and appeal to donors, banks, and investors – here’s what can’t be lost: the truly effective mission-oriented, holistic culture of time, listening, accepting people where they are, compassion, tough love, tenacious pursuit of healing, and wholeness for a community. The core beliefs contained in each of our original acorns should not be diminished by the growth to the mighty oak, but instead flourish to seed the rest of a broken health care system – and perhaps, one day in the future, define a new way of giving our communities a chance to live long, healthy, disparity-free lives. |
