Long before the nationwide epidemic of opioid addiction made headlines, community health centers across the country were witnessing it and confronting it on their doorsteps.
Indeed, the most vexing public health problems, such as addiction or the effects of lead contamination, typically make their first appearance on the front lines of community health centers before being declared a national crisis.'
Health centers are often the “canary in the coal mine” for emerging public health challenges. And in their role as community responders they have become innovators.
For instance, Cornell Scott-Hill Health Center in New Haven, Conn., recently launched a comprehensive model for addiction treatment and pain management in a primary-care setting. Not only does the center operate an inpatient detox center, but a doctor who specializes in addiction medicine works with a psychiatrist to develop an integrated treatment program. The clinicians collaborate in partnership not only to treat addiction, but to target the root causes of it, such as chronic pain or complex mental health disorders.
Another strong example is Dr. Leslie Hayes, who practices at El Centro Family Health in rural and medically underserved Espanola in New Mexico—a state with one of the highest drug overdose rates in the nation. Her passion is working with patients suffering from opioid-use disorders, including pregnant women and new moms. Hayes' center provides women with the support and continuous care to ensure healthy babies. She was recently honored by the White House as a Cham-pion of Change.
Their work reflects the broader calling among clinicians at community health centers to address behavioral health in a primary-care setting. More than 80% of health centers offer substance abuse and/or mental health services. The centers also work with other entities to widen the range of solutions for addiction with services such as counseling, acupuncture, chiropractic and group therapy.
Thanks to federal funding recently released by HHS, 271 health centers in 45 states are developing programs to respond to the opioid abuse and heroin epidemic. The funds will help health centers hire approximately 800 providers to treat nearly 124,000 new patients. It could not come at a more critical time: Seventy-eight Americans a day are dying from opioid overdose, according to the Centers for Disease Control and Prevention. Anti-opioid legislation passed by Congress and signed into law includes resources to boost monitoring for sources of abuse in states and removes barriers to providers so more patients can access medication-assisted treatment. These are important steps, but ending a public health crisis of this scale demands a new way of thinking.
Addiction is a chronic illness that requires a continuum of support services and lifelong management. As problem solvers, health centers understand that addressing such a crisis requires a multitude of interventions anchored in the community. People must have unfettered access to the care and services they need for a sustained recovery. Health centers stand ready to provide those services, but public investment is essential.
Health centers have a long tradition of bipartisan support in Congress. Democratic presidential nominee Hillary Clinton has pushed for an expansion of the Health Center Program, following in the footsteps of former President George W. Bush and President Barack Obama. Their initiatives over the course of the past 16 years have doubled the number of facilities, making it possible for them to serve nearly 25 million people, up from 10 million in 2000. Yet, even such strong bipartisan support for a program is no guarantee for continued funding to strengthen or even maintain their capacity and advance their mission. Without congressional action next year, a crucial funding stream for health centers could expire, bringing with it devastating cuts.
No single silver bullet will eradicate the nationwide problem of addiction. Nevertheless, investing in a proven model such as health centers is a step in the right direction. Health centers have been in the business of improving population health for more than 50 years with community-based solutions that work and save the U.S. healthcare system $24 billion a year.