A Neighborhood Model for Smarter Care

Community health centers have been remarkably successful in bringing vital and too often missing health-care services to low-income communities and communities of color. More than 1,200 of these centers provide primary care services to 18 million Americans - or about one in every 17 people. Seven out of 10 patients are below the poverty level.

These centers -- which get most of their funding from Medicaid and some from Medicare -- tackle some of the most vexing health challenges in America, and have been stunningly successful. In communities served by these centers, health disparities have shrunk or even disappeared.

In my hometown of Oakland, Calif., for instance, La Clinica de La Raza has served as a crucial community anchor, providing check-ups, vaccinations and a welcoming embrace for thousands of low-income families for nearly 40 years. Just last year, the clinic's 26 sites throughout Alameda County provided services to more than 50,000 patients who otherwise would have been stranded.

The ability of places like Clinica de La Raza to respond in an integrated, cross-disciplinary fashion makes them an invaluable asset in communities often hit hardest by disease and chronic illness.

One of the most important parts of these centers -- aside from their accessibility -- is their "cultural competency." That means they have doctors and nurses who actually understand the language, beliefs, practices and cultures of their patients in a deep and meaningful way. That same empathetic lesson is also being taken out of the clinics and onto the streets by "community health advisers," who serve as culturally competent liaisons connecting residents to the centers and making sure they are getting adequate care.

However, because these centers serve the "medically disenfranchised," they are heavily reliant on federal funding, from either Medicare and (especially) Medicaid. As the budget for Medicaid is increasingly threatened, centers like these are at risk of losing the community connection that made them so successful to begin with -- and sending more people to costly trips to ERs and hospitals for primary and preventative care.

It would be nothing short of tragic to see this promising and proven model flounder or even crumble for lack of funding.

By Angela Glover Blackwell  |  June 30, 2009; 10:30 AM ET  | Category:  Health Care Reform Save & Share:                 
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