U.S. health secretary emphasizes importance of health clinics for the underserved

Some of the best medical practices occur at community health centers, U.S. Secretary of Health and Human Services Kathleen Sebelius told a group of community health center-affiliated doctors, healthcare professionals, patients and clinic officials at the Eisner Pediatric and Family Medical Center in Downtown Los Angeles on Monday morning.

Sebelius was announcing that the National Health Service Corps' Students to Service Loan Program -- which provides financial support to fourth-year medical students who are committed to a career in primary care, in exchange for their service in underserved communities -- had awarded $9.1 million to fund such students in 30 states and Washington, D.C.

The health secretary also led a panel discussion on the importance of community health clinics, calling them a "framework of healthcare in the most underserved areas and rural communities that's just critical."

"[A] critically important piece of this puzzle [is] a renewal of American values," said Sebelius. "[That's] an ongoing promise we make with our citizens that if you work hard, you should be able to raise a family, own a home, put away a little for retirement -- and be protected from losing it all if you or your family gets sick." To achieve that renewal, she continued, "we really need a healthcare system that gives healthcare access to all Americans, no matter where they live."

In a place like South Los Angeles, that's no small challenge. Sebelius said 60 million Americans live in communities with a shortage of primary care providers. Of those, 3.4 million live in California. The personnel provided by the National Health Service Corps helps, she told OnCentral, but the "real promise" is going to be in 2014's federal healthcare mandate.

"[In] 2014, a lot of the patients who are now being seen [with] no insurance coverage at all, no financing, will suddenly have the power to pay for some or all of their care," she explained. That means clinics will be able to move from "a totally charitably-funded operation into more of a business proposition going forward."

"If suddenly the patient load becomes a bit more self-sustaining, then it becomes a whole different model," Sebelius said. "And I think that's really the promise of what's out there.

"Some of the best practices are here at community health centers," she added.

Yasser Aman is the president and CEO of one of those centers -- UMMA Clinic, on West Florence Avenue. He said the incentives provided by arrangements like the Students to Service Loan Program are critical.

"In many places, in underserved areas, there are significant workforce gaps around actual health providers," he said. "Specifically in South Los Angeles, where there is really no other incentive other than doing work in the community economically, to serve in the community, these incentives that are provided by loan repayments and so forth are very, very crucial for recruitment for clinics like [those] in South L.A. or in other parts of the county."

Aman said that community health clinics are in the midst of an evaluation of sorts -- of what their image and role is in the communities they serve, and how that will change after 2014's mandate. "Community health centers working in underserved communities, historically, are often the last place for most patients who have no place else to go," he said. "For many decades, that has been a comfortable place for health centers. I think with health reform and an increase in people who have actual access to care, [we're looking at] how do we retain our patients, how do we go above and beyond what our patents have depended on -- the local community clinic."

Sebelius acknowledged some of the healthcare-related struggles faced by residents of South Los Angeles, pointing to a better scenario a couple years down the road. "Some of the clients who are in South L.A. are likely to be the so-called 'dual-eligible': the poorest, oldest citizens," she said. "And there is a lot of work underway to look at the health needs of those poor, elderly citizens to make sure that their only option isn't to be shipped off to a nursing home which is where they don't want to end up. … I think [there are] also a lot of families whose children may qualify for children's health insurance [but the rest of the family] doesn't qualify. The promise of 34 million Americans by 2014 having a full access to healthcare benefits, a full way to pay for things … that's a whole new day on the horizon."

Until then, Sebelius said her federal department is going to try to "fill some of the gaps," in addition to beginning some major outreach efforts, "to say to people particularly in the most underserved areas -- here's what's coming. Here's what you can begin to think about. Here's how you're going to qualify. Here are the outreach efforts, to make sure that people actually know there are some benefits headed their way."

photo credit: José Martinez/KPCC