>> Crossley: ♪ ♪ ♪ ♪ >> Crossley: WELCOME TO "BASIC BLACK".

SOME OF YOU ARE JOINING US ON OUR BROADCAST AND OTHERS OF YOU ARE JOINING US ON OUR DIGITAL PLATFORMS.

I AM CALLIE CROSSLEY, HOST OF UNDER THE RADAR, 89.7.

TONIGHT, COMMUNITY HEALTH CENTERS, ON THE FRONT LINES.

WE, LIKE YOU, ARE DEALING WITH THE EFFECTS OF THE CORONAVIRUS PANDEMIC, AND ARE TAKING PRECAUTIONS.

WE ARE WORKING WITH LIMITED STAFF AND OUR GUESTS ARE JOINING US REMOTELY.

DORCHESTER'S THE COLUMBIA POINT OPENED ITS DOORS SIX DECADES AGO WITH A MISSION TO OFFER HEALTHCARE TO PATIENTS OF COLOR AND THE POOR.

MASSACHUSETTS'S FIRST COMMUNITY HEALTH CENTER IS NOW PART OF A GROUP OF COMMUNITY HEALTH CENTERS IN THE STATE SERVING RACIAL AND ETHNIC MINORITIES AND LOW-INCOME RESIDENTS.

TODAY MORE THAN 1 MILLION PATIENTS A YEAR, ONE IN SEVEN, GET HEALTHCARE AT A COMMUNITY HEALTH CENTER.

DURING THE COVID CRISIS, THESE HEALTH HEALTHCARE CENTERS MADE SURE THAT COMMUNITIES OF COLOR GOT EQUAL ACCESS TO TESTING AND VACCINES.

AND THE NEW OMICRON VARIANT HAS PUT THESE CENTERS BACK ON THE FRONT LINES PICKING UP THE SLACK FROM HOSPITALS SLAMMED WITH AN OVER FLOW OF SICK PATIENTS.

HOW ARE THEY MANAGING THROUGH THE ONGOING PANDEMIC WHILE PREPARING FOR THE NEXT BATTLE?

JOINING US REMOTELY, DR. CHARLES ANDERSON, PRESIDENT AND CEO OF THE DIMOCK CENTER IN ROXBURY, GREGORY WILMOT, INTERIM PRESIDENT AND CEO OF EAST BOSTON NEIGHBORHOOD A HEALTH CENTER, AND DR.

GUY FISH, PRESIDENT AND CEO, GREATER LAWRENCE FAMILY HEALTH CENTER.

WELCOME TO ALL OF YOU.

>> NOW, I JUST DESCRIBED YOU AS BEING ON THE FRONT LINES, OR YOUR INSTITUTIONS AS BEING ON THE FRONT LINES, AND I WANT PEOPLE TO BEFORE WE DIVE INTO WHAT IS CURRENTLY HAPPENING, REALLY UNDERSTAND WHERE YOU ARE IN TERMS OF THE SPECTRUM OF HEALTHCARE, YOU ARE NOT SOLO PRACTITIONERS, THERE ARE HOSPITALS AND THEY ARE THE COMMUNITY CENTERS.

SO JUST A BRIEF, YOU KNOW, WHAT YOU -- WHERE YOU STAND AND WHO YOU SERVE, DR. CHARLES ANDERSON, SO PEOPLE HAVE A SENSE OF WHAT WE TALK ABOUT WHEN WE SAY THAT YOU ALL ARE ON THE FRONT LINES.

>> FIRST OF ALL, I REALLY APPRECIATE BEING HERE AND BEING ABLE TO HAVE THIS CONVERSATION, BECAUSE I DO THINK IT CAN BE PRETTY CONFUSING SOMETIMES, WHEN WE THINK ABOUT THE ROLE WE PLAY AND WHO WE ARE, SO AT THE DIMOCK CENTER WE ARE ON NINE ACHIERS IN THE MIDDLE OF ROXBURY, WE SERVE ROUGHLY 19,000 INDIVIDUALS ON AN ANNUAL BASIS, THIS IS INDIVIDUALS WHO ARE RECEIVING CARE ACROSS A SPECTRUM WHICH CAN INCLUDE PRIMARY CARE, OBSTETRICS, PEDIATRICS, DENTAL CARE, MENTAL HEALTH, EYE CARE, AND ALSO IN OUR CAMPUS WE HAVE A SHELTER, WE DO SUBSTITUTE USE DISORDER SO WE HAVE AN INPATIENT DETOX, CLINICAL STABILIZATION, WE HAVE A RESIDENTIAL RECOVERY HOMES ON OUR CAMPUS, AS WELL AS A SHELTER FOR FAMILIES ON OUR CAMPUS.

