Metro

Community health center expansion brings savings, challenges

R.I. centers provided $184 million in savings in 2013 through cost avoidance, primary care integration

By
Senior Staff Writer
Tuesday, October 21, 2014

Jane Hayward, president and CEO of the Rhode Island Health Center Association speaks about the importance of community health centers in Rhode Island in a lecture Monday.

The Alpert Medical School hosted a lecture Monday on Rhode Island’s community health centers presented by David Bourassa, chief medical officer of Thundermist Health Center, and Jane Hayward, president and chief executive officer of the Rhode Island Health Center Association.

The lecture opened with a video of Jack Geiger, “the founding father of the community health center movement in the United States,” who also spoke at the Med School last year, Bourassa said.

“Every time I see him, I get excited,” Hayward said. “He is a tremendously inspirational man.”

Community health centers provide low-income areas with a variety of medical specialties as well as social work services, food pantries and educational programs, Hayward said.

“We always think about community health centers as a project of Lyndon Johnson’s war on poverty,” but the concept actually originated in South Africa in the 1940s, she said.

“In 1948, this experiment of community health centers came to a screeching halt because of the passage of apartheid laws in South Africa.”

Geiger brought the concept of community health centers back to the United States after his work in South Africa, and the idea spread through “tremendous bipartisan support,” she said.

But the funding that was allocated for community health center expansion in the Affordable Care Act was largely removed by Republican legislators, Hayward said, adding that “there have been some dollars put on the table recently to help community health centers” despite the cuts.

More so than in other states, these centers have a big impact on primary care in Rhode Island, Hayward said. All the federally qualified health centers in the state offer dental care. “We really provide the backbone of dental care in the state for people who don’t have dental insurance,” she added.

Rhode Island’s community health centers are also equipped to manage electronic health records, which allows other providers to view patients’ medical history. Additionally, the state has no municipal- or county-level health departments, so the department of health has no “boots on the ground,” she said.

The R.I. Department of Health must fund health care reform ventures because it has no clinical capacity itself, she added.

“We’re not small change in this business anymore,” Hayward said, pointing to the $184 million in savings that community health centers provided in 2013.

“People think that NGOs don’t pay taxes. But our employees pay taxes. There are lots of other ways that tax revenue is generated,” she said.

But acquiring funding from the state government continues to be a challenge, Hayward said. While community health centers focus on decreasing long-run costs through efforts to reduce the risk of chronic diseases, she said, policymakers focus on a one-year budget.

The lecture was presented in association with BIOL 6504: “Health Care in America,” a pre-clinical elective that serves as “an enrichment to the curriculum that we have in medical school,” said Sanchita Singal ’13 MD’17, one of the student leaders of the course. Singal leads the course with Sachin Santhakumar MD’17, Allan Joseph MD’17 and Ali Rae MD’17, and the course is advised by Eli Adashi, former dean of medicine and biological sciences and professor of obstetrics and gynecology, Arthur Frazzano, associate professor of family medicine, and Michael Lee, assistant professor of emergency medicine.

“We invite speakers from all over different parts of the nation to come and talk about important topics in health policy,” Singal said, adding that these issues “are really important for future physicians to know about as they venture into the world of health care.”