Community Healthcare Network

The Urban Health Scholars kicked off Friday with a visit to the administrative offices of the Community Healthcare Network where we met with Dorothy Farley, VP of Social Services, and Elizabeth Howell, VP of Development and Public Relations.  The Community Healthcare Network (CHN) was formed in 1981 to strength the administration and management of 12 community based storefront health centers serving the underinsured and uninsured. At the time CHN was formed the centers provided basic family planning services, but they have since grown to provide primary care, mental health and social services in response to the growing needs of the underserved communities they serve.  CHN currently serves over 75,000 people in Manhattan, Queens, Brooklyn and the Bronx.  More than 96 % of CHN patients are people of color, many being immigrants.

Dorothy highlighted that during the development of the clinics into the comprehensive primary health care centers they are today, the clinics were quick to respond to emerging health needs in the community such as the AIDS epidemic and teen pregnancy.  Care and counseling for these health issues was incorporated in the regular flow of clinic visits in an effort to make the patients feel respected and comfortable receiving their care as opposed to ostracized.  Currently, CHN is working tireless to improve the care delivered to transgendered patients.  They are educating their staff around pertinent issues in caring for transgendered patients as well as working to increase health literacy in this population.

Elizabeth emphasized the strong mission that the clinics have to provide culturally competent healthcare and to respond to the needs of the community.  Most of the clinic administration, social workers and nurses are from the community which helps to achieve this mission. However, Dorothy mentioned that there are challenges in finding physicians from the community and they typically rely on hiring physicians from outside who speak the predominant language in the community.  A big challenge that results is that the hired physicians typically on work for 2-3 years as there loans are forgiven and then move onto other work, significantly hampering the ability of the clinics to provide continuity of care to patients.  When hiring for cultural competency, she looks for individuals who are respectful of patients and willing to make mistakes, learn from them, and actively learn more about the community they serve. 

Dorothy also emphasized the importance of team based care and improving health literacy in each of the clinics in meeting the diverse needs of their patients.  Most of the health centers have social workers, dieticians, health coaches and behavioral specialists in addition to physicians, nurses and physician assistants.  Through this team of players the health centers strive to empower patients by improving health literacy.  Health literacy is critical for patients to understand there diagnosis, follow a treatment plan and prevent future illnesses.  A hallmark of a successful health literacy program is to have the patient tell their understanding of their illness and treatment plan to a healthcare provide. CHN practices this in addition to providing clear informative illness brochures as well as access to a patient portal where patients may monitor their health record.

Looking into the future, CHN faces challenges in sustaining financial support for their clinics since over a third of CHN patients are uninsured and 75 % have incomes below the national federal poverty level.  Moreover, the rising rates of mental health illnesses in the communities that CHN serves is a current challenge facing CHN that they are striving to address in a culturally sensitive manner.

The Scholars enjoyed learning about the history of CHN and the ways in which each of the clinics responded to community needs. 

-David Whitehead, UHS Scholar Class of 2017