AND NOT STOPPING THERE WE ALSO HAVE HEAD START, EARLY HEAD START, EARLY INTERVENTION SO AN EDUCATIONAL COMPONENT SO I THINK IT IS REALLY IMPORTANT FOR PEOPLE TO UNDERSTAND THAT FEDERALLY QUALIFIED HEALTH CENTERS ARE NOT JUST A PLACE WHERE SOMEONE RECEIVES TRADITIONAL HEALTHCARE, BUT WHAT WE REALLY CARE FOR ALL OF THE NEEDS THAT THE COMMUNITY REQUIRES.

>> Crossley: AND GREGORY WILMOT, EVEN THOUGH YOU SERVE IN A SIMILAR ROLE, DO COMMON TASKS YOU ARE VERY DIFFERENT IN HOW YOU MAY BE ADDRESSING YOUR PARTICULAR COMMUNITY.

SO AS YOU DESCRIBE FOR ME WHAT YOUR COMMUNITY HEALTH CENTER, HOW ITS ROLE MANIFESTS EVERY DAY, EXPLAIN A LITTLE BIT OF THAT ABOUT HOW YOU MIGHT DIFFER FROM DIMOCK, FOR EXAMPLE.

>> WONDERFUL.

AND THANK YOU AGAIN, IT IS SUCH AN IMPORTANT TOPIC.

SO EAST BOSTON NEIGHBORHOOD HEALTH CENTER IS UNIQUE IN THAT IT IS THE LARGEST COMMUNITY HEALTH CENTER IN MASSACHUSETTS.

WE SERVE ABOUT 120,000 PATIENTS PER YEAR, SERVING AREAS OF EAST BOSTON, REPEAT, PELETIER, WINTHROP, AND ALSO COMPLETED THE FIRST OF ITS KIND IN MASSACHUSETTS A MERGE WE ARE THE SOUTH END COMMUNITY HEALTH CENTER IN 2020.

WE OPERATED 24/7 EMERGENCY DEPARTMENT, WE ARE ONE OF TWO FEDERALLY QUALIFIED HEALTH CENTERS IN THE COUNTRY THAT OPERATE 247 EMERGENCY DEPARTMENT, AND THAT WAS REALLY IMPORTANT FOR US TO RESPOND TO THE UNIQUE CHANCE OF OUR COMMUNITY.

BUT LIKE THE DIMOCK CENTER, WE PROVIDE A WIDE RANGE OF SERVICES AND VERY COMPARABLE TO THE DIMOCK CENTER, BUT WE REALLY TRY TO FOCUS ON THE UNIQUE ASPECTS OF OUR COMMUNITY, FOCUSING ON PROGRAMS THAT ARE UNIQUE TO WHAT IS A LARGELY LATINX POPULATION.

>> Crossley: THE SAME QUESTION TO YOU, DR.

FISH.

THE COMMONALITIES AND WHAT IS UNIQUE TO YOUR COMMUNITY HEALTH CENTER?

>> THANK YOU, CALLIE, A PLEASURE BEING HERE WITH YOU.

AND HELLO TO MY GOOD FRIENDS GREG AND CHARLES.

LAWRENCE, THE GREATER LAWRENCE FAMILY HEALTH CENTER SERVES AS A COMMUNITY OF LAWRENCE, MASSACHUSETTS, BEHAVIORAL, METHUEN AND NORTH ANDOVER.

WE COUNT 65,000 INDIVIDUALS THAT WE SERVE IN A POPULATION THAT IS JUST ROUGHLY SLIGHTLY LARGER THAN THAT.

BUT WHAT IS UNIQUE ABOUT LAWRENCE, SINCE ITS FOUNDING IN 1847 LAWRENCE HAS BEEN AN IMMIGRANT COMMUNITY.

IT WAS FOUNDED AS A MILL TOWN, AND THE TEXTILE MILLS THAT WERE ESTABLISHED HERE, MANY, MANY YEARS AGO FIRST BROUGHT IN THE IRISH, THEN FOLLOWED BY THE ITALIANS AND FINALLY BY THE HISPANIC COMMUNITY.

OUR LATINX POPULATION MAKES UP 70 PERCENT OF THE TOWN.

WE HAVE A HUGE NUMBER OF ONLY SPANISH SPEAKERS OR THE BILINGUAL SPEAKERS SO WE HAVE TO BE VERY SENSITIVE TO THE NEEDS OF THE IMGRANT COMMUNITY AND THE BILINGUAL COMMUNITY SUCH THAT ALL OF OUR SERVICES NEED TO BE TRANSLATED AND MADE AVAILABLE IN TWO OR MORE LANGUAGES.

