John Snow, Inc. - Day in the Life - Community Health Centers in the United States

Community Health Centers in the United States

Expanding the Power of Community Health Centers in Rural Indiana

Photo of Pat Fairchild Pat Fairchild
Vice President
JSI employee since January, 1979

Today I'm visiting the Edinburgh/Trafalgar Family Health Center, which operates two health centers in rural communities south of Indianapolis, Indiana, the 12th largest city in the United States. We are preparing a major grant application for federal funding. Besides providing money to expand services for people without health insurance, the grant will bring Edinburgh/Trafalgar into a national network of community-based health care facilities and increase the reimbursements it can receive from the national Medicaid program.

Louise Neufelder and Marc Hackett at the new Edinburgh Family Health Center

The U.S. has some of the best health care in the world, but not everyone has access to it. We lack universal health coverage, and many people live too far from health services they need. In a growing number of communities, local health centers are the safety net. As many as 11 million people use these facilities for their primary health care, and JSI has been a part of this movement since our beginning.

The Johnson Memorial Hospital created the Trafalgar Health Center in 1996 so rural patients would not have to drive a long way for primary care. Louise Neufelder, VP for Patient Care Services, and Marc Hackett, the Practice Manager for Edinburgh/Trafalgar, welcome me at the hospital and we get started. The grant application demands a lot of thought. We must identify the community's biggest health problems and provide a plan for attacking each of them. In this part of rural Indiana, disproportionate numbers of people live with chronic illnesses such as diabetes and coronary disease. The community has high prevalence of obesity and tobacco use rates, which contribute to these illnesses. The health centers bring prevention and services much closer to the people who need them.

Community health centers have been a critical component of the United States health system for more than 30 years, providing high-quality, culturally appropriate, and affordable health services to the country's medically under served and uninsured residents. Today, a national network of more than 825 federally funded Community Health Centers operates 3400 primary care delivery sites in urban and rural communities throughout the country, making health care accessible for more than 11.5 million patients each year.

JSI has been working with community health centers since our earliest days, helping them improve operational efficiency and quality, assisting with strategic planning and program development and working with communities to develop new health centers. We are committed to continuing our work with health centers so we can help improve access to health care for everyone in the U.S.

Louise, Marc, and I jot down activities that federal funding could support, including expansion of medical staff at both of the sites. We discuss a strategy for adding more consumers to the Edinburgh/Trafalgar board of directors, a requirement of the grant. I'm excited to see Louise and Marc's commitment to their health centers and their enthusiasm about working hard for this grant.

Next, Marc drives me to the Edinburgh Family Health Center. The brand-new facility sits among green lawns, on land purchased with the help of state funds - it's clear that Indiana's state government sees value in community-based health care. The staff are friendly, the offices very attractive and efficiently organized.

After lunch, we head for the Trafalgar Health Center - and Marc's car breaks down. We are towed to a small auto repair shop, whose owner gets us back on the road. This incident reinforces how much rural people depend on their cars, a key reason to bring health care closer to where people live.

Travel problems have been a theme on this trip. Yesterday, I awoke at 5 am for my flight from Logan Airport, which was cancelled. By late afternoon, I was finally leaving the Indianapolis airport in a rental car, only to find the highway I needed closed due to a multiple-car accident. Picking my way south on back streets, map in hand, I then had to stop for a while as a long, long freight train crossed the road.

The abbreviated visit to Trafalgar is all I have time for today. Back at the airport, it is no surprise to find my flight home has been cancelled. Plenty of time to reflect on what I've seen today - a community's pride in and respect for their local health care resource.