Vermont health centers can lead the way

By:  Nancy Remsen
Burlington Free Press

Sen. Bernie Sanders told representatives of community health centers gathered in the conference room of his Burlington office Monday that they could have a “profound impact” on health care, not only in Vermont, but the nation.

“You could be a model for America,” he told the group, who represented eight federally qualified health centers operating at 41 locations across the state. The primary care offered at these centers saves lives and money, Sanders said. “If we can document it is saving money for the system that would be huge.”

Vermont’s eight centers serve 108,000 Vermonters with primary, dental and mental health care — the highest penetration per capita in the country, Sanders said.

Under the new national health reform act, federally qualified health centers will benefit from an injection of $12.5 billion over the next five years to help expand the access they offer to basic medical care from 20 million Americans to 40 million. There also is $1.5 billion in new funding for the National Health Service Corps which gives doctors, nurses and other health care professionals help in paying off school debts in exchange for working in medically underserved areas — the same spots where federal qualified health centers set up.

Vermont should take advantage of the opportunity to expand the community health center network to all counties and broaden the scope of services offered, Sanders said. “We are now looking at nothing less than a revolution in primary health care which will be an important factor in transforming our entire health care system,” Sanders said. “That, my friends, is what we are talking about.”

During a two-hour brainstorming session, representatives of current and potentially future health centers discussed service gaps they’d like to fill, the need to educate the public about what they offer, opportunities to do more preventive medicine and strategies to encourage more doctors in training to choose primary care.

Dr. John Matthew of The Health Center in Plainfield spoke of the need for more dental care that his center has addressed locally and now regionally. The center will soon have capacity to see 14 dental patients at a time and carry out some oral surgery procedures, too.

The new funding might allow the Plainfield-based center to improve the dental services it offers via a van featuring two fully equipped dental stations that travels to Alburgh, Eden, Cambridge and Bradford. Matthew said his center has plans for an adjacent building where the van could be cleaned and restocked. The design would allow the building to be used for public fitness classes when the van was on the road.

Andy Majka represented Springfield Medical Care Systems, a 1-year-old federally qualified health center. “We are finding a lot of people don’t know about our services.”

“Outreach takes a lot of work,” Sanders said. As a politician, he said, “You learn that you think people know something, but they really don’t.” Sanders urged the group to think about how to let more Vermonters know what the centers offer. “You guys have a very good product to sell. Some people have the misconception that the centers are ‘poor people’s clinics,’” Sanders said. “They serve everybody who walks in the door. They are for the middle class.”

The group talked about how they could focus on prevention — especially as school districts and state government shrink budgets affecting health care. “Include school nurses in your meetings,” suggested Gail Auclair of Little Rivers Health Care with three locations in Orange County.

Matthew agreed. Kids are often the window into families in need, he said.

Sanders noted that the federal health reform law would not only fund expansion, but also provide dollars to help recruit the primary care staff critical to the centers.

Matthew said health centers have a role in showing prospective students how rewarding primary care can be. He praised the University of Vermont program that places first- and third-year medical students at centers such as his for short visits.

David Reynolds, health policy adviser to Sanders, spent 30 years operating Northern Counties Health Care in Essex and Caledonia counties, the first federal qualified health center network in the state. He summed up the change in fortune for health centers.

“This is an incredible opportunity I never thought I’d see,” Reynolds said. “The program is now perpetually authorized. With the spotlight comes the searchlight. We have to make sure we do this well.”