Thanks @NEJM for sharing a call to action to fund community health centers Margaret Hayden and I drafted. COVID has hit CHCs hard, and it’s time for Congress to act. If you agree CHCs are critical, please tweet at your Rep/Senators!
nejm.org/doi/full/10.10…
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nejm.org/doi/full/10.10…
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2/ For background: CHCs are federally funded clinics that provide *universal* (all welcome regardless of insurance/immigration status), *comprehensive* (primary care/BH/vision/dental) and *accountable* (>50% of board must be pts) care.
3/They are on the frontlines for low income & Black/Brown folk. 70% pts have incomes below FPL, more than half are racial/ethnic minorities per @NACHC. Orgs that have pioneered care for homeless individuals, like @BHCHP, are CHCs. @michellemorse @marybassett @jessiegaeta 
4/ We’ve witnessed the magic at Upham’s Corner in Boston. At their best, CHCs are spaces of listening, healing, and organizing. They embody, as Cornel West said, justice as “love in public”.
5/ But right now, CHCs are struggling. COVID has slashed office visits, which clinics rely on - revenues are way down, many staff remain furloughed, ~15% sites temp closed. Telemed helping, but margins already razor-thin to begin with. @NACHC @MassLeague @FamiliesUSA
6/ This is ironic b/c CHCs have been critical to our COVID response. 90% are testing sites, most tested are people of color, w/ higher test positive ratio than natl avg per @KFF. kff.org/coronavirus-co…
@sarahkliff @JuliaLMarcus @choo_ek @ashishkjha @ASlavitt @AbraarKaran
@sarahkliff @JuliaLMarcus @choo_ek @ashishkjha @ASlavitt @AbraarKaran
7/ As residents, we’re scared we may lose our ability to practice at CHCs if they go under. Feel like we’re learning what radical love can look like. That underlying each dx of diabetes or depression is an affirmation of dignity. @MubeenShakir @DarshaliVyas
8/ Working in CHCs isn’t always easy - many understaffed, rely on heroic effort of nurses in particular. But that’s *by design*. The Community Health Center Fund (provides ~20% revenue to CHCs, more in non-expansion states) only renewed for months at a time, expires in Fall.
9/ CHCs live in constant uncertainty. Hard to run a high functioning system if you can’t plan, hire, build systems. But, it doesn’t have to be this way. @atychen @vivek_murthy @leoeisenstein @colleenfarrell
10/ We’re living in the dawn of a new America. As we reimagine a moral health system, we should look to CHCs for the blueprint; they are the closest we have to a preferential option for the poor. @gregggonsalves @amykapczynski @donberwick @doctorsforamerica @davechokshi
11/ If we really believe that #BlackLivesMatter, then we should center CHCs as the foundation of an antiracist system and give them the staff, space, stuff, and systems to do right by patients. @ucheblackstock @oniblackstock @cameronnutt
12/ We need to follow the lead of @AyannaPressley, @ewarren, & @SenSanders and fund CHCs. We need emergency funding & long-term reauthorization of the CHCF, and we need it now. We need to invest in CHCs in every PCP shortage area nationally. @justicedems @DoctorsForBiden
13/ We also need to cover all those uninsured now. We should look to bills proposed by @pramilajayapal to make that happen in short-term, and we should fight for #MedicareForAll @micah_johnson_ @AbdulElSayed @rgunns @PNHP @awgaffney @swoolhandler
14/ So grateful to the nurses, doctors, interpreters, MAs, staff, leadership, and of course, patients at Upham’s. Privilege to learn from mentors @AyrenneAdamsMD @hallierozansky @DrWilfredoM @laurenmalish @davidasanchezmd @PoojaRRaval + whole team.
15/ Special thanks to bro @sandeep_kishore + sister Biva for helping us reflect and inspiring us always. END
