Community Meeting on Community Health Centers

Wednesday, June 18, 2014 @ 7:00 PM

Jobs with Justice Jamaica Plain Office

3353 Washington Street corner Green

Near Green Street T Station, on Bus Route 42

One Biolab Battle Lost, War Goes On

Led by Roxbury Safety Net and a coalition of labor, peace, religious, legal and scientific experts and activists, the coalition to stop the BU bioterror lab brought this fight to the Boston City Council with the introduction by Councillors Yancey, Jackson and Pressley of an ordinance to ban work in Boston on the most dangerous germs on the planet. On May 14th, that effort was defeated 5-8. Other approaches are being developed while we plan to celebrate twelve years of struggle and our holding those germs at bay for six years.

Health Justice to the Ballot

Two questions on the November 4th ballot relate directly to health care, the Patient Safety Act and the Hospital Profit Transparency & Fairness Act. The former addresses the epidemic of untimely deaths in our acute-care hospitals, as corporatization has transformed them into assembly lines, with unnecessary hospital deaths now the third biggest killer in the country. This act will put a limit on the number of patients a nurse may be made to care for at once, with provision for added staffing as acuity rises. The latter measure would force hospitals that receive taxpayer money to reveal how that money is being used, and it would claw back excess profits and CEO compensation to enhance Medicaid reimbursements to safety-net and community hospitals teetering on the edge.

Affordable Alternative Medicine for the Inner City by Quentin Davis & Richard Mandell

This is the first in a series on the availability and affordability of alternative/holistic medicine in the inner city, with an emphasis on Chinese medicine. Responding in June will be Richard Mandell, licensed acupuncturist, formerly Director of The Dimock Acupuncture Substance-Abuse-Treatment Program, Student Supervisor with The New England School of Acupuncture (NESA), co-owner and practitioner at Roxbury Community Acupuncture, and currently Executive Director of The Global Acupuncture Project. Responding in July will be Beth Sommers, CJ Allen & Anne Drogin.

QD: Thirty years ago, just before the Reagan cutbacks, mention acupuncture to a Roxbury resident and you might get one of two answers: "Quackery!" or "Something that will never, ever be recommended by my doctor or covered by my insurance company, public or private.” What happened in the intervening years? How was progress made toward providing affordable, expert care in Chinese medicine at Boston clinics, and why was that not sustainable? What gains have been made in coverage by MassHealth and private insurers to accredited programs?

RM: At Dimock, acupuncture was first introduced as part of the outpatient substance-abuse treatment program. I believe this was very successful and initially embraced by both staff and administration. In addition, The AIDS Care Project (now part of Pathways to Wellness) had an acupuncture clinic as part of Dimock’s HIV program. Ultimately, I was able to introduce acupuncture to the larger community by getting The New England School of Acupuncture (NESA) to have student clinics at Dimock. This rapidly went from one clinic per week to at least eight. This was a very busy clinic as extremely popular among student interns. When NESA decided to end the student clinics at Dimock, a number of former student supervisors (licensed acupuncturists) decided to create a low-cost/affordable clinic at Dimock. None of these remain in existence. In no case was the closure due to lack of public (patient/client) interest. NESA pulled out due to its own internal decision making, including their dislike of the space in which the clinics took place. I believe that in the other cases, closure was ultimately due to Dimock’s inability and/or lack of desire to truly integrate acupuncture into the health center. Sometimes closure resulted when there was a change in staff, and because of this lack of integration there was little motivation for the new staff member to support the use of acupuncture. MassHealth (including DPH) always supported the use of acupuncture in substance-abuse treatment. I believe there have been some recent changes that will include support of acupuncture in a more general way; other responses in this article will have more details. Insurance coverage remains spotty, and its use rather labor intensive.

QD: Were you personally involved? What would you say was the main barrier to affordable care at the clinic/community health center where you practiced - e.g. mold, unwillingness of interns to travel to the inner city, administrative blundering, or overall cost of the program?

RM: Much of this I answered in the question above. The space in which the student clinics at DImock as well as the low-cost treatment clinic took place was somewhat problematic. Mold was an ongoing issue due to the fact that it was in the basement and there was periodic flooding. But there was not a lack of practitioners/student interns. DImock administration seemed always to be putting out fires related to the whole facility, and acupuncture always remained at the bottom of priorities. In my opinion, it was not a cost issue at all. It’s more of being able to see the larger picture.

QD: Why did some of you persist in this effort, aside from belief in the efficacy of the methods? Plenty of people outside the inner city want acupuncture and are willing to pay dearly for it.

RM: My professional life has really been about increasing access to acupuncture. Be it here in the Boston area, in Uganda, or in Mexico, I have felt that everyone deserves access to an effective, cost-effective form of medicine. Even my practice in Brookline focuses on making it affordable to everyone, not just those with financial means. On a very personal level, I really began my professional life as an acupuncturist at Dimock, and I also learned a great deal from all of my patients. I see myself as part of the community.

QD: Are clinics like Pathways to Wellness meeting a need which should be covered by public insurance? What gains have been made? What remains to be done?

RM: I would say that community acupuncture clinics are meeting the need of more people, offering affordable treatments on a sliding scale. Given that the insurance industry continues to be inefficient and profit, rather than people, oriented, I have never felt that struggling to get broader insurance coverage is the answer. If we had universal, single-payer insurance, then I would certainly push for the inclusion of acupuncture. In general, acupuncture is inexpensive. As I mentioned above, my experience has been that the issue is not cost but acceptance. (I will also add that health centers do sometimes have real space issues; however, the community-style approach lessens the negative impact of this.) Administrators need to gain a more holistic view of health and wellbeing, and see that the inclusion of acupuncture draws patients to health centers and aids with compliance to all interventions.

QD: If community health centers were not subject to sequestration cutbacks or to closings such as at Martha Eliot (adult) and RoxComp, could the benefits of acupuncture and Chinese herbal medicine be enjoyed by ever increasing numbers of citizens in Roxbury, Dorchester and the South End? Has word of mouth created a strong market for affordable alternative/holistic care, including acupuncture and Chinese herbal medicine?

RM: Again, I feel that administrators (as well as other biomedical providers) need to view the inclusion of acupuncture as a plus rather than a burden. I also think that funders (public and private) need to embrace the fact that helping to keep people healthier (preventive and holistic) brings down total costs. Yes, word of mouth continues to contribute significantly to the market

What is Healthcare Justice?

• Access: Can you get the care you need?
• Affordability: Will you go bankrupt if you do?
• Quality: Will you survive your encounter?
• Equality: Do you meet special barriers to care?

Directory:

For more information on campaigns to make health care a right, not a commodity:

Mass-Care
Healthcare NOW!
Labor Campaign for Single Payer

For help navigating the current system:

Boston Mayor’s HealthLine @ 617-534-5050

Health Care For All - Massachusetts
Consumer Health HelpLine @ 800-272-4232

Massachusetts Health Connector
Customer Support @ 877-623-6765

Sponsor: Boston Ad Hoc Committee for Healthcare Justice

For more information, contact:

Quentin Davis @ 617-553-2949 or davisquestin@gmail.com
Sandy Eaton @ 617-510-6496 or sandyern@comcast.net

Health Justice for Boston is archived on Seachange Bulletin.