When we think about the growing demands health reform will place on community health centers (assuming that we are thinking about community health centers at all – and we should be) we tend to think about the shortage of primary care doctors in underserved communities, and the increasing numbers of soon-to-be-insured patients needing such care.
According to the National Association of Community Health Centers, about 20 million patients get their primary health care needs at more than 8,000 U.S. locations. I’ve seen various projections of how that will grow under health reform (depending on fun ding and other factors) but the NACHC says it could double, to 40 million, within another five years.
There’s another aspect to the community health center workforce – one that, frankly, I had never thought about until I got a release about a set of grants a few weeks ago from a small foundation that focuses on community health. The clinics don’t just need doctors and nurses. They need people who can just run the places – who can make appointments and keep records, and do the coding and billing, and handle the health IT, and do health outreach in the community, and the case management. And they need people who speak a bunch of languages and be culturally sensitive. In other words, they need all kinds of people who can do the work necessary for these clinics to become effective “medical homes.”
So the RCHN Community Health Foundation recently announced grants of about $150,000 to $200,000 each to five very different community health groups, in five quite different settings. (On the foundation’s home page you can find links to some of the coverage it has gotten.)
- Aaron E. Henry Community Health Services Center, Clarksdale, Miss.
- Charles B. Wang Community Health Center, New York
- Penobscot Community Health Care, Bangor, Maine
- Seattle Indian Health Board, Seattle
- Wai’anae Coast Comprehensive Health Center, Wai’anae, Hawaii
The details vary, but they are developing training programs (which can be done during the work day), partnerships with local schools, community and four-year colleges, internships, outreach to potential entry-level workers who hadn’t thought of this career path, worker retention programs – with an eye both toward their own needs, their workers’ future advancement, and job creation in their communities, including veterans. In some cases, they will be designing their resources and programs with a clear eye toward having them spread, to be available and useful to other clinics, other communities.
- How are clinics in your areas preparing – not just expanding physically (there was a lot of money in the 2009 stimulus package for that), but how are they expanding in other, qualitative dimensions?
- Have they begun the transition to medical homes?
- Have they installed electronic medical records? (They are doing so at a faster pace than many more resource-rich practices.)
- Who is working for them?
- How are they being trained – and retained – for the coming changes in the delivery and financing of health care?
You – and your reader, listeners, and viewers – may be quite surprised by some of the innovative, change-embracing answers.