Delivery of Care

The bricks and mortar of a new model of health care delivery emerges

RI's first Neighborhood Health Station takes shape with the purchase of an urgent care center in Central Falls

Photo by Scott Kingsley

Edward Schottland, president of Memorial Hospital, Sara Perry, Central Falls Practice Manager at Blackstone Community Health Care, and Central Falls Mayor James Diossa, three of the collaborators in creation of a new student health clinic at Central Falls High School, the first step taken in launching a Neighborhood Health Station in the square-mile city.

By Richard Asinof
Posted 5/18/15
The creation of a bricks-and-mortar Neighborhood Health Station in Central Falls, the first of its kind in Rhode Island, as a new kind of collaborative approach to health care delivery at the neighborhood level, is a remarkable achievement. Its success may prove to be the beginning of a new wave of similar community facilities.
How will the State Innovation Model’s plan adopt and integrate the new Neighborhood Health Station in Central Falls as part of its vision? What kinds of new research analytics can be employed in a nimble fashion to build an interactive presence at the new Neighborhood Health Station? When will Providence look to create a similar Neighborhood Health Station model as part of its ongoing sustainability and economic development plans? What can the working group to reinvent Medicaid learn from the collaborative approach to neighborhood health care? What kinds of shared savings program can be implemented to support this kind of innovative approach to health care delivery by insurance companies and managed care programs under Medicaid and Medicare?
Health care innovation as a critical factor in the state’s future economic development is a huge omission in the current economic plans being marketed by Gov. Gina Raimondo and Stefan Pryor. The top industry sector for recent Rhode Island graduates from RIC, CCRI and URI working in Rhode Island is health care, more than triple the other sectors, according to a recent Providence Plan DataHub story. Further, projected employment will increase by some 14,000 between 2012 and 2020, according to statistics published in April of this year by the R.I. Department of Labor and Training, with the average annual wage between $30,000 and $60,000. Without a mapping of health care innovation in Rhode Island, the Raimondo administration’s plan for future economic development is swinging and missing badly where the demand for future job growth will be.

CENTRAL FALLS – Did you hear what happened on Friday? Rhode Island took another giant step in the creation of the first-ever Neighborhood Health Station in the state, promising to change the way that health care is delivered.

The significance of that news – a sea change in one of the state’s largest industry sectors – was swallowed up by the swirl of everyday events: shootings, death penalty verdicts, train derailments, Volvo races, baseball stadiums, drone strikes, drug busts, basketball and hockey playoffs, proms, and graduations.

It’s hard to compete with the attention deficit disorder-driven 24/7 news cycle where death, mayhem and fear often dictate the headlines. It’s even harder to capture the import of an evolutionary change that has occurred over a two-year time period.

Particularly, when it’s good news – and when it’s centered on Central Falls, the square-mile city that has all too often served as the poster child for what can go wrong in an urban community.

But the acquisition by Blackstone Valley Community Health Care of the Notre Dame Ambulatory Center at 100 Broad St. in Central Falls, from Memorial Hospital, for $720,000, is big, big news for Rhode Island’s health care delivery system.

Some of the details were covered in brief news blips and stories, rewriting the news release that was issued on Friday, May 14:

Blackstone Valley plans to invest some $5 million in renovating the facility, which will include a new dental suite of offices, made possible through a grant by Delta Dental of Rhode Island.

The new 27,100 square-foot facility will be home to Blackstone Valley’s primary care services now located at 9 Chestnut St. in Central Falls, accommodating an additional 6,000 new patients annually, more than doubling the current number of patients of 4,560 now being seen.

Blackstone Valley will be hiring another 11 clinicians to its staff, including physicians, OB/GYN providers, dentists, hygienists and clinical social workers.

The quotes in the news release previewed some of the changes underway to develop a collaborative approach to community health care.

“The long-term vision for the building will be to create a place where 90 percent of the health and wellness needs of the community can be met,” said Raymond Lavoie, executive director of Blackstone Valley.

“Memorial Hospital is committed to providing access to quality health care and wellness programs in the community and this visionary move exemplifies that commitment,” said Edward Schottland, Memorial Hospital president and COO.

“This announcement is great news for Central Falls,” said Central Falls Mayor James Diossa, praising the investment by Memorial Hospital and Blackstone Valley, and saying that he was looking forward to collaborating with Lavoie, Schottland and Dr. Michael Fine, the former director of the R.I. Department of Health and a champion of Neighborhood Health Stations.

The stories converge
There are five distinct story lines that converge in the creation of Rhode Island’s first Neighborhood Health Station, all of them reported on in detail by ConvergenceRI during the last 21 months [and most of them not covered by traditional news media].

