Community Health Centers (08/09/2010 Webchat)

Uploaded by USGOVHHS on 09.08.2010

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[Jenny Backus] Hi, I'm Jenny Backus from the Public Affairs Department
here at HHS, and welcome to our webchat on health care
and the Affordable Care Act, the new law that's designed
to put you back in control of your health care.
This week we're celebrating National Community Health
Center Week.
America's community health centers now serve over
20 million people in 7,000 communities in all 50 states.
We're also celebrating the nurses and doctors,
physician's assistants, nurse practitioners,
and health care workers who work in our community health centers.
The new Affordable Care Act contains some important
provisions that helps to increase the number of
doctors and nurses who provide care.
The law also strengthens community health centers,
which are so important as a delivery mechanism for
so many Americans.
Joining us today to talk more about community health centers
and about workforce is U.S. -- the Secretary of the
U.S. Department of Health and Human Services,
and my boss, Kathleen Sebelius; Dr. Mary Wakefield,
the administrator of the Health Resources and
Services Administration, also known as HRSA;
Dr. Luis Padilla, medical director of Upper Cardozo
Health Center, which is part of Unity Health Care;
and Dr. Andrea Anderson, who is the assistant medical director
at Upper Cardozo, a part of Unity Health Care Center.
Thank you all for joining us.
[Multiple Speakers] Thank you for having us.
[Jenny Backus] So, we have a Community Health Center Week.
Why do we celebrate community health centers,
and why are they important in the context of all the
different reforms that we've been talking about with
health reform?
[Kathleen Sebelius] Well, we talk a lot about primary care,
and what that means is health and wellness check-ups,
helping women who are pregnant deliver healthy babies,
making sure that people get preventative care on
a regular basis, get testing for issues that may come up
later in life, and what we have is 1,100 community health
centers throughout this country, almost 8,000 sites.
They can be mobile vans or in schools or clinics or in rural
and urban areas that deliver very high quality, lower-cost
preventive health care to almost 19 million Americans.
So, this is a critical piece of health care delivery.
It is about people having a doctor and a nurse and
practitioners who they can go to connected to their neighborhood.
Both the Recovery Act and the Affordable Care Act,
two pieces of legislation passed just in the last year,
have put new resources so this footprint can be expanded,
because we still have lots of areas in the country where
it's too far away to get to a doctor or a nurse.
Kids have to wait too long to get an appointment,
and we want to make sure that all Americans have access
to high-quality, lower-cost primary care.
[Jenny Backus] Mary, you run HRSA, which is in charge of
delivering care to a lot of these communities.
Can you talk a little bit about specifically how
the Recovery Act and the Affordable Care Act are
helping to improve community health centers,
and how important are community health centers in sort of HRSA's
mix of services that you offer to people?
[Mary Wakefield] I'll start with your last question.
HRSA has a number of programs that focus on delivering
services, primarily primary care services, as the secretary
indicated, to individuals across the United States,
and one of our centerpiece programs is exactly this one:
it's the community health centers program.
It provides a wonderful network of services available to
individuals and families that are in need of preventive
health services, screenings, immunizations, vaccines,
and it treats everyone from a pregnant woman
through an infant to an elderly individual.
So, it's an array of services important to communities,
and it's one of our centerpiece programs
at the Health Resources and Services Administration.
The Recovery Act was very important in terms of
strengthening this important part of our health care
delivery system in the United States.
Through the Recovery Act, the Congress and the
administration supported $2 billion being added to
providing a platform to facilitate the work of
community health centers.
Of those $2 billion, they were used to extend the reach
to patients across the country in the vicinity of well over
2.5 million new patients being seen by virtue of
that investment.
So it had a lot of repercussions for people.
Some of the folks who are watching probably participated
as a result of that investment, some of their neighbors did,
and so on.
So, in other words, $2 billion to extend the reach of
community health center, and the way that money
through the Recovery Act was used was by investing in
construction and renovation of clinics; also, by expanding
services to, for example, make available oral health,
dental services, to a community that may not have had
ready access to a dental hygienist or a dentist.
