Delivery of Care

Neighborhood Health Station grows up in Central Falls

Construction officially begins on new $15 million facility that seeks to redefine population health and public health outcomes in a citywide approach

Photo by Richard Asinof

Ray Lavoie, executive director of Blackstone Valley Community Health Care, and Dr. Michael Fine, hold up an architectural rendering of the new $15 million Neighborhood Health Station facility, now under construction in downtown Central Falls, with an expected completion date in August of 2018.

By Richard Asinof
Posted 8/28/17
More than cranes in the skyline in Providence, or proposals for a new stadium in Pawtucket, building a Neighborhood Health Station in downtown Central Falls is an investment in sustainable economic development and improved health outcomes, at the community level.
What are the approaches that Central Falls Neighborhood Health Station has taken in addressing major health issues – adolescent pregnancy, smoking cessation, and substance use – through its coordinated health IT system analytics? How could the development of Neighborhood Health Stations, and, for that matter, health equity zones, fit into the plans for economic development championed by CommerceRI? Are there ways that the Neighborhood Health Station model can be replicated in other communities around Rhode Island? Are there opportunities to include community health centers as the home to academic research around public health?
So much of the current focus of news reporting on the current health delivery system – what Dr. Michael Fine insists on calling a market based upon wealth extraction – revolves around the economic bottom line of profit and loss of health systems, rather than focusing on public health outcomes. As a result, the value of achieving public health outcomes often gets left out of the conversation, an externality to the bottom line.
The news media shares much of the blame for the gaps in coverage, similar to the gaps in health coverage for poor folks, who are often not included in how health care coverage is framed in the news – except as an added burden to taxpayer expenses.

CENTRAL FALLS – This week, Central Falls will kick off its annual restaurant week, “A World of Flavors in One Square Mile,” with some 18 establishments offering luncheon specials for $7.99 and dinner specials for $14.99, running from Aug. 28 through Sept. 3, the latest in a series of community events promoting the rebirth of the smallest urban center in Rhode Island.

A much more significant development kicked off last week: the construction company building the new $15 million Neighborhood Health Station at 1000 Broad Street began its preliminary work preparing the site for the 47,000-square-foot facility, ripping up the macadam behind the Notre Dame Urgent Care Center building.

The new facility, developed by Blackstone Valley Community Health Care, a community health center serving Pawtucket and Central Falls, has been designed to accommodate as many as an additional 10,000 patients a year. When you include the current patients being seen at Blackstone’s Central Falls offices and its urgent care facility, it translates into resources to attend to the needs of some 16,000 patients a year, with 50,000 to 60,000 patient visits a year.

Translated, the new Neighborhood Health Station facility will provide health care services to about 90 percent of the residents of Central Falls, which has a population of 19,406, according to the 2015 census.

Telling the story
In anticipation of construction beginning, the Local Initiatives Support Corporation of Rhode Island scheduled a photo shoot late last week with two of the principals behind the team effort: Dr. Michael Fine, senior population health and clinical officer, and Ray Lavoie, the executive director of the Blackstone Valley Community Health Care Center. LISC RI had helped to provide financing for the project, and the photo shoot is a planned a news item to published on the LISC RI website.

The new Neighborhood Health Station is redefining the concept of population health and how to achieve public health outcomes, according to Fine and Lavoie.

“I don’t think there is any other community health center [in the nation] that has taken on, as its moral, ethical and clinical responsibility, the health care of everyone in a city,” Fine told ConvergenceRI, in an interview last year, a few days before the unofficial groundbreaking on Oct. 8, 2016, which featured Viola Davis in a homecoming event. [See link to ConvergenceRI story below.]

That’s what is different about the Neighborhood Health Station in Central Falls, Fine had explained in the interview. “Everyone else depends on people walking through the doors.”

In turn, Lavoie had elaborated how the development of a Neighborhood Health Station in Central Falls required a new way of thinking about health care delivery.

“The approach being taken by the Neighborhood Health Station in Central Falls, our attempt to deliver 90 percent of the health services needed by 90 percent of the population of a geographic region, cannot be simply a rearrangement of medical office locations, nor can it be achieved simply with various co-location schemes,” Lavoie said.

To achieve the health outcomes sought, Lavoie continued, the new approach required breaking down existing silos and, at the same time, building up a health IT platform that connects providers and patients as well as providers to providers, without intermediaries.

“To be successful at improving population health in the community, and to accomplish this at a lower cost to the health care system, clinical information must be readily available to all treating clinicians in the community,” Lavoie said.

To accomplish this, Blackstone Valley has built out its health IT infrastructure to support a community health platform for clinicians, owned and operated by clinicians, for the benefit of all members of the community, financed by a grant from the Rhode Island Foundation.

In a time of disruption
The Neighborhood Health Station in Central Falls, like its sister facility in Scituate, represent a fundamentally different approach to the delivery of health care in a time of major disturbance and disruption.

Awash in red ink, Memorial Hospital of Rhode Island, now owned by Care New England, is in the process of being acquired by Prime Healthcare, a California-based health system.

Care New England, in turn, is involved in negotiations to merge with Partners Healthcare in Boston, the largest health system in Massachusetts. Westerly Hospital, previously acquired by Lawrence + Memorial Hospital in New London, is now part of the Yale New Haven system. South County Health, the last remaining unaffiliated acute care community hospital in Rhode Island, is reportedly in talks with Yale New Haven.

Prospect Medical, the for-profit equity firm that owns CharterCARE, has plans to expand its holdings in western Connecticut. [The recent collapse of the pension system for retired nurses that worked at St. Joseph’s reveals some of the potential downsides of hospital acquisitions.]

In turn, the failure by the Republican Congress to repeal Obamacare and replace it with Trumpcare, a political move foiled in large part by public resistance, has postponed but not removed the threats to financing of Medicaid and Medicare.

As the chessboard keeps changing
While pundits hail the appearance of construction cranes in downtown Providence, and legislative leaders square off about the value of investing in a new baseball stadium complex in downtown Pawtucket to replace McCoy Stadium, the construction of the new Neighborhood Health Station facility in downtown Central Falls offers not just a new approach to the delivery of integrated health care and population health covering 90 percent of the residents in Rhode Island’s smallest city, it also represents a model of sustainable economic development, keeping the money spent on health care local – and, equally important, working to improve public health outcomes through integrated care.

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