CHCs show how to provide holistic care to patients
Earlier this year, a national study of physicians found that doctors believe their patients’ unmet social needs lead directly to worse health and that they wished the healthcare system would pay to connect patients with the services they need.
An Institute for Alternative Futures (IAF) study released in March suggests that community health centers (CHCs) are uniquely positioned to meet their patients’ social needs as well as their clinical ones and can offer a model to others seeking to provide more holistic care to their patients.
“There are a lot of features about community health centers that make us logical places to be able to work on social determinants of health,” said Ellyn McKenzie, vice president, communications, at Sixteenth Street Community Health Center in Milwaukee.
“Because of our geographic location and our links to the community, we have a real natural tendency to do services that relate to the living conditions, the socioeconomic status of our patients.”
Those services include early childhood development and school readiness programs, childcare and preschool programs, after-school, youth leadership and mentoring programs, operating community resource centers and offering parenting, nutrition and adult education classes.
CHCs may be well positioned to work on social determinants of health (SDH) but financing SDH programs is an ongoing challenge.
“Because we see SDH initiatives as core programming in pursuit of our mission, we try not to view them as ‘extra’ services,” said Lander Cooney, CEO of Community Health Partners, a nonprofit community health clinic network in Montana. “However, when it comes to funding, we do need to think that way because of various requirements placed on our federal 300 grant and other funding sources.”
Most CHCs use grants to fund their SDH programs said Yasemin Arikan, a research assistant with IAF and co-author of the IAF’s “Community Health Centers Leveraging the Social Determinants of Health” study released in March. However, CHCs also get creative to fund their programs.
Some, like Community Health Partners, dedicate part (even if it’s miniscule) of their operating budgets to SDH programs, said Arikan, but more often they turn to income generating activities, like renting out meeting spaces or providing consulting services, offering patients sliding scale fees and creating fundraising events.
“It’s a constant challenge to keep bringing program funds to support our patient education and medical support services,” said McKenzie. “How do we do it? We work hard at it.”
At Sixteenth Street, McKenzie said, the CHC employs a full-time grant writer to work mostly on government grants and a development director to work on private funding sources. The center also holds an annual fundraising event that brings in money but also raises the center’s visibility in the community.
“You end up making some pretty nuanced decisions about how you want to use your dollars and marry up grant sources to accomplish what your priorities are,” she said.
Not all SDH programs require significant funding, points out Arikan. CHCs offer programs such as providing access to donated clothing and food, job shadow opportunities and free legal advice through partnerships with other organizations.
Healthcare organizations looking to CHCs to find SDH models have to understand and take to heart one core thing about CHCs: their knowledge of their communities is key to their successes, Arikan said. “These organizations maintain a very close relationship with their communities, and continuously work on getting to know them even better,” she said.