The first is the concept of Neighborhood Health Stations, championed by Dr. Michael Fine, as a way to transform the delivery of health care in Rhode Island, promoting a vision of community facilities throughout the state, focused on primary care and health and wellness. The battle of whether or not to include the concept of Neighborhood Health Stations within in the architecture of the $20 million State Innovation Model plans was lost in heated political turf struggles with state bureaucrats in the summer of 2014. Ironically, the bricks-and-mortar plans for a Neighborhood Health Station in Central Falls have emerged despite the SIM plan snub – and the resignation by Fine in the first months of the new Raimondo administration. [See links to Convergence stories below.]

The second is the excellence of Blackstone Valley Community Health Care and its innovative operations as a community health center. Through the sophisticated use of health IT at the point of care, it has bent the medical cost curve by about $3 million a year during the last four years, through a patient-centered team approach, all the while serving the economically challenged populations of Pawtucket and Central Falls. Its model of community health care was showcased in December of 2014 by the new master’s program in executive healthcare at Brown University. By building out its own health information exchange and investing in health IT, it has raised the bar for what federally qualified community health centers can achieve. The pilot programs for community health teams in South County and in Pawtucket and Central Falls, being run by the Care Transformation Collaborative, are employing health IT systems through Blackstone Valley. [See links to ConvergenceRI stories below.]

The third is the way that health care reform in Rhode Island has embraced a collaborative approach in training future physicians and nurses, with a focus on primary care, family and community. The underlying premise is that medicine and health are much bigger than what happens in the doctor’s office. That approach has been endorsed by the leadership at the Department of Family Medicine at Memorial Hospital and the Alpert Medical School at Brown University. It has also been the focus of a series of programs underwritten by the R.I. Department of Health promoting community and neighborhood health, most recently in the establishment of 11 Health Equity Zones throughout Rhode Island. [See links to ConvergenceRI stories below.]

The fourth is the willingness of Central Falls – the mayor’s office, the school department, and the city’s economic development and planning department – to promote a new vision of the city that puts health and wellness of the community as an economic imperative. As a result, a new collaborative school health clinic at Central Falls High School opened in October of 2014, and new kind of school discipline program, known as youth restoration, that was inaugurated under retiring superintendent Frances Gallo. [See links to ConvergenceRI stories below.]

The fifth is a new kind of leadership that has emerged within the Rhode Island’s health care delivery system, willing to wrestle with the need to challenge and change the status quo. Louis Giancolo, president and CEO of South County Hospital, has doubled down on his investment in community after considering – and rejecting – potential alignments with larger hospital systems. Dennis Keefe, president and CEO of Care New England, has often pushed the agenda for a collaborative strategy with health insurers and other hospitals. Brown University has moved quickly to invest in the creation of the School of Public Health and its new Master’s program in health care leadership. [See links to ConvergenceRI stories below.]

What’s still missing from the equation
There are many other parts to the jigsaw puzzle of health care delivery in Rhode Island that are either missing or in the midst of changing their shape, and conversations that need to collide, converge and intersect to create a better understanding of the landscape for health innovation in Rhode Island.

•   The role of nursing and nursing education.

•   The expansion of home visitation and nurse family partnership programs.

•   The renewed investments in early childhood education and all-day kindergarten.

•   The development of new initiatives around the diagnosis and treatment of toxic stress.

•   The expansion of evidence-based research to document successful interventions in early childhood learning and nutrition at the community level.

•   The integration of green and healthy homes as a key strategy of community health.

•   The support for full integration of innovative work of peer-based recovery coaching and recovery housing programs.

•   The recognition that the path to economic opportunity begins at the front door of homes in a healthy community.

•   The recognition of how the patients’ voice and the development of mobile device apps will change the conversation around health care.

•   The willingness to invest more resources in the increasing need for comprehensive care for seniors as the demographics shift toward a growing “old old” population in Rhode Island.

The new political reality
In a health care world where reinvention is the name of the game – the reinvention of Medicaid, the new statewide compact to move toward Accountable Care Organizations and away from fee-for-service as a business model, the development of tiered insurance products as a way to market care through hospital systems, the adoption and implementation of health IT systems that will capture population health analytics across a continuum of care, the expansion of patient-centered medical homes under the Care Transformation Collaborative, and the rapid growth of retail care clinics by large consumer stores – the creation of Rhode Island’s first Neighborhood Health Station in Central Falls stands out as an important marker, testing a new kind of 21st century health care delivery.

More than just a new political reality, it is also an emerging economic fact, one that promises to redefine the landscape. It is a story that will continue to evolve. Stay tuned.

© | subscribe | contact us | report problem | About | Advertise

powered by creative circle media solutions

Join the conversation

Want to get ConvergenceRI
in your inbox every Monday?

Type of subscription (choose one):

We will contact you with subscription details.

Thank you for subscribing!

We will contact you shortly with subscription details.