WE ALSO DO AS THE OTHER CENTERS PROVIDE BEHAVIORAL HEALTH SERVICES, PEDIATRIC SERVICES, WE DO A WHOLE RANGE OF TESTING AND OF COURSE COVID IS PRESENTING ITS OWN UNIQUE CHALLENGES BUT WE HAVE RICH TO THE OCCASION AND HAVE DONE AN ENORMOUS AMOUNT OF TESTS, ABOUT 130,000 COVID TESTS TO DATE THROUGH OUR HEALTH CENTERS AND CLINICS, SO IT IS VERY MUCH THE IMMIGRANT COMMUNITY THAT WE SERVE AND ALL OTHERS AS WELL.

>> OKAY.

SO NOW THAT WE HAVE A SENSE OF WHERE YOU ALL FIT IN THESE COMMUNITIES AND THE PARTICULAR SPECIAL AND UNIQUE LINK YOU HAVE TO THE COMMUNITIES THAT YOU SERVE, LET'S LEAP AHEAD TO THIS MOMENT IN TIME WHERE WE HAVE NOW BEEN IN COVID FOR, OH, GOD, MORE THAN TWO YEARS AND YOU ALL HAVE HAD YOUR UPS AND DOWNS.

WE WILL GET TO SOME OF THOSE LATER THAT, YOU KNOW, OTHER HEALTH INSTITUTIONS HAVE SUFFERED.

BUT WE ARE AT A CRITICAL POINT IN THIS MOMENT BECAUSE OF THE OMICRON VARIANT AND HOSPITALS ARE SLAMMED.

SO YOUR PARTNER HOSPITALS HAVE AN OVER FLOW OF THESE SICK PATIENTS.

THAT PUTS PRESSURE ON WHAT YOU NORMALLY DO IN YOUR COMMUNITIES.

DR. ANDERSON, HOW ARE YOU ABLE TO RESPOND AND WHAT EXACTLY ARE YOU DOING TO SORT OF MITIGATE THAT SITUATION SO THAT IT BEST HELPS THE COMMUNITIES THAT -- THE COMMUNITY THAT YOU SERVE IN ROXBURY?

>> SURE.

IT IS A COMPLEX CHALLENGE, AND ONE OF THE THINGS WE FOCUSED ON IMMEDIATELY WAS HOW DO WE MAINTAIN A DEGREE OF ACCESS TO THE BASIC SERVICES?

AND AS THIS STARTED TO HE EMERGE IN THIS CURRENT SURGE, WE SAID LET'S SWITCH TO SOME OF THE THINGS IN THE PAST THAT HAD SOME DEGREE OF SUCCESS.

SO WHAT CAN WE MOVE TO TELEHEALTH AND HOW CAN WE LEVERAGE WHAT WE HAVE LEARNED FROM TELEHEALTH TO DO IT EVEN MORE EFFICIENTLY AND MORE EFFECTIVELY THIS TIME AROUND?

SO WE HAVE ACTUALLY KIND OF REALLY THOUGHT THROUGH HOW WE DELIVERED OUR SERVICES THROUGH THAT PORTAL, WHICH HAS BEEN REALLY CRITICAL IN MAKING SURE THAT WE MAINTAIN A LEVEL OF TRADITIONAL ACCESS, BECAUSE WHAT WE DID FIND IS AS WE WERE GETTING READY TO A PLACE IN THIS PANDEMIC PEOPLE WERE STARTING TO COME BACK, ALL OF THE DEFERRED AND DELAYED CARE WAS STARTING TO BE ADDRESSED AND WE DIDN'T WANT TO STOP THAT, AND SO IT WAS REALLY THIS SWITCH TO TELEHEALTH, REORGANIZING THE TIMES OF CLINICS, REORGANIZING THE WAY CLINICS WERE STAFFED, AND OF COURSE A LOT OF THAT DRIVEN BY THE STAFFING CHALLENGES BECAUSE COVID ALSO AFFECTS STAFF, SO WE HAVE HAD TO PIVOT ALMOST ON A DAILY BASIS TO MAKE SURE WE MAINTAIN LEVEL OF ACCESSION THAT THE COMMUNITY REQUIRES.

>> Crossley: DR.

FISH DOES THAT SOUND FAMILIAR?

ARE YOU PIVOTING ON A DAILY BASIS BECAUSE OF THAT OVER FLOW SITUATION IN HOSPITALS, PUTTING PRESSURE ON YOUR CENTER?

>> YES.

ONE OF THE THINGS THAT I SHOULD HAVE MENTIONED IN OUR INTRO IS THAT WE ARE A LITTLE UNIQUE IN THAT WE ARE THE FIRST COMMUNITY HEALTH CENTER IN THE NATION TO ESTABLISH A RESIDENCY PROGRAM, DOCTORS IN TRAINING AFTER MEDICAL SCHOOL TYPICALLY WORK IN HOSPITAL SETTINGS FOR SOMEWHERE BETWEEN TWO TO SIX YEARS.

WE WERE THE FIRST COMMUNITY HEALTH CENTER TO ESTABLISH A RESIDENCY PROGRAM AND FAMILY PRACTICE.