In addition, those dollars through the Recovery Act
were used to expand the availability of services.
So we picked up about 127 new sites that were able to be
established through the Recovery Act dollars,
and those Recovery Act dollars also supported somewhere in
the vicinity of about 6,600 positions, jobs,
for people working in those facilities.
So a lot of good was done with that investment.
Well, you can now turn your attention then to the
Affordable Care Act because you asked me about that, too.
What does that investment look like?
That investment is an investment that will roll out over the
course of the next five years.
We've already started to move those resources,
but they'll be available through the next five years in the
amount of about $11 billion.
Again, that will allow us to expand our reach of those
services to underserved communities,
both rural and urban, across the United States.
[Jenny Backus] I mean, those numbers sound really impressive,
but I wonder, how does that sort of translate into the work
that you guys are doing on the ground, and, Dr. Padilla,
what's it like to work in a community health center,
and how did you and Dr. Anderson get to a community
health center?
[Luis Padilla] Well, I got to a community health center through the
National Service Corps.
The National Service Corps afforded me the opportunity
to complete my medical education.
Without that program I would not have been able to pay.
My family didn't have the means to pay for medical school.
So that was the beginning.
In addition, I had an interest in primary care,
and in a particular an interest in underserved communities.
So that's how I got into working with Unity.
I was recruited by them as a scholar.
I wanted to work in this community.
I live five blocks from where I work, so I'm invested in the
community, which was something I also wanted to do.
So for me, it's a dream come true of being a
family physician in an urban setting and being
a community physician, which is what I wanted to do.
[Jenny Backus] How -- I'd like to hear your story, too, Dr. Anderson,
but also can you both talk just quickly about how
community health center and all these great resources that the
secretary and Dr. Wakefield just talked about,
what do they actually mean in somebody's day-to-day life?
[Andrea Anderson] Well, thank you for having us here, and I want to echo
what Dr. Padilla said.
I also came to the Unity Health Care through the
National Health Service Corps as well.
I was looking for a place where I could be invested both in the
community and in the health of my patients,
and the administration's commitment to our community
health centers and the funding that has been spoken about
has made it possible for us to expand our services
and will continue to make it possible to expand our services.
Our organization sees about 500 patient visits a year
for 84,000 patients.
So we're very, very busy.
We're seeing a lot of patients, a large, vast array of patients,
and these are people that need our services that look to us
as an advocate for them in their community.
I also live in the community, five blocks in the other
direction, and I also feel that not only are we committed to
the clinical and medical needs of our community,
but also for its social needs.
We're advocates in our community.
Just a few months ago we participated in a new
farmers market in our community bringing fresh fruits and
vegetables to this community that didn't have access before,
who are looking for ways to deal with their high blood pressure,
help their children lose weight, fight the pediatric obesity
problem that we've been seeing in our communities.
Not only are we making an impact in a clinical matter but also
for the vast social needs of our community,
and I think they appreciate it.
[Jenny Backus] Well, you've talked a lot about prevention, Secretary Sebelius.
It seems like a community health center is sort of key to a lot
of the different programs that we've been talking about,
prevention, health information technology, a lot of these
different programs.
How does this go in your larger strategy, I guess,
on the health reform?
[Kathleen Sebelius] Well, I think both Dr. Wakefield and I have had a chance to visit
community health centers all over this country,
and just like Dr. Anderson and Dr. Padilla explained,
these are often in the heart of neighborhoods and doing more
than a typical doctor's office.
That certainly goes on, great treatment for patients,
but the kind of relationships that are built where people
come, generations of families -- I've been there with a
grandma, a mom, the kids, everybody who is seeing
a health care provider.
Often there are counseling services or additional help;
people are connected to one another.
So a lot of what we know about good health is,
is it not only is what happens when you get a check-up,
but it's where you live, it's what you eat,
it's can you get exercise, it's what happens in school,
what's going on in the surrounding areas.
