Community health centers in New Hampshire and across the nation are at tremendous risk. Without Congress’s action by Sept. 30, health center funding will immediately be cut by 70 percent.
The National Health Service Corps (NHSC) funding, which goes hand-in-hand with the health center funding by supporting providers dedicated to working in underserved areas, will be eliminated. Nationally, the Department of Health and Human Services estimates that this “funding cliff” could lead to about 3,000 health center sites closing their doors, 50,000 Americans losing their jobs, and 9 million losing their health care.
In New Hampshire, 12 federally funded health centers provide primary care, substance use disorder treatment, oral health services, and behavioral health services to over 89,000 citizens in underserved areas. Granite Staters will lose access to health care services when we need them the most, in the midst of an opioid epidemic, if the funding cliff isn’t fixed.
Community health centers save the American health care system billions of dollars every year ($1,263 per patient per year) by keeping people healthy and out of hospital emergency departments. Research has found that a substantial proportion of ER visits are either non-urgent or could have been avoided through timely primary care. Health centers play a vital role in reducing these avoidable ER visits by providing accessible, continuous and comprehensive primary care, especially to those at risk of using the ER for avoidable or preventable care.
Health center funding is specifically designed to provide access to care for patients in communities where doctors and services are scarce or non-existent. A 70 percent reduction in the funding of New Hampshire’s health centers means an estimated loss of nearly $16 million, with almost half of health center patients in New Hampshire losing access to health care.
Health center leadership in New Hampshire described a loss this big as “devastating,” as they would have to close sites, change their sliding fee discount programs, and eliminate services including dental and substance use disorder treatment.
For example, one CEO whose health center is located in an urban section of New Hampshire devastated by the opioid crisis, would have to terminate all services outside of primary care – leaving 2,200 patients who receive their dental, pharmacy, behavioral health, and substance use disorder care at this center with no place to turn.
The “funding cliff” also encompasses elimination of the NHSC funding, which allows primary care medical, dental and behavioral health clinicians to repay their health student loans in exchange for a two-year commitment to work at an approved NHSC site in a high-need, under-served area.
Over 55 percent of NHSC loan repayment awards are made to providers working in community health centers. NHSC funding is a critical resource for health centers in recruiting competent clinicians and attracting them to New Hampshire because it is more difficult to recruit clinicians in the rural and underserved areas of our state.
Our state is already experiencing a primary care workforce shortage with 132 reported health center and safety net provider vacancies. Any lapse in NHSC funding will be catastrophic for clinical field strength in New Hampshire.
I urge you to support the continuation of health center and NHSC funding so that health centers can continue to serve New Hampshire communities and patients. Please call your members of Congress (dial 1-866-456-3949) to ask them to fix the “funding cliff.” The health of the Granite State depends on it.
Tess Stack Kuenning is president and CEO of Bi-State Primary Care Association.
SOMERSWORTH — Although the merger between Goodwin Community Health and Families First Health and Support Center has been in the works for three years, the collaboration between the two organizations goes back a lot further.
The two public health centers plan to merge by year’s end and held two public forums recently. At the Dover forum, David Staples, chairman of the board of Goodwin Community Health, talked about how the merger idea came up three years ago.
“One thing led to another,” he said. “We started having monthly meetings and said let’s do this.”
Once the merger is complete, Goodwin CEO Janet Laatsch will lead the merged organization as CEO. Laatsch, who has expertise in finance and nursing, has served as CEO since 2005. Helen Taft, Families First’s executive director since 1989, will retire once the transition is complete.
Taft said there’s already been a lot of cooperation and collaboration between the organizations.
According to a statement, Goodwin and Families First share similar heritages and values and nearly identical missions. They also share a 30-year history of collaborating on best practices, staffing solutions and population health programs, like mobile health care, to meet the needs of their adjoining service areas in southeastern New Hampshire and southern Maine.
Taft said Families First has two mobile medical vans that have traveled to Strafford County for many years.
“We really started to look at this five years ago,” Taft said. “We share a lot of the same patients who often move back and forth because of the cost of housing.”
Taft said there’s been a lot of talk on regionalization and mergers in health care.
“We are two of the most integrated health care centers in the state,” she said. “We can share experiences. We’ve both done a lot with the substance misuse and medically assisted treatment and the intensive outpatient program.”
Taft said there is a lot of synergy. Families First offers parenting programs that are needed in Strafford County.
“The economies of scale and consolidating administration will help,” she said. “Bigger can be better when it comes to access to capital and grants.”
Taft said the merged organizations will help with staff retention and give both units more bench depth.
Laatsch said both organizations have resources the other doesn’t. She called the merger a tremendous evolution for both organizations that will ultimately benefit patients by broadening community health care and sharing best practices.
“Throughout the process of becoming a single organization, our focus will be on continued patient-centered care to every single Families First and Goodwin Community Health patient,” she said.