OUR PARTNER HOSPITAL LAWRENCE GENERAL UTILIZES OUR RESIDENTS AND THE HOSPITAL FOR THEIR TRAINING, AND JUST LAST WEEK WE GOT A CALL FROM LAWRENCE GENERAL HOSPITAL CEO WHO SAID WE WERE JUST FLAT OUT, WE HAVE THE -- OF RESIGNATIONS THAT HAPPENED IN 2021, WE HAVE THE OMICRON SURGE, WE HAVE MORE PATIENTS THAN WE HAVE EITHER BEDS OR NURSES AND, CAN YOUR DOCTORS HELP US CAN YOUR RESIDENTS HELP US?

OUR FACULTY STAFF AND OUR RESIDENTS HAVE STEPPED UP AND ARE ACTUALLY MANNING AND ENTIRE FLOOR OF PATIENTS, 28 PATIENTS, SO WE GET IT VERY DIRECTLY THAT WAY.

THE OTHER THINGS THAT WE HAVE DONE THAT HAVE BEEN HELPFUL IS GOING TO WORK FROM HOME WHEN ABLE STATUS, BECAUSE AGAIN MANY OF OUR EMPLOYEES ARE PATIENTS AND OUR PATIENTS ARE EMPLOYEES, SO THEY WOULD BE DEAF CAN STATED IN THEIR HOMES AND FAMILIES AS WELL BUT STILL ARE MISSION DRIVEN AND COMMITTED TO WORK SO WE ARE MAKING WORK AT HOME IF ABLE AVAILABLE TO ALL OF OUR STAFF.

>> Crossley: WHAT IS THE PRESSURE ON YOUR CENTER THAT YOUR RESIDENTS ARE NO LONGER AVAILABLE TO YOU IN YOUR CENTER NOW, THERE AT THE HOSPITAL?

>> RIGHT, WE HAVE HAD THIS, TO SHIFT OUR SCHEDULES CONSIDERABLY, IT IS AT A LOSS TO THEM OF THE DIRECT CLINICAL OUTPATIENT EXPERIENCE, AND SO THE GOOD THING IS THAT WE HAVE BEEN ABLE TO TRANSITION AS DR. ANDERSON SAID TO TELEHEALTH AND THE BENEFIT OF TECHNOLOGY IS THAT YOU CAN ACTUALLY TURN PATIENTS QUICKER BECAUSE YOU ARE NOT WALKING THEM BACK AND FORTH AND SO MANY OF OUR OTHER FACULTY AND STAFF HAVE STEPPED UP TO BREACH THE GAP WITH THE RESIDENTS AT THE HOSPITAL PICKING UP TELEMEDICINE SHIFTS.

>> GREG WILMOT, NOW YOUR CENTER, EAST BOSTON, YOU HAVE A 24-HOUR OR EMERGENCY ROOM, RIGHT, CENTER?

AM I CORRECT SO THAT IS UNIQUE IN ITSELF AND I DON'T KNOW HOW THAT PLAYS OUT BETWEEN YOU AND YOUR, YOUR PARTNER, YOUR HOSPITAL PARTNER IN THIS MOMENT NOW WITH THE OMICRON SURGE.

NO, IT IS REALLY IMPORTANT, AS YOU IMAGINE DURING THE SURGE AS THINGS GOT STARTED, IT DROVE A LOT OF PEOPLE TO EMERGENCY DEPARTMENTS SO BECAUSE WE HAVE THAT LOCAL COMMUNITY BASED EMERGENCY DEPARTMENT AND WERE ABLE TO A TAKE SOME PRESSURE OFF OF THE BMC'S AND THE MGH'S, OUR LOCAL HOSPITALS, WE ALSO OPENED UP WHAT WE CALL AN INFLUENZA LIKE ILLNESS CLINIC, AND THAT REALLY HELPED TO ENSURE THAT PERSONS THAT HAD FLU-LIKE SYMPTOMS OR COVID SYMPTOMS WERE ABLE TO COME SEE US, WE WERE ABLE TO QUICKLY IDENTIFY AND DIAGNOSE WHAT MIGHT BE THE CHALLENGE FOR COVID PATIENTS WERE ABLE TO THIS GET THEM STARTED IN THE COURSE OF TREATMENT OR RECOMMEND THAT THEY ISOLATE, SO THAT REALLY DID HELP TO MANAGE THE SURGE AS THEY GOT GOING.

WE HAVE SO IMPLEMENTED COVID ORAL ANTI-VIRALS SO AGAIN, HAVING THE OPPORTUNITY FOR FOLKS TO QUICKLY GET ACCESS IN THEIR COMMUNITY, TO TREATMENT, AND THEN GET ON A COURSE OF TREATMENT WITH THE COVID ANTI-VIRALS, THAT WAS A HELPFUL WAY TO MAKE SURE THAT FOLKS WERE NOT SUFFERING FROM SEVERE ILLNESS.

