(Feb 19, 2018) Catherine Read talks with Dr. Basim Khan, Executive Director of Neighborhood Health, a Federally Qualified Health Center (FQHC) located in Northern Virginia. Neighborhood Health was started in an apartment complex by nurses from the Alexandria Health Department back in 1997, becoming an FQHC in 2004. In their first year as a clinic, they saw 1,500 patients and in their 20th year they saw 18,000 patients through their 12 clinics located in Alexandria, Arlington and Fairfax County.
Neighborhood Health provides an integrated medical home to community residents regardless of their ability to pay. Their goal is high quality healthcare that is affordable and accessible to everyone in the community. Their clinics provide Family Practice/Internal Medicine, Pediatrics, Women’s Health, Behavioral Health Counseling and include health screenings, cancer screenings, on-site lab services, immunizations, mental health screenings, dental services and a pharmacy program. They provide language interpreters (sometimes via phone), offer sliding scales to patients who may have high deductibles for their health insurance plan, and provide medications to patients less expensively than through retail pharmacies. Community health centers provide primary healthcare to over 300,000 people in Virginia and to 27 million patients in the U.S. Providing high quality primary care delivers better health outcomes for patients and helps to drive down overall costs.
Dr. Kahn talks about how Neighborhood Health strives to serve as a patient advocate in a really “complicated health system.” In talking about issues of equity and social determinants of health, he points out that our healthcare and social services spending in this country is comparable to other developed nations, but we spend far more on healthcare and far less on social safety net services. Social determinants of health include factors such as education levels, income, the zip codes we live in, the type of housing and employment we have, and our access to adequate healthy food. Working to provide better equity in healthcare outcomes includes Neighborhood Health’s strong partnerships with other local agencies, non-profits and service providers. They work closely with local Community Services Boards to help patients get mental health services and case management when needed. They work with Departments of Health and Human Services that also provide employment assistance, and help with issues of aging and disability. This is the “community” in community health services that treat the whole patient through providing social services that impact health outcomes.
Neighborhood Health continues to expand their services, meeting patients where they are in the community. They currently work with Alexandria City Schools to provide dental care to low income students in 8 elementary school through a mobile bus that provides the services right on school grounds. That includes routine cleanings, x-rays, and fillings as needed. Catherine Read pointed out that this is an example of the type of partnership that is at the core of the Community School model – a model of education we don’t currently have in Virginia. Providing needed services to students through the school impacts educational and health outcomes for many students who lack access to things as basic as food, clothing, dental and healthcare, school supplies and tutoring.
Dr. Khan addresses public health issues such as the opioid crisis and how the trend of medicalizing so many issues has resulted in the over prescribing of pain medications. The epidemic of chronic diseases such as hypertension, diabetes and cancer are tied to social determinants, yet we seem to lack the political will to prioritize key things that need to be addressed, such as affordable housing, which impact health.
In the last segment, Medicaid Expansion in Virginia is addressed and what the impact would be on the patients Neighborhood Health serves. The most immediate impact would be the ability to refer patients to local specialists instead of having the University of Virginia as the only option. There are substantive discussions taking place during the 2018 Legislative Session in Richmond that have both parties negotiating terms that now include a “work requirement” proffered by the Trump Administration as an option states can elect to mandate. At the time of broadcast, Medicaid Expansion was still very much up in the air with the future outcome very uncertain.