I think the more that health care is integrated into
a community setting, that the providers are really connected
to the community, the healthier, the more prosperous we're all
going to be.
And community health centers do that in a wonderful way.
[Jenny Backus] Now, we've heard about National Health Service Corps.
We know what it is.
Dr. Wakefield, I know that's another one of the things
in HRSA's portfolio.
What is the National Health Service Corps, and how does
it relate to this community model that the secretary's
been talking about?
[Mary Wakefield] The National Health Service Corps -- excuse me -- is a
really important program that makes health care providers,
primary care providers specifically, available
to underserved communities, again, both rural and urban.
National Health Service Corps providers have,
in exchange for service -- two years, three years,
up to five years of service, in exchange for service,
can have their loans repaid, for example,
from their medical school or dental school, nursing school,
and so on.
So it's a very important program that allows us to place
health care providers, primary care specifically,
in communities that need them the most and at the same time
provide an incentive to those individual clinicians who are
recipients of either scholarships or loans
through the program.
We, through the Recovery Act, doubled the number of
National Health Service Corps providers that were available,
and looking forward, through the Affordable Care Act,
fortunately we're going to be able to markedly expand those
numbers again.
So, for all the next generation of health care providers that
want to go to medical school or want to serve in underserved
communities, here's a vehicle now that will provide them
both with loan repayment as well as a place to serve,
two reasons why I think most people feel really good about
the National Health Service Corps.
[Jenny Backus] I'm going to ask you guys a couple of questions that
we've actually gotten from viewers that may seem simple
but it would be important because you're actually
on the ground.
"What do I do if I don't have health insurance?
Will a community health center see me?"
[Luis Padilla] Yes.
Community health centers -- federally qualified community
health centers see patients regardless of ability to pay,
so they will see you.
It's actually a program that allows discounted care.
So patients can certainly come in, and we have patients that
come in to Unity -- close to 20 percent of our patients
have no insurance, no coverage, and we see them.
[Jenny Backus] Now, they've also asked, "If I'm on Medicaid,
can I get treated?"
[Luis Padilla] Of course, yes.
[Jenny Backus] So, you guys work to help that out?
[Luis Padilla] Right, and most community health centers accept an array
of insurance plans, so we accept private insurance as well.
We encourage anyone from the community to use our services.
[Andrea Anderson] We're committed to providing quality care for anyone
who walks through the door, so we see underserved,
Medicaid, Medicare, private insurance,
and patients who have no coverage.
[Jenny Backus] Can you talk a little more about -- I know you guys
run some great programs at Unity.
In fact, I think the first lady has visited Upper Cardozo.
Can you talk a little bit about some of the other programs that
you work and how do they help you stay healthier down the
road, prevention, fitness, some of the stuff you
just mentioned?
[Andrea Anderson] Well, one program that is near and dear to my heart
is a program called the Reach Out and Read Program,
which is a program that encourages early-childhood
literacy among low-income children and families.
Now, someone may say literacy, health care,
how do they match up?
But we know that close to 90 million Americans suffer
from low health literacy where they're not able to read their
medications, they're not able to read a food label,
not able to figure out their insurance coverage,
and that leads to health disparities and poor health
outcomes, and we see that these things start in childhood.
Children who are not read to on a daily basis,
and over 50 percent of children in this country are not read to
on a daily basis, they start school two years behind their
5-year-old counterparts who have had books in the home.
So at our clinic, at each well-child visit,
starting at six months old we give families books that
are age appropriate for their children and we talk to them
about why it's important to read every day:
What kind of goals do you have for your child?
Do you want your child to attend college?
Well, this is how you're going to be able to get them
to that point.
The families are really excited about it.
They take it on and they're happy, and even I had a
wonderful experience.
One of my 9-year-old patients who went through the program,
she came back to me and wrote me a letter in her little
9-year-old print with stars and rainbows on it about how much
she loved reading, how I helped her with reading,
and how she wanted to be a doctor so she could help
children to read and to help them be smart.