>> SO ONE OF THE ISSUES THAT IS THREADED THROUGH A LOT OF THE SITUATION YOU FOUND YOURSELF IN UNDER PRESSURE FROM THIS PARTICULAR PANDEMIC HAD TO DO WITH EQUITY, THE HEAD OF THE MASS LEAGUE OF COMMUNITY CENTERS MICHAEL CURRY HAS SAID THAT THERE HAS OFTEN BEEN A PIECEMEAL APPROACH TO SUPPORTING COMMUNITY HEALTH CENTERS OF WHICH THERE ARE 52 IN THE STATE.

AND THAT THERE NEEDS TO BE A HOLISTIC ONE, RECOGNIZING THAT RACISM IS VERY PRESENT IN HEALTHCARE, THAT YOUR PATIENTS KNOW THAT FOR REAL, LIVE THAT, AND THERE NEEDS TO BE SOME ATTENTION PAID TO THOSE ACCESS ISSUES THAT REALLY REAR THEIR HEAD AND BECAME VISIBLE DURING THIS PANDEMIC AND CERTAINLY EVEN MORE VISIBLE WHENEVER YOU HAVE THESE KINDS OF SURGES.

SO DR. ANDERSON, HOW DO YOU RESPOND TO THAT?

MICHAEL CURRY IS OF THE OPINION THERE OUGHT TO BE AN EQUITY OFFICER ACTUALLY, A, A CABINET LEVEL PERSON TO OVERSEE A IN A HOLISTIC WAY WHAT IS HAPPENING WITH THE COMMUNITY CENTERS THAT PROVIDE SUCH A CRITICAL ROLE IN PROVIDING PRIMARY HEALTHCARE FOR UNDERSERVED COMMUNITIES.

>> THERE IS NO DOUBT ABOUT THE FACT WE NEED TO APPLY EQUITY LENS TO EVERYTHING THAT WE ARE DOING IN HEALTHCARE, BOTH AT THE COMMUNITY CENTER HEALTH LEVEL BUT I WOULD SAY THE HOSPITALS, EMERGENCY ROOMS, REALLY ACROSS OUR HEALTHCARE CENTER, ACROSS THE COUNTRY, YOU KNOW, ONE OF THE THINGS THAT WE FIND SPECIFICALLY IS THAT WE HAVE TO REMEMBER DURING THIS PANDEMIC THE DEATH RATE DUE TO OPIOIDS FOR AFRICAN-AMERICAN MEN INCREASED BY 70 PERCENT.

AND WE JUST STOP AND PAUSE FOR A MINUTE AND THINK ABOUT WHAT THAT MEANS IN TERMS OF THOSE MEN BEING CONNECTED TO SO MANY OTHER FAMILY MEMBERS IN THEIR COMMUNITY, AND WHAT WE FOUND IT HAS BEEN REALLY CRITICAL IN TERMS OF THAT EQUITY LENS AND AGAIN ONE OF THE UNIQUE PARTS WE TALKED ABOUT IS IN SUBSTANCE USE DISORDER IN THE DETOX AND THE STABILIZATION AND WE HAVE MADE THE OPPORTUNITY AVAILABLE AND WE HAVE DO ENA TREMENDOUS AMOUNT OF OUTREACH TO MAKE SURE THAT OUR SERVICES ARE ADDRESSING THOSE UNIQUE NEEDS AND INDIVIDUALS AT MASS AND CAS, 60 PERCENT OF WHOM ARE PEOPLE OF COLOR TO MAKE SURE THAT WE ARE CREATING BEDS SPECIFICALLY DESIGNATED AND ACTUALLY LEVERAGING OUR STAFF WHO ACTUALLY MIRROR OUR COMMUNITY TO BE ABLE TO PROVIDE THIS SORT OF RECOVERY COACHING AND SUPPORT.

AND CANE TO TALK ABOUT HOW WE ARE HELPING THE HOSPITAL SYSTEMS WE ARE HAVING INDIVIDUALS WHO ARE BEING TRANSPORTED FROM HOSPITAL EMERGENCY ROOMS BECAUSE THEY ARE OVERLOADED, WHO ACTUALLY NEED DETOX SUPPORT WHO ARE ACTUALLY COMING ON THE OUR CAMPUS AND BEING ADMITTED BECAUSE OF THOSE SERVICES.

SO WE ARE ACTUALLY LOOKING AT EVERYTHING THAT WE DO TO MAKE SURE WE ARE ADDRESSING THOSE GAPS IN CARE AND SPECIFICALLY THOSE GAPS IN CARE A THAT ARE MORE SEVERELY IMPACTING THOSE OF COLOR.

>> Crossley: DR.