State Sen. David Watters, D-Dover, attended the Dover forum and said the merger is terrific for these two organizations.
“They’re so well-known there’s a real synergy here to create a regional organization to improve health care outcomes while still respecting the missions of the two organizations,” Watters said. “We’re at a very exciting moment in health care.”
Jeffrey Hughes, vice president and chief strategy officer at Wentworth-Douglass Hospital, said they support the merger.
“In my 30 years in health care, I believe this to be one of the most challenging periods we have ever seen,” Hughes said. “This merger will help prepare and also allow for sharing of the best ideas.”
Staples said they are doing the right thing, at the right time, for all the right reasons.
“We have done the due diligence and a lot of work over the past three years and there’s a lot of work ahead for all of us,” Staples said.
The merged organization will include Families First facilities in Portsmouth and Seabrook, Goodwin Community Health in Somersworth, and mobile health clinics in five Seacoast towns. For more information, visit GoodwinCH.org and FamiliesFirstSeacoast.org.
In an uncertain health care environment, Janet Laatsch, CEO of Goodwin Community Health – the Somersworth-based community health center that provides primary health care and more for thousands of patient and clients in Strafford and Carroll counties and parts of southern Maine – tries to assess how the repealing, replacing or dramatically scaling back the Affordable Care Act will affect organizations like hers.
Goodwin has community roots stretching back to 1969, when founder Avis Goodwin started the first prenatal clinic in the country. Earlier this year, Goodwin announced a merger with Families First Health & Support Center of Portsmouth to combine the strengths of each organization and to position the organizations for stronger negotiating and price bargaining positions.
The merger is expected to be completed in the fall and will serve an estimated 17,000 clients at Families First facilities in Portsmouth and Seabrook, Goodwin Community Health in Somersworth and mobile health clinics in five Seacoast towns.
Laatsch, who has a background in nursing and finance (she has an MBA from the University of New Hampshire), joined Goodwin in 2001 and will lead the merged entity, which will retain locations and names.
Q. Why the merger with Families First?
A. It makes good sense, and with all that’s happening in the health care industry, the timing could not be more perfect to regionalize health care delivery services.
What makes community health centers unique is that our staff and board members live in and know the communities they serve. We’ve already had a long history of collaborating on best practices. We are both strong organizations in excellent financial shape with legacies of patient-centered care and cutting-edge work.
They do a lot more than we do on the development side, and they have used mobile vans for health and dental care, which we plan to use in our area. We have a pharmacy and they don’t, so we will be able to extend those privileges to their patients. We want some of our model and we want some of theirs.
Helen Taft (Families First CEO) and I knew this was a great merging of synergies that would benefit the region and allows to negotiate better deals as a larger organization.
Q. How did the merger process unfold?
A. Beginning in 2013, the boards of Goodwin and Families First began having proactive discussions about a merger that would leverage the strengths of both organizations. It was a very long process.
We did internal and financial and contractual due diligence, and then even more financial due diligence with projections for a combined budget. I was humbled because Families First raises about $1.2 million in development funds and we were only raising around $200,000. It was a good, honest process and when it was over we could see how this will benefit everyone. We will be able to leverage our combined budgets and unique programs for more substantial grants for family programs, dental and medical care and substance abuse programs.
Q. What is one of the misunderstood aspects of the substance abuse crisis?
A. We identified a major need and have put a strong focus on behavioral health since 2008 to deal not just with the recovery aspect of addiction. While there is so much focus on the opioid crisis, alcoholism gets diagnosed more, and more people are dying from it. It’s been around a lot longer and it’s hidden more easily than illicit drugs.
Q. How are your concerns about the various proposal to replace the ACA?
A. We hope not to go backwards. Clearly Medicaid expansion has helped us serve patients who didn’t have any insurance coverage. We have cut our uninsured rate from 35 percent to 19 percent, about 1,000 patients (the merged organization will have an estimated 3,200 uninsured patients).
The proposals to cut Medicaid would give states autonomy without the money and that will mean a shrinking of our financial resources. This is unfortunate if we do go back to where we were because studies have shown that Medicaid coverage saves money and costs 24 percent less than other forms of coverage. We will still have a sliding fee and because community health centers have faced tough times before, we know how to stretch our dollars. And we have strong community support from major organizations like the Business and Industry Association of New Hampshire, which understand the value we bring.
Q. What has feedback about the merger been?
A. We haven’t heard from one person who thinks it’s a bad idea. The donors and staff at Families First get it, and both organizations are seeing what each other can offer the other. We don’t plan any layoffs among our combined 240 employees, and in fact still have open positions for physicians, and we would love to hire a psychiatrist.
