Can neighborhood health stations help curb costs?

LOCAL TREATMENT: Vanessa Semedo, right, a senior at Central Falls High School, at the school's health clinic with Sara Perry, left, Central Falls practice manager for Blackstone Valley Community Health Care, and LeTotha Wiggins, medical assistant. / PBN PHOTO/MICHAEL SALERNO
LOCAL TREATMENT: Vanessa Semedo, right, a senior at Central Falls High School, at the school's health clinic with Sara Perry, left, Central Falls practice manager for Blackstone Valley Community Health Care, and LeTotha Wiggins, medical assistant. / PBN PHOTO/MICHAEL SALERNO

Imagine that in every Rhode Island community, there was a health center or clinic that guaranteed same-day appointments for ill patients even on the weekends. The center would offer community outreach and wellness programs and would dramatically reduce the state’s soaring health care costs and increase the health of its residents.

Dr. Michael Fine, former director of the R.I. Department of Health, and a group of medical, civic and professional collaborators, have long imagined these neighborhood health stations and have laid the groundwork to open the first one, in Central Falls.

There’s just one thing standing between these stations as an idea and an actuality: money to build and run them. But those behind the initiative are confident that once the idea is conceptualized, funding and statewide backing will follow.

“There’s no service – yet,” Fine said. “But people are committed to getting it done. We don’t have a primary care system that takes care of everybody.”

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Fine led the concept’s development while at the health department, with the intent of introducing the state to health centers that included not only full medical, dental and behavioral health services – such as the state’s nine community health centers do – but also emergency and community health-outreach services.

Offered station services would be determined on a community basis, recognizing that the individual health needs of Rhode Islanders vary based on geography and socio-economic factors.

As collaborations between communities, health care providers and hospital systems, the stations would provide Rhode Islanders the opportunity to receive 90 percent of needed medical services within a few blocks of their home, reducing unnecessary emergency room visits and costs and increasing preventative-care engagement.

The result, Fine said, would be healthier citizens and a more economically stable state.

“The single most significant health care challenge that Rhode Island faces is the challenge of health care costs,” Fine said. “Preventive care becomes effective when we get services to the entire population – and we don’t have a way to do that.”

Central Falls City Planner Stephen Larrick said the city is the ideal choice for the first station.

“Central Falls has been identified as a community where there are significant health disparities compared to other communities. We have the lowest income and highest poverty in the state,” Larrick said.

According to a 2011 study by the Rhode Island Public Health Institute, 30 percent of Central Falls adult citizens report being in fair or poor health, compared to 11.5 percent of adults in core Rhode Island cities. The study also reported that 68 percent of Central Falls adults don’t maintain a healthy weight and that only 59 percent of adults had been tested for diabetes in the last three years.

Last fall, a student health clinic that runs much as a neighborhood health station would operate opened at Central Falls High School. A collaboration between Blackstone Valley Community Health Care Center, Memorial Hospital and Central Falls, the clinic offers students medical services, including vaccines, sick visits and physicals during and after school hours. A Memorial Hospital doctor takes appointments there once per week.

“This is a first step between all the parties [who would be involved] in a neighborhood health station,” said Christine Grey, chief operating officer of the Blackstone Valley Community Health Care Center. “The students are taking very well to it and they have been using the services. The next step is determining a location for the neighborhood health station.”

Larrick said the Notre Dame Ambulatory Center building on Broad Street has been identified as a possible station site. Another possibility is to expand the Blackstone Valley Community Health Center’s building, which, Larrick said, is bursting with patients.

Care New England and the Blackstone Valley Community Health Center have a joint grant to conduct a feasibility study of costs and concept for the Notre Dame site.

Two years ago, students of Roger Williams University architecture professor Eleftherios Pavlides and Rhode Island College assistant professor of nursing Lynn Blanchette collaborated on designing 10 possible health stations for Scituate. The designs were based on what services the town’s station would offer and what would attract residents not only when they were sick but also for preventative-care measures, including yoga classes and a farmer’s market.

“It’s important that providers consider where you live and work when they’re trying to help you live a healthier lifestyle,” Blanchette said.

Blanchette, who has worked as a community-health nurse for more than 30 years, said while funding is a roadblock to the health stations, support for their need is also lacking.

“People are intrigued, but we’re going to have to start with one,” she said.

Fine envisions at least 75 stations – one for every 12,000 or so Rhode Islanders.

“Just imagine what life would be like if we had 75 of these stations,” Fine said. “[Similar practices in other states] have been able to reduce emergency room visits by 50-60 percent.” •

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