FISH, A, WOULD A MORE INTENSE OR FOCUS ON THE INEQUITABLE ACCESS ISSUES WITH REGARD TO COMMUNITY HEALTH CENTERS MAKE SENSE TO YOU, BE BETTER FOR YOU?

>> ABSOLUTELY, CALLIE.

I WOULD LIKE TO DRAW A VERY SHARP DISTINCTION BETWEEN TWO THINGS THAT GET CONFUSED ALL THE TIME.

ONE IS MEDICAL CARE AND THE OTHER IS HEALTHCARE.

THEY ARE VERY DIFFERENT.

WE HAVE GREAT HOSPITALS IN BOSTON, WORLD CLASS GALAXY CLASS HOSPITALS THAT DO AMAZING THINGS FOR PEOPLE THAT ARE REALLY, REALLY SICK.

BUT I DON'T RUN A HOSPITAL, I RUN A COMMUNITY HEALTH ACCEPTANCE OF RESPONSIBILITY AND THE FOCUS IS ON HEALTH, AND WHEN WE TALK ABOUT HEALTH, YES, WE DO SOME MEDICAL, WE HAVE DOCTORS AND NURSES AND NURSE PRACTITIONERS AND WE, WHO DO, AND WE DO MEDICAL THINGS FOR OUR PATIENTS BUT WE ARE ALSO FOCUSED ON HEALTH, WHICH MEANS ONE OF THE THINGS LIKE NUTRITION -- ACCESS TO HOUSING, HOW DO YOU MANAGE IF YOU HAVE ECONOMIC CONSTRAINTS AND SO YOU ARE CHOOSING BETWEEN YOUR NED SIN VERSUS YOUR RENT PAINT AT THE END OF THE MONTH?

WHAT IF IF I DON'T YOU ARE JUSTICE INVOLVED?

THESE ARE ALL CONDITIONS, UPSTREAM CONDITIONS WE CALL THEM SOCIAL DETERMINANTS OF HEALTH WHICH ARE PART OF HOW WE HAVE TO LOOK HOLISTICALLY AT THE PEOPLE WHO WALK THROUGH OUR DOORS, PARTNER WITH OTHER INSTITUTIONS THAT HELP SOLVE THESE PROBLEMS ON A DAILY BASIS, AND REALLY LIFT THE HEALTH OF THE COMMUNITY.

SO ONE OF THE THINGS THAT I AM REALLY DELIGHTED ABOUT AND WE CAN TALK MORE ABOUT IN I AM SURE, IS THAT THE DIFFERENCE BETWEEN HEALTHCARE AND MEDICAL CARE OFTEN COMES DOWN TO REIMBURSEMENT, HOSPITALS HAVE ACTUALLY BEEN DOMINATING THE FLOW OF MONEY FROM THE STATE GOVERNMENT AND FEDERAL GOVERNMENT WITH RESPECT TO PAYMENT AND REIMBURSEMENT AND COMMUNITY HEALTH SENSE HAVE OFTEN BEEN AN AFTERTHOUGHT.

WHAT WE ARE SEEING NOW WITH A REFORM THAT IS COMING THROUGH IS INCREASED PAYMENT TO COMMUNITY HEALTH ACCEPTANCE OF RESPONSIBILITIES LIKE OURS FOR MEDICAL CARE, THE RATES HAVE GONE UP SUBSTANTIALLY, BUT ALSO INCLUDING BEHAVIORAL HEALTH, SUBSTANCE USE DISORDER AND OTHER ASPECTS OF THE CARE THAT WE DELIVER ON A DAILY BASIS, FINALLY GETTING REIMBURSED.

>> Crossley: YES, AND GREGORY, THE REIMBURSEMENT DROP THAT HAPPENED, PARTICULARLY DURING THE EARLY STAGES OF COVID WAS QUITE INTENSE, 50 TO 70 PERCENT AT COMMUNITY HEALTH CENTERS, GOVERNOR BAKER DID PROVIDE A STATE BAILOUT TO COMMUNITY CENTERS AND WAS INSTRUMENTAL IN CHANGING, RAISING SOME OF THOSE STRUCTURAL FEES THAT DR.

FISH HAS REFERRED TO.

SO -- BUT STILL, THAT IS A LOT OF WEIGHT ON COMMUNITY CENTERS TO PROVIDE WHAT DR.

FISH AND DR. ANDERSON HAVE MADE CLEAR, WHICH IS HEALTHCARE AND NOT MEDICAL CARE A, AND IN THE FILLED OF A CRISIS THAT IS SORT OF THE DOUBLE WHAMMY.

>> ABSOLUTELY.

AND DR. ANDERSON AND DR.

FISH TOUCHED ON SOME REALLY IMPORTANT ISSUES.

COVID TAUGHT US A LOT ABOUT THE CHALLENGES IN OUR PUBLIC HEALTH SYSTEM.