SOMERSWORTH and PORTSMOUTH, August 28, 2017 – The U.S. Department of Health and Human Services (DHHS) recently announced that it will award a combined $267,000 to two community health centers serving the Greater Seacoast area. Goodwin Community Health of Somersworth was awarded $123,000, and $144,000 will go to Families First Health and Support Center of Portsmouth. The health centers, who intend to merge this fall, will use these funds to continue enhancing access to low-cost, quality health and wellness services. Specific areas of focus will include improving quality of care, increasing access to care to vulnerable populations, enhancing delivery of high-value health care, addressing health disparities and maintaining their highest-level (Level 3) Patient-Centered Medical Home status.
Janet Laatsch, who will lead the merged organization as CEO, commented on the funding, “Being recognized for achievements in driving down costs for both patients and the healthcare system as a whole, helps expand access to services to the people that need them. With continued support, we can keep increasing efficiencies to develop quality improvement systems and work to create more access in the communities we serve in the greater Strafford and Rockingham County areas.”
In total, nearly $105 million has been awarded by DHHS to 1,333 health centers across the country. The funding directed to the Seacoast area of New Hampshire builds on the investment in quality improvement made by DHHS through annual awards since 2014, including a total of $250,000 awarded to Goodwin and Families First last year. According to new data released by the Health Resources and Services Administration, nearly 26 million people relied on a health center for primary health care in 2016. This included one in three people living in poverty, one in 10 children under age 18 and one in six rural residents in the United States.
To learn more about Goodwin Community Health visit www.GoodwinCH.org
To learn more about Families First Visit www.familiesfirstseacoast.org/
The Health Resources and Services Administration is part of the U.S. Department of Health and Human Services. HRSA is the primary federal agency responsible for improving access to health care services for people who are uninsured, isolated, or medically vulnerable. For more information about HRSA and its programs, visit www.hrsa.gov
The next Empowering Whole Health support group will be starting Wednesday, September 6th from 4:30 to 6pm here at Goodwin, and meets weekly for 11 weeks.
Empowering Whole Health is open to the public, so anyone and everyone is welcome! The group focuses on goal setting and how to realistically reach your goals for health and wellness. Our past group members (since 2014) have all had amazing results in meeting their goals including
- Weight loss
- Coping with chronic pain and other long-term conditions
- Stress and anxiety reduction
- Finding employment
- Quitting smoking
- And much more!
Patients and group participants have seen some terrific results, here’s one testimonial from Empowering Whole Health alumni Sheri McSheehy.
Other comments from past participants have included:
“This group was just what I needed at this time in my life. Thank you!”
“Nice to have others to talk to, enjoyed it thoroughly!”
“This group taught me I am not alone with my physical/emotional struggles. The subjects shared helped bring me back to life and gave me hope. Thank you.”
“Loved the meditation aspects of the group.”
“Participating as a peer leader was an amazing experience. Thank you Goodwin for hosting this group and making it possible for our community.”
If you or someone you know is interested or has any questions, please contact us at (603) 994-6356.
Roberta Stanhope is a board certified Psychiatric Nurse Practitioner with 23 years of experience. She specializes in providing safe, evidence based, and appropriate pharmacologic and non- pharmacologic treatment tailored to meet her patients’ unique needs to promote optimal wellness and mental health. Her specialties include but are not limited to, depression, anxiety, mood disorders, PTSD, ADHD, grief, bipolar, and psychotic disorders.
Roberta received her Bachelor of Science degree in Nursing at Boston University in 1982. She worked with terminally ill cancer patients at a Massachusetts General-affiliated hospital and in outpatient settings as an RN. After completion of her Masters in Nursing from the University of South Florida in 1994, she worked with adult civilian and military personnel in community mental health, correctional, private, and Federal settings.
Kevin J. O’Connell is Licensed as a Clinical Mental Health Counselor, an Internationally Certified Advanced Alcohol & Drug Counselor, and a Master Licensed Alcohol and Drug Counselor (MLADC). He earned his Master’s Degree in Counseling Psychology from Lesley University Graduate School of Arts and Social Sciences in 1993.
He has twenty five years of experience working with adults, couples, families, and groups in private practice, hospital settings, and non-profit community based agencies providing creative and transformational therapy. He integrates eastern, western, traditional and transpersonal approaches to enhance health and wellness in body, mind, and spirit. He applies an integrally informed, strength based; solution focused approach and uses evidenced based principles in guiding individuals needing assistance with a wide variety of co-occurring disorders to enhance lasting change and improved quality of life.
Janice joins Goodwin Community Health in 2017. She is a board-certified Family Nurse Practitioner with the American Academy of Nurse Practitioners. She earned her Master of Science in Nursing from the University of New Hampshire 2007 and completed her Nurse Practitioner education in 2010. She previously enjoyed caring for patients throughout the lifespan at a primary care practice in Bristol, NH.
Janice particularly values getting to know her patients and their family members. She is currently attending classes at the University of New Hampshire with the goal of earning her psychiatric certification. She hopes to provide continuity in care across physical and psychological conditions.