Removing barriers to quality health care
By Fred Allebach
My primary health provider could make much more money in private practice, but has made a principled choice to work at the Sonoma Valley Community Health Center. It’s safe to say that at a non-profit, community health clinic that many are serving the public out of principled ideals. My provider told me, “I love what I do”, and “I want to see the Clinic get an opportunity to shine.”
The Sonoma Valley Community Health Center is the only one of its kind in Sonoma Valley. It meets the federal government’s definition as a community-based and patient-directed organization that serves a population with limited access to health care. The mandate: provide comprehensive, culturally competent, quality primary health care to medically underserved communities and vulnerable populations.
Community health care centers are located to serve underserved, high-need communities and have a board of directors composed of a majority of actual clients, precisely to reflect the particular needs of the community.
These type of clinics are not “free;” they offer sliding scale payment, require proof of income or a tax return and accept all insurance including what other providers won’t because of low reimbursement rates, for example MediCal and Partnership.
Explains CEO Cheryl Johnson, “The difference between a clinic and a private doctor’s office is that we are required to offer other services to remove barriers from care and to further assist patients maintain their health.”
The Clinic serves everyone, but primarily focuses on underrepresented populations – the uninsured and underinsured. Of the Clinic patients, 84 percent of are at or below 200 percent of the federal poverty level; 43 percent have MediCal; 8 percent Medicare; 10 percent have private insurance; and 33 percent are uninsured.
The low-ability-to-pay of the Clinic patient population is characteristic of a serious need for health care and dental services among the underserved in Sonoma County. The Clinic served 6,114 patients in 2014, totaling over 26,000 visits. Those numbers are expected to increase in 2015, the Clinic’s first full year in its expanded and upgraded facility at 19270 Sonoma Highway.
Preventative measures at the clinic include programs for Women, Infants and Children (WIC), wellness education and outreach, childhood immunization, transportation services and access to health insurance offered through the Affordable Healthcare Act. Americorps national service workers help at the Clinic in outreach and other educational efforts. The diabetic education program, in conjunction with Redwood Empire Food Bank, specifically tailors delivered food to the needs of certain patients.
The Clinic collaborates with La Luz, the Vintage House, Redwood Empire Food Bank, Bay Area Legal Aid, and also FISH (Friends In Sonoma Helping) which helps supply gift bags to pregnant patients. The Clinic is looking forward to increased collaboration with other organizations.
Health has many determinants that stem from aspects of our underlying social fabric. Social isolation, for example, can lead to depression. Depression can lead to medical needs and other corollary costs. The Clinic is developing specifically targeted classes to address these issues.
The Clinic is a grant-supported Federally Qualified Health Center and meets particular criteria under the Medicare and Medicaid programs. Nearly 70 percent of Clinic revenue comes from seeing patients, 14 percent comes from a federal grant and the rest from private foundations and donations.
Johnson says of donors: “Members of the donor community has been incredibly supportive of the health center,” Johnson says. “Without their support, our current facility would not have been possible. Now the key is to expand and maximize our services to honor that support.”
Some of that expansion will require upfront support, she said, until those efforts are ramped up and become self-supporting.
‘Health’ has a parallel to ‘sustainability’ in that the same types of models and concepts employed to measure groundwater or CO2 emissions fit the health field as well. One could say health equals sustainability. Health is a value that demonstrates our care for ourselves and others. By taking preventative, proactive actions, we avoid serious long-term costs. These costs to society typically do not include the unseen or hidden repercussions of an actual transaction. By being aware of these future costs and by being healthy, or sustainable, we conserve and value life and the environment.
As a long-term patient at the Sonoma Valley Health Center, I’ve found the staff to be friendly, capable and professional. I feel well cared for, as do my friends and associates. In the waiting room I have observed relaxed patients, kids and spouses.
My current primary and behavioral providers are excellent people who meet all the criteria I personally value in health care settings: being present, genuinely caring, and very well prepared. The front desk process and nurses are also great. I couldn’t be happier with my level of service and good bedside manner all the way around.
Overall the Clinic has a great atmosphere. This leads to the crux of what the Clinic does for our community: provides a full slate of primary, dental and behavioral care. If these services were not available locally, many people would not have access, period.