ONE THING I WOULD ADD IS THAT CONTINUED INVESTMENT IN COMMUNITY HEALTH CENTERS AS AN INTEGRAL PART OF OUR PUBLIC HEALTH SYSTEM IS REALLY IMPORTANT.

WE HAVE GREATLY CONTRIBUTED TO THE TO THE STATE RESPONSE TO COVID IN TERMS OF ACCESS TO TREATMENT, ACCESS TO VACCINATION, ACCESS TO TESTING, ACCESS TO RAPID ANTIGEN TEST ALSO NOW AND THOSE ARE SOME THINGS THAT WE CAN CONTINUE TO DO FOR NEXT PUBLIC HEALTH CRISIS THAT MIGHT EMERGE OR AS WE CONTINUE TO RECOVER OUT OF THIS CRISIS.

AND SO CONTINUED INVESTMENT IN COMMUNITY HEALTH CENTERS AS AN INTEGRITY GRADUAL PART OF THE STATE'S HEALTH SYSTEM .. IS ABSOLUTELY IMPORTANT.

WE HAVE BEEN FORTUNATE WE PARTNERED WITH THE FEDERAL GOVERNMENT ON A NUMBER OF ASPECTS OF OUR COVID RESPONSE AND OUR LOCAL STATE GOVERNMENT IN THE BARACK THE -- BAKER ADMINISTRATION SO THAT TYPE OF PARTNERSHIP AND INTENTIONALITY IS ABSOLUTELY CRITICAL.

>> Crossley: ONE OF THE THINGS I HAVE LEARNED FROM, YOU KNOW, JUST GETTING READY TO HAVE THIS CONVERSATION IS, WHILE YOU ARE OFTEN UNDERFUNDED, IF YOU WILL, YOU HAVE TO DEAL IN THE MOMENT OF THE CRISIS, BUT AT THE SAME TIME BE LOOKING FORWARD ABOUT WHAT YOU ARE GOING TO DO FOR YOUR POPULATION AND BE SORT OF REALLY ON THE CUTTING EDGE, SO, IN FACT, MOST OF YOU WERE OFFERING THE VACCINES AND THE TESTING EARLY TO YOUR PARTICULAR COMMUNITIES, WHEN THE VACCINE AND THE BOOSTERS, YOU ARE OFFERING THAT EARLY AND NOW GREGORY WILMOT YOU MENTIONED EARLIER YOU ARE TURNING TO THERAPEUTICS, THE ORAL MEDICATIONS I KNOW THAT IS SOMETHING THAT ALL OF YOU ARE LOOKING AT AS A WAY TO HELP BOOST THE POSSIBILITY OF JUST REGULATING THAT -- EVERYBODY'S WELL-BEING, SO THAT YOU DON'T HAVE THESE DIPS BACK INTO CRISIS MODE FOR HEALTHCARE.

HOW DID YOU MANAGE TO DO -- I MEAN, YOU ARE WORKING ON A SHOESTRING THERE, DR. ANDERSON TO DO ALL OF THIS.

WHAT CAN YOU SAY ABOUT HOW YOU ARE MANAGING TO DO THAT?

>> AND THEN THERE ARE SEVERAL THINGS, YOU KNOW, YOU DON'T DO THIS ON YOUR OWN, RIGHT?

WE DO IT THROUGH OUR AMAZING STAFF WE HAVE BUT ALSO THE RANGE OF PARTNERSHIPS WE HAVE.

WE HAVE FOUND DURING THIS PANDEMIC THAT THERE ARE ORGANIZATIONS AND INDIVIDUALS WHO ARE ALSO WANTING TO BE A PART OF THIS IMPORTANT WORK.

EVERYONE IS STARTING TO REALLY UNDERSTAND THE VALUE THAT COMMUNITY HEALTH ACCEPTANCE OF RESPONSIBILITIES CAN PLAY, BECAUSE QUITE HONESTLY, WE ARE WITH THE ONES WHO BUILT THESE TRUSTED RELATIONSHIPS WITH COMMUNITIES AND SOME OF WHICH GO BACK OVER 100 YEARS, LIKE US HERE AT THE DIMOCK CENTER HAVING BEEN A HOSPITAL AT ONE POINT BEING WHERE WE ARE FOR 150 YEARS, AND MANY PARTNERS ARE STARTING TO UNDERSTAND THAT IF YOU REALLY, REALLY WANT TO GET TO THINGS LIKE LEVELS OF VACCINATION ACROSS THE STATE, YOU HAVE GOT TO REALLY DO THAT THROUGH THE COMMUNITY HEALTH CENTERS AND IN LEVELING THAT TRUSTED PARTNERSHIP THAT WE HAVE FORMED WITH THE COMMUNITY.