I was excited to see that she connected what I did
with what she was going to do in the future.
So that's one program that we're really working very hard on in
our clinic.
[Jenny Backus] We're running low on time, so I just want to hit
Dr. Padilla and then final thoughts from the secretary
and Dr. Wakefield.
Anything else special about community health centers or
the National Health Service Corps that you want people
to know about?
[Luis Padilla] Well, I just want people to know that they get
exceptional care at community health centers;
it's quality care.
I always cringe when I hear people say,
"Well, that's for people who don't have insurance
or low income," but we have Harvard graduates,
Stanford graduates, Yale graduates, UCLA, Brown, --
[Female Speaker] Me, too.
[Luis Padilla] -- so this is top-notch quality care that you're receiving,
and I really encourage community members to seek them out.
The Recovery Act has afforded Unity Health Care the
opportunity to expand its services, and with the money
that we have received we'll be able to provide services for
an additional 10,000 to 15,000 new patients in the District.
So, it's amazing what the money has done and will do,
what the workforce issues will be addressed with the
National Service Corps expansion.
We need more primary care providers.
I encourage medical students out there to really seek
primary care as a specialty and, in particular, underserved care
as a career.
[Jenny Backus] Dr. Wakefield?
[Mary Wakefield] I would just say that I think that the National Health Service
Corps and the community health centers program are two of our
best bridges between the federal government and communities
across the country, because this is where resources go to support
this type of health care provider,
individuals who are very committed to their communities
and to very high quality care, and you know what?
The data actually underscores exactly the points that
they've made, that the care is high quality,
very cost effective, and it really is a health home
in the best sense of those words.
[Jenny Backus] Secretary, we've talked about some of the investments
in community health centers.
I know you've actually -- last week and will probably in the
future, make some announcements about the workforce, too.
I'd like to get your closing thoughts, but if you could
touch on that, too, because I know there's a lot of folks
that are interested in the new resources that are coming
to support providers.
[Kathleen Sebelius] Well, when we leave here in a few minutes,
Dr. Wakefield and I are going to go talk to some of the
new National Health Service Corps members.
I think about 600 are in town today, and we want to welcome
them, but also announce a new grant opportunity for
nurses and nurse educators.
We need more primary health care providers of all kinds,
and nurses are on the front lines of a lot of health care
delivery, so this is kind of a piece of the puzzle.
I know a lot of folks worry about are there going to be
enough doctors, are there going to be enough nurses,
what are we going to do about the future.
These two investments, not only in clinics, in mobile units,
in expanding the places where primary care providers can
deliver great, quality care, but also in making sure that
we double the number.
I think over the course of these two investments,
they'll be about 16,000 additional primary care
providers and mental health techs, nurses, doctors,
nurse practitioners who will be able to actually meet the needs
of a lot of Americans who want a health home, who want a doctor,
who would much rather see somebody early on and get
preventive care than end up in a chronic condition
in a hospital.
[Jenny Backus] Well, I think this is a topic we could probably spend about
four shows on, but I want to thank you all for coming.
One thing I want to tell you all watching at home,
HRSA's website -- and you can also get there through, find a health center at
So go to or through,
and we can help you find a community health center
in your community.
I want to thank our guests, Secretary Sebelius,
Dr. Wakefield from HRSA, Dr. Luis Padilla,
and Dr. Andrea Anderson both from the Upper Cardozo
Unity Health Care System.
Thank you, guys, all for coming.
And, please, folks watching at home, the greatest thing about
the Internet is that you can watch it and we'll archive
the show, so you can send it around and you can watch it
anytime you want, and you can get your friends to watch
it, too.
So we hope you pass this information along today.
If you're interested in a career in health care,
check out HRSA's website.
Don't miss the National Health Service Corps,
and visit your local community health center.
Thanks for joining me, and we'll see you next time.
I'm Jenny Backus.
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