Delivery of Care

Reaching the promised land

The new Neighborhood Health Station built by Blackstone Valley Community Health Care on Broad Street in Central Falls is poised to open its doors to patients in three weeks

Photo by Richard Asinof

The new Neighborhood Health Station facility in Central Falls plans to open its doors to patients in the middle of February, offering residents of Central Falls a one-stop shop for health care needs for primary care, urgent care, dental care, behavioral health care, physical therapy, lab work and pharmacy needs.

By Richard Asinof
Posted 1/21/19
With little fanfare, the new Neighborhood Health Station facility in Central Falls is scheduled to open its doors in the next few weeks, bringing with it hope to the residents of the city.
What can be learned about innovation in Rhode Island around health care from the nation’s first Neighborhood Health Station in Central Falls? How can the work of Blackstone Valley Community Health Care become more integrated into the activities of the health equity zone serving Pawtucket and Central Falls? What can be learned from the efforts to coordinate EMS transports in Central Falls with urgent care that will be part of the Neighborhood Health Station? Will members of the Sankofa Initiative in the West End of Providence take a tour of the Neighborhood Health Station?
In the same way that The Providence Journal has failed to report on Health Equity Zones, a similar kind of self-perpetuating blindness seems to exist around the Neighborhood Health Stations in Central Falls and Scituate. Here is Rhode Island, a national leader in two health innovation initiatives, and the local news media does not appear interested in covering them. Why not?
Beyond the click-bait reporting about murder, mayhem, anxiety and outrage, there are events and occurrences that promote the promise of a better future here in Rhode Island.

CENTRAL FALLS – This past week, as a team building exercise, Blue Cross & Blue Shield of Rhode Island invited Angela Ankoma, an executive vice president and director of community investment at United Way of Rhode Island, to lead a discussion about the continuing legacy of Dr. Martin Luther King, Jr., asking: “What do you see from your mountaintop?”

The goal was to find common ground about what can be done – as an individual, as an organization and a community – to further King’s mission and to make societal improvements from a health care perspective, according to a Facebook post.

There are numerous challenges when it comes to the delivery of health care in Rhode Island, related to cost, access, outcomes, health equity, drug pricing, social disparities, and managing community health.

In the discussion, Ankoma put her finger on one of the biggest problems. “When your fastest growing populations in the state are significantly impacted by inequalities, you have a crisis that needs to be addressed,” Ankoma said, as quoted in a Facebook post.

Bringing hope, better health to Central Falls
One response to Ankoma’s observation – and to the broader challenge, what do you see from your mountaintop from a health care perspective – can be found in the opening of the first urban Neighborhood Health Station in Central Falls, being built by Blackstone Valley Community Health Care, the first of the its kind in the nation. [There is also a rural Neighborhood Health Station currently operating in Scituate, R.I.]

It has been a little more than two years since ground was broken for the new Neighborhood Health Station in the smallest city in Rhode Island, with native daughter Viola Davis lending a shovel, offering a message of hope and perseverance to the residents of the city, one that seemed to reflect the dialogue from one of Davis’s memorable characters from “The Help” – you are smart, you are important, you are kind.

Ray Lavoie, the executive director of Blackstone Valley Community Health Center, which has built the new 47,000-square-foot facility at 1000 Broad St. in Central Falls, one of the first new buildings constructed in the city in more than a decade, has shepherded the construction project to completion, navigating an often bumpy road.

The new facility, which is tentatively scheduled to be open for patients on Feb. 15, pending being granted a Certificate of Occupancy, will initially provide primary care and urgent care services from 8 a.m. to 5 p.m. The Neighborhood Health Center offers a different vision of health care and its relationship to the community. A grand opening is planned for later this spring.

Lavoie, in a previous interview with ConvergenceRI, described the underlying concept in straightforward terms: “A neighborhood health station is pretty much a one-stop shop, where residents of Central Falls can get most of their health care needs met,” he said.

The new Neighborhood Health Station will be the first of its kind in an urban setting in the nation, providing primary care and urgent care to about 75 percent of the nearly 20,000 residents of Central Falls, integrating dental care, behavioral health care, physical and occupational therapy and a pharmacy, all at one site, in walking distance for most Central Falls residents.

In addition, the Blackstone Valley Community Health Care health center’s comprehensive population health management analytics system will create the first community-wide data warehouse in real time to connect the social determinants of health with the primary care patients, a powerful public health tool.

Community input

The story began back in 2013, as Central Falls began to emerge from bankruptcy, and the R.I. Department of Health, as part of a listening tour, heard what the residents of Central Falls wanted.

“This journey began back in the fall of 2013,” Lavoie said, “when the good Dr. Michael Fine, [then serving as director of the R.I. Department of Health], did a listening tour in Central Falls. Central Falls had recently emerged from bankruptcy. And, what he heard from the citizens was loud and clear: they wanted more access to health care.”

In a recent interview by ConvergenceRI with Lavoie and Fine, senior clinical and population health officer at Blackstone Valley, the two discussed the economic impact of the Neighborhood Health Station on Central Falls.

“There’s some evidence that suggests 25 percent of economic activity in rural areas comes from health care,” Fine said. “Twenty-five percent.”

The size of that number surprised even Lavoie, who responded with: “Wow.”

And, Fine continued, “I suspect that the same amount is potentially true in urban areas. But we are so used to the colonialism of hospitals that we’re used to economic energy that often comes from health care being expropriated to other places.”

The Neighborhood Health Station, Fine argued, “is really an opportunity to look at what can happen when you bring health care back to the community, and see it not just as a health enterprise but also as an economic development enterprise.”

Translated, the new Neighborhood Health Station facility benefits the health and well being of the city’s residents, keeping the money spent on health care in Central Falls.

Lavoie believes that the new Neighborhood Health Station will have a major impact on population health for the residents of Central Falls. “We like to think that we’re providing them the gift of good health and good health outcomes. That is what community health centers are really all about.”

As part of the its approach to health care delivery, the health center is expanding its outreach into the community, increasing the number of health coaches working as part the primary care teams, supported through a grant from The Rhode Island Foundation to add health coaches to its primary care teams, in order to promote health behavior change and bridge linguistic and cultural barriers between its medical staff and its patients.

Deploying health coaches within a single clinical enterprise that can instantly produce clinical data on patients, Lavoie explained. “It has potential to have a profound impact on the public health of an entire community that has high levels of poverty, unemployment and poor health outcomes,” he said.

The urgent care center at the new Neighborhood Health Station in Central Falls will also serve as the focal point to develop a partnership with the city of Central Falls’ EMS services, supported by a $35,000 grant from The Rhode Island Foundation.

“These partnerships will help us make sure that EMS is available whenever it is needed, and that Central Falls residents have access to the urgent care and primary care they need,” said Mayor James Diossa.

Central Falls as a future hub of innovation in health care
In the competing narratives around health care, the innovations being created around community health care in Central Falls can literally get lost in translation.

The new Neighborhood Health Station was not mentioned in Gov. Gina Raimondo’s State of the State address. It was not part of the future envisioned by the State Innovation Model project. It awaits a visit from CommerceRI Secretary Stefan Pryor to better understand how Neighborhood Health Stations could become a vibrant economic development model replicated in other Rhode Island communities. It awaits new signage from Central Falls Mayor James Diossa when welcoming people to his city.

But for the residents of Central Falls, it will be become an easy place to find, a facility that becomes an important part of their everyday lives, in walking distance.

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