AND SO WE HAVE BEEN ABLE TO DO A FAIR AMOUNT OF WHAT WE HAVE DONE IN TERMS OF MEETING NEEDS, IN TERMS OF FOOD INSECURITY, ET CETERA THROUGH LARGE PARTNERSHIPS, PLACES LIKE STOP AND SHOP AND OTHERS, AND BIG CORPORATIONS THAT ARE SAYING, LOOK, YOU ARE THE ONES TO GIVE US THE RETURN ON THIS TYPE OF INVESTMENT, BECAUSE YOU ARE THE ONES THAT CAN REALLY DO THIS WORK WHERE IT NEEDS TO BE DONE MOST.

>> Crossley: GREGORY, DO YOU THINK THAT THE SILVER LINING OF THE CRISIS, IF THERE IS ONE, IS THAT COMMUNITY HEALTH CENTERS ARE ON THE BIG STAGE NOW WHERE PEOPLE DO HAVE A GREATER APPRECIATION FOR THE VALUE YOU PROVIDE?

>> I THINK THAT IS A SILVER LINING FOR SURE.

YOU KNOW, I TOUCHED ON THE IMPORTANT WORK THAT COMMUNITY HEALTH CENTERS DO AS PART OF OUR OVERARCHING HEALTH SYSTEM ..

I DO THINK THERE IS GREATER APPRECIATION FOR THAT AS A WE LEARN MORE ABOUT WHAT THOSE SERVICES LOOK LIKE AND HOW VITAL THEY ARE TO THE COMMUNITIES.

I THINK ADD -- ADDED SILVER LININGS IS THE PANDEMIC DID SHINE A LIGHT ON SOME GAPS AND REALLY ACCELERATE A NUMBER OF POLICIES THAT HAVE BENEFITED COMMUNITY HEALTH CENTERS BUT ALSO BENEFITED COMMUNITIES SERVED BY COMMUNITY HEALTH CENTERS, BEING ABLE TO IMPLEMENT QUICKLY TELEHEALTH SERVICES, EXPANDED BEHAVIORAL HEALTH SERVICES, BEGINNING TO REALLY BUILD OUT A MORE COMPREHENSIVE GUESS SEARCH OR PREPAREDNESS RESPONSE.

THOSE ARE THINGS THAT WE CAN SAY ARE STILL VERY LININGS FROM THE PANDEMIC, BUT I ABSOLUTELY, I AGREE THAT IT HAS ALLOWED COMMUNITY HEALTH CENTERS TO STEP FORWARD, SHOWCASE THE WORK THAT WE DO, DAY IN AND DAY OUT, AND IT HAS GIVEN US AN OPPORTUNITY TO THANK A OUR MOST VALUED ASSET, OUR STAFF AND FOR THEM TO FEEL REALLY PROUD AND GOOD ABOUT THE AMAZING WORK THAT THEY DO EVERY DAY.

>> SO DR.

FISH, I DON'T HAVE MUCH TIME HERE, BUT DO YOU THINK THAT WE SHOULD REFRAME AND THIS THINK ABOUT COMMUNITY HEALTH CENTERS AT CANARIES IN THE MINE WHEN WE TALK ABOUT HEALTHCARE CAN?

LIKE YOU SEE IT FIRST BECAUSE YOU ARE A ON THE FRONT LINES.

>> WE ARE ABSOLUTELY ON THE FRONTLINE, AND I THINK THE POINT OF THAT IS THAT WE SERVE THE MOST VULNERABLE POPULATION INFORMATION OUR SOCIETY.

THESE ARE FOLKS WHO IN MY COMMUNITY HAVE LITERALLY JUST GOTTEN OFF THE AIRPLANE AND NEED TO BE PLUGGED INTO ALL KINDS OF SYSTEMS.

IN THE DOMINICAN REPUBLIC WHERE A VAST MAJORITY OF MY PATIENTS ARE FROM, THE CENTRAL AMERICAN STYLE OF GETTING MEDICAL ATTENTION IS TO SHOW UP IN THE ER.

WE KNOW IN AMERICA THAT IS THE MOST EXPENSIVE THING THAT YOU CAN DO, AND IT DOESN'T LEAD TO LONG-TERM ENGAGEMENT ABOUT BEING HELPFUL, INSTEAD IT IS A STOP STOPGAP.

SO WE ARE SEEING PATIENT WHOSE ARE MOST AT NEED AND BEING ABLE TO ADDRESS THEM AND FOCUS ON THE NEEDS OF COMMUNITIES LIKE THIS, ONLY LISTS THE ENTIRE STATE ITS HELPFULNESS.

>> Crossley: THAT'S A GOOD PLACE FOR US TO STOP.

THAT'S THE END OF OUR BROADCAST, THE END OF OUR SHOW I WANT TO THANK ALL OF YOU FOR JOINING US AND NOW STAY WITH US AS WE CONTINUE OUR CONVERSATION ON OUR DIGITAL PLATFORMS, FACEBOOK AND YOUTUBE.

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