Increasing Exposure to Community Health Centers

1. Increasing Exposure to Community Health Centers Zachary Ginsberg Public Health Justice American Medical Student Association November 11, 2006

2. Community Health Centers • aka Federally Qualified Health Centers • Emphasis on prevention and community wide health care delivery • Community responsive & accountable • Located in areas where care is needed but scarce • Governed by community boards

3. CHC: Service Provided • High quality • Affordable preventive services • Primary care • medical • dental • mental health • Continuity of care • Tailored to fit the special needs and priorities of their communities

4. CHC: who do they serve? • 15 million people nationally • Chronically ill • Vulnerable populations • Migrant populations • Uninsured • Homeless • Others in need • Role of CHCs on the rise as people have difficulty gaining access to medical care

5. CHC: How do they compare? • Meet or exceed nationally accepted practice standards for treatment of chronic conditions. • Improved health outcomes for their patients • Lowered the cost of treating patients with chronic disease

6. A few facts about the Status Quo • 46 million people are uninsured • Another 45 million people are underinsured • Chronic diseases account for one-third of the years of potential life lost before age 65.  • The direct and indirect costs of diabetes are nearly $132 billion a year.  • The estimated direct and indirect costs associated with smoking exceed $75 billion annually.  • In 2001, approximately $300 billion was spent on all cardiovascular diseases. Over $129 in lost productivity was due to cardiovascular disease.  • Nearly $68 billion is spent on dental services each year.

7. Who has carries the greatest burden of disease?

8. So we’re all equal, right? Wrong!

9. CHC: Quality of Care CHCs are best equipped to handle: Chronic disease $1.4 trillion annually are spent on health care in the United States. $3 out of every $4 in U.S. healthcare expenditures are due to chronic disease care 90 million people suffer from chronic disease in the U.S. The Uninsured 47 million uninsured 45 million underinsured Underserved and diverse populations

10. CHC: who uses them? The current public health infrastructure lacks the support to expand the program services in highest demand with the greatest cost inflicted upon our most vulnerable communities

11. CHC: Where do CHCs fit?

12. CHC: Challenges in the Status Quo • Current health care infrastructure is based on historical circumstance and antiquated laws rather than on efficiency or effectiveness criteria • CHCs are a new model but face the following challenges: • Chronically ill • Funding cuts • Workforce Shortage

13. CHC: Cost of Care • Community Health Centers provide an affordable model for delivery of health care services to otherwise underserved communities • CHC: $1.30/day/patient • ED: $126/visit • Private Physician: $250 • Bamezai, Melnick & Nawathe. Costs of Emergency Department Visits. Annals of Emergency Medicine. Vol 45(5). May 2005.

14. CHC: Funding • Funding • We must leverage the potential savings from: • Preventing acute exacerbations of chronic disease • Reduce nonemergent visits to EDs • Title VII • Recent cuts in state funding are the largest cuts in 60 years • Allocation of resources to local agencies remains a low priority for policy makers • The cost of excluding the few may make our system unaffordable for everyone tomorrow

15. CHC: Workforce

16. CHC: Workforce • Students rotating through Community Health Clinics are more likely to pursue primary care and work for the underserved • Establish a set of standards for public health workers

17. What’s being done? • Nationally: Health Disparities Collaborative • Goal: Change the way primary care is provided • CHC are learning a systematic approach to quality improvement • provide a framework for delivery of care to those with chronic illnesses • Deliver cost-effective and high-quality health care to underinsured and uninsured • Prepare medical teams • 600 Health Centers nationwide are participating

18. What’s being done? • AMSA • USPHMCA • Widening the pipeline • Student Debt Relief • Student Run Clinics • Health Disparities & Social Justice Campaign • Equity Pledge

19. Take Action • Call your Senator & Representative and tell them you want them to increase Title VII funding to expand Community Health Centers nationally to cover 45 million people suffering without medical care!!