Critical care for those in need
Community health center helps bridge health care divide
by Regan White
regan@thecharlotteweekly.com

Carolyn Allison, C.W. Williams Community Health Center’s chief executive officer, came to the center six years ago from Kaiser Permanente. She shares the story often as an example of the center’s lasting value. “As a large HMO (Kaiser Permanente) is no longer here, yet in spite of the changes in the economy and the health care industry, this health center has been strong throughout it all to remain here (and) valuable to the community,” Allison said. “That speaks volumes to this practice.”

“We started services 25 years ago with primary care services, pediatrics, in- trauma and family practice,” said Carolyn Allison, CWWCHC’s chief executive officer. “Now we offer additional services including full OB/GYN services, a homeless health care initiative, mammography screenings, a diabetes program including ophthalmologic services, an HIV/AIDS program and more.”

The center has expanded to include an office on Randolph Road where the obstetrics and gynecology services are offered in addition to traditional primary care services. In 2005, the center treated nearly 11,000 patients. Approximately 45 percent of the center’s patients receive Medicaid and close to 30 percent are uninsured. In the past six years, the center’s staff has doubled to more than 60 employees, a number that continues to grow with the demand for the center’s services. According to Allison, the center cares for the second-largest number of Medicaid and uninsured patients outside the hospital system.

Finding funding
CWWCHC is the only community health center in Mecklenburg County. Only 23 community health centers exist in North Carolina, part of a health care model established 40 years ago during the Johnson administration. A couple thousand exist across the country. Each is its own nonprofit with its own board of directors, the majority of which is made up of patients. “It’s very unique to have patients on the board, but it helps you remain focused as a CEO and stay in touch with the true issues that exist,” Allison said.

Every community health center receives funding from the Health Resources and Services Administration – monetary help which, according to Allison, is misleading to the reality of the center’s funding challenges. “A lot of people think the federal grant helps us offset all our costs,” she explained. “We run a $7 million practice and only 13 percent of our funds come from the federal government. That puts a huge burden on the health center to find other sources of funding.”

A typical physician visit costs $150 to $200, yet CWWCHC asks patients to only pay $20 if they’re uninsured. “That’s why we’re in such need of support from the community because we’re going to provide medical services regardless of an individual’s ability to pay. That is the mission of the health center,” Allison said.

Helping hands
CWWCHC offers its services, including onsite labwork and medications from its onsite pharmacy, on a sliding pay scale determined by national poverty guidelines. Thanks to federal, state, local and organization grants, individual contributions and medication donations from pharmaceutical company Pfizer, CWWCHC is able to provide affordable medical care to its patients, 60 percent of whom live below the federal poverty level and 10 percent of whom live below 200 percent of the federal poverty level. In 2005 alone, the center spent $1.4 million on care for the uninsured.

Community alliances also provide a critical component to the center’s success. “We seek to partner with other agencies in town to offer services for the uninsured and underinsured population,” Allison said. The center contracts most of its physicians from Presbyterian Hospital and private practices and collaborates with more than 28 local organizations.

Partnering for progress
Four years ago the center began its homeless health care initiative through a partnership with Urban Ministry and the Uptown Shelter. A nurse practitioner was hired last year for the program with a grant from the county. General nursing assessments are provided onsite at both agencies for the homeless population; individuals requiring medical assistance are deferred to the Wilkinson Boulevard location to see a primary care provider. “We’re beginning to see repeat visits from the homeless, so that’s critical,” Allison said. “It’s not a one-and-done visit. Individuals are establishing relationships with primary care providers.” Both agencies provide patient transportation, and grant funding also offsets the cost of medication for the homeless.

A partnership with ID Consultants led to the center’s HIV/AIDS program. “Our Wilkinson Boulevard office sits in the epicenter of the fastest growth rate of individuals with HIV and AIDS in Mecklenburg County,” Allison said. “Six years ago we were managing 17 patients with HIV. At the end of 2006 we were treating 280 patients.” Infectious disease specialists from ID Consultants provide HIV services at both CWWCHC locations for half a day each week. “Individuals with Medicaid and (those) who are underinsured have extreme difficulty accessing specialty care,” Allison said. “We are considered a safety net organization.”

Allison has seen the safety net expand over the years to catch the fall of more mainstream populations. “It’s not just homeless individuals; it’s a lot of working people and people from small businesses,” she said.

Compassionate care
Bill Brown first became acquainted with CWWCHC when he worked at the Uptown Men’s Shelter. He has been a patient at the center for five years and a board member for nearly three. “I think it’s the only service available to people with little or no income,” Brown said. “It’s certainly an underestimated value in our community because it provides a venue where people can be treated for everything from the common cold to hypertension (without) having to go to the emergency room, which is then overbearing in terms of cost to the medical community.”

Most important for Brown is the spirit in which the services are delivered – something Allison calls compassionate care. “It’s all done with an air of dignity,” Brown said. “Routinely when you go to (a) health care provider and you come from the homeless community you may not be treated with the same dignity that somebody who is a paying consumer might enjoy.”

It’s a standard of care in which Allison takes great pride. “It’s really important that the people we serve here have a voice,” she said. She noted that in a few days she would travel to Washington, D.C., to let members of Congress know truly what is being done on the front lines and how dollars spent on health centers are being used wisely. She hastened to add, “But more is always needed. It’s important we don’t develop a comfort level around that until there is a crisis.”

To make a monetary donation to CWWCHC or to volunteer, call Allison at 704-391-0819. Visit www.cwwilliams.org for more information.