Serving Patients in Need

FQHCs play a key health care role in the state’s most poverty-stricken neighborhoods.

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When Governor Chris Christie proposed cutting $8 million from clinics that focus on women’s health, he said that, in many ways, these clinics were duplicating the services offered by existing Federally Qualified Health Centers (FQHCs).

What is an FQHC? What do they do and whom do they serve?

I recently spoke with Dr. Pamela Clarke, president and CEO of Newark Community Health Centers Inc., one of the state’s most prominent FQHCs, with five locations in underserved areas in Newark and neighboring communities. The centers serve people who are at least 200 percent below the poverty level and those who are unemployed and have no other access to health care. Services are offered to the uninsured on a sliding fee scale based on income and family size.

FQHCs started in the 1960s as a means of providing access to care for people who did not have the money to go to a doctor. “There are people who have migrated here to the United States, and they live in these concentrated areas, and you will find that in these areas, they don’t have a doctor to go to,” Clarke says. “So FQHCs are located in these areas to provide access to the care they need.”
Newark Community Health Centers Inc. itself was founded in 1986 and has since expanded into East Orange, Orange and Irvington.

The conditions and capabilities of individual FQHCs are largely dependent on how much federal funding they receive, Clarke says. Her own center, “got a $6.4 million grant from the federal government to improve our facilities. So we are going to build a beautiful health center [with 24 exam rooms]. So you will have some health centers that have trailers, but you will have centers that have 24 exam rooms.”

FQHCs face many obstacles, including a lack of primary-care physicians to serve patients in need.
“It is a challenge for all FQHCs,” Clarke says. “New Jersey is very fortunate in that we have teaching hospitals that can produce a lot of doctors, with a lot of them staying in New Jersey and going into private practice or hospitals. FQHCs have a different mix, meaning that the people we serve are so diverse. A doctor will come in one day and have a patient who speaks Portuguese.

They will come in the next and a person will speak Spanish. And then they have that person who cannot come in because they can’t afford it. So in essence we need providers who are culturally sensitive to the diverse number of people they will treat.” But, Clarke adds, “there are not enough of these type of doctors to go around.”

As might be expected, necessity is the mother of invention for these services. Clarke says that FQHCs have gotten more creative by using nurse practitioners and physician assistants to treat patients. However, these professionals are overseen by board-certified doctors who also have their own patients, so that puts a burden on them as well.

Despite the challenges, Clarke says FQHCs have a great impact on the communities they serve. “We have to be there for the patients every day,” she says. “The number of people who come through our door is great, and all the physicians ensure we provide quality service to these patients. So if we can manage their chronic-care illnesses and can reduce them, then we are making people healthier. We are also reducing the costs to hospitals by treating these patients…. Instead of going to the emergency room, they come to us.”

For more information about Newark Community Health Centers Inc., go to nchcfqhc.org.

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