Navigating Healthcare

By Diane L. Marolla, LICSW

“Look, if you have somebody who doesn’t have health insurance, who doesn’t have a doctor or dentist, and to deal with their cold or flu or dental problem, they go to an emergency room – in general, that visit will cost ten times more than walking into a community health center.” Bernie Sanders

Rarely, a week will go by, without someone contacting me about where they can get affordable, quality, healthcare. Usually the phone call or email is about purchasing affordable health insurance or how to afford healthcare costs with a high deductible/high co-pay health plan. Sometimes the call or the email is from someone who cannot afford health insurance so they opt to go without it. When I receive these emails or phone calls, I always do my due diligence in guiding the individual to where they can get information to make the best decision for themselves. More often than not, individuals are hopeful that I have some easy, quick fix, affordable answer for them. Unfortunately, I do not. I always use the discussion as an opportunity to teach someone about our healthcare system and how important it is for them to understand all aspects of healthcare. Although the passage of the Affordable Care Act (Obamacare) attempted to fix all of the problems with healthcare affordability and accessibility, it did not. Americans still struggle with getting affordable healthcare. Medical bills remain the leading cause of bankruptcy in the United States. Healthcare premiums continue to go up year after year, employers continue to struggle to offer healthcare to their employees, the cost of prescription drugs are out of control, and our elected officials in Washington continue to fight and play politics without finding a reasonable solution for the healthcare debacle.

Thankfully, despite all the challenges with healthcare, we still have our community based health centers or as they are formally called Federally Qualified Community Health Centers (FQHC’s) here locally (and nationally) serving every patient or client that walks in their door regardless of their ability to pay. Established by the Health Resources and Services Administration (HRSA) under the Bureau of Healthcare, FQHC’s, were established to target the uninsured, low income, and “at risk” populations. As the underinsured and noninsured populations have grown, FQHC’s have further evolved. They offer primary care medical, dental and behavioral health services. Additionally, they offer social services and serve patients and clients from birth to their senior years.

It was in the mid 2000’s, while working for a local health insurance company, that I first learned about our local community health centers. Up until that time, I was unaware of their existence since my years of experience in healthcare were working in a hospital. I was impressed by their model of care where it was “one stop shopping” for a patient and their families as patients and clients receive primary care, mental health/ substance abuse, and dental care in one location. In addition to health care services, I was equally impressed how patients and clients were able to access services such as: energy assistance and weatherization programs, food pantries, health education workshops, and programs for women, children and seniors.

Today, our local health centers remain a critical part of our community in the delivery of quality, affordable primary care. They have all upgraded their physical infrastructures to offer state of the art facilities to their patients and clients. Recently, I have been working closely with East Bay Community Action Program. I spoke with Stephanie McCaffrey, Vice President of Health Administration and Chief Strategy Officer from East Bay Community Action. According to Stephanie, “health centers enjoy national certifications that other practices may not have (National Commission on Quality Assurance Level 3 (NCQA), and the Joint Commission).” “We have board certified clinicians and offer rigorous training for our clinical staff.” Stephanie goes on to say that health centers work closely with the local health insurance companies “to provide high quality of care, maximize efficiency, and to reduce the total cost of care.”

According to the Center for Healthcare Research & Transformation, “only eight health centers existed in the 1960’s.” Now, according to the National Association of Community Health Centers, the United States has over “1400 health centers with 11,000 locations.”

In RI, we have nine FQHC’s that serve over 170,000 residents in RI:

Blackstone Valley Community Health Care – Pawtucket
Block Island Health Services – Block Island
CCAP/Family Health Services – Cranston
East Bay Community Action Program – Newport
Providence Community Health Centers – Providence
Thundermist Health Center – Woonsocket
Tritown Community Action Agency – Johnston
Well One Primary Medical Dental Care – Pascoag
Wood River Health Services – Hope Valley

Each of our FQHC’s have multiple locations in the communities they serve. For example, East Bay Community Action Program serves primarily the East Bay community with multiple offices conveniently located in Newport, East Providence, and Barrington. East Bay Community Action Program , “gladly accepts all patients regardless of their ability to pay.” They do, take all of the major health insurances, but will assist patients with sliding fee schedules and payment plans should a patient have a high deductible/co-pay health plan. Recently, I took advantage of the lab services East Bay Community Action Program has available. I was carrying around my lab orders from my Primary Care Physician (PCP) for months never being able to find the time to have my blood drawn. I gave them my insurance card, had my blood drawn, and I was good to go.

What struck me when I first learned about health centers, then and now, is that our local health centers have never strayed away from their mission of serving their communities. The staff that they employ are often part of the communities they serve, so when you seek care or services, you immediately feel that you are a person and not a number, and that you and your family are genuinely cared about. Their clinicians and staff will gladly assist anyone who is having difficulty accessing, paying for, or navigating healthcare. If a patient does require specialty care, through the extensive network of community provider relationships they have developed, they will make necessary referrals and work together with specialty providers in the coordination of the patients care.

I highly encourage all Rhode Islanders to become familiar with their local health centers. Additionally, our health centers look for volunteers and donations, so I encourage you to support them should you be looking for an opportunity to serve your community.

For more information re: Rhode Island’s Federally Qualified Health Centers, please call The Rhode Island Health Center Association at 401-274-1771 or visit their website at