The Paid Leave Podcast

Why More Than 1 out of 8 Residents Use Community Health Centers for Care.

• The Connecticut Paid Leave Authority • Season 3 • Episode 22

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August 4 through august 10th is National Health Center week. Deb Polun serves as the Chief Strategy officer at the Community Health Center Association of Connecticut known as (CHC/-ACT). It is the statewide association that supports the work of Connecticut’s Community Health Centers, which provide primary medical, dental, and behavioral healthcare to 420,000 people across CT each year. In her role, Deb provides leadership on public policy and advocacy, helps build and strengthen community and corporate relationships, and helps plan for a sustainable community health center network. Deb says that Community Health Centers are beautiful buildings that offer quality health care whether you have insurance or not.
Deb also realizes that CT Paid Leave can benefit her employees and the people they serve t the Community Health Centers with income replacement during a serious health crisis. The program ensures they can take care of themselves without having to worry about paying bills.

To find a Community Health Center near you please go to: Community Health Center Association of Connecticut | CHC/ACT (chcact.org)

To apply for benefits or for more information please go to: CT Paid Leave

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Nancy Barrow:

Hello Connecticut, and welcome to The Paid Leave Podcast. The title basically says it all. I'm Nancy Barrow, and I will be delving into this new state program and how it can help you and your family. This podcast will give you information you should know about Connecticut Paid Leave and maybe just a little bit more Connecticut paid leave brings peace of mind to your home, family and workplace. Welcome to The Paid Leave Podcast. August 4 through August 10 is National Health Center week. Deb Polun serves as the chief strategy officer at the Community Health Center Association of Connecticut, known as CHC Act, it's the statewide association that supports the work of Connecticut's Community Health Centers, which provides primary medical, dental and behavioral health care to over 420,000 people across Connecticut every year. And in her role, Deb provides leadership on public policy and advocacy and helps build and strengthen community and corporate relationships and helps plan for a Sustainable Community Health Center Network. Deb and her husband live in West Hartford, and she's also a local elected official. Welcome to the paid leave podcast. Deb, thank you so much. Nancy, it's so nice to have you here. So how many community health centers are around the state?

Deb Polun:

We have 17 Community Health Center organizations in Connecticut. They each have multiple sites, so there are actually hundreds of access sites. Oh, through the 17 community health centers across Connecticut, are there different locations? Yep. So they have different locations, and they also have locations set up in schools. So these are called school based health centers, and most of our community health centers do partner with the local schools so that kids can go in, either on their lunch or during study hall and have primary medical or behavioral health or sometimes dental services. And it is convenient for both the children, but also for their parents, who now don't have to leave work, pick them up, bring them to an appointment, bring them back and then go back to work. Community health centers have actually been around for 60 years, and there are 1400 of them across the country, 17 here in Connecticut.

Nancy Barrow:

So tell me about the Community Health Center Association of Connecticut. Like, what do you do and who are the people that you serve?

Deb Polun:

We are essentially the trade association, the statewide association that works with the community health centers. So we don't provide any direct health care at CHC act, what we do is we help them do what they do better. We provide training and technical assistance on things like clinical operations, their finance back office, things like HR, IT operations to help them provide care in the very best way possible, in the most efficient way possible, and in the highest quality way so people all across the state can access health care in a variety of locations and get the very best health care. They're all each independent nonprofit organizations, and we also are an independent nonprofit organization.

Nancy Barrow:

How do you make How do you well, then how do you make money to make it run? That's that's hard, because healthcare is expensive.

Deb Polun:

Healthcare is expensive, yeah. So CHC Act has a board of directors. Our board is actually the leaders of each of the health centers around the state, brilliant. And so they come together and they help guide us. We are, unlike most trade associations, we are mostly grant funded. So we actually receive a grant from the federal government to provide this training and technical assistance. Every state has an organization like we do that supports the community health centers in their state. So we have that funding. And then we have a variety of other funding sources, including federal and state agencies, as well as some private organizations that fund the work that we do. Ultimately, what's most important is the work that's being done in the health centers all around the state, providing health care to people who may not have access anywhere else.

Nancy Barrow:

Right? So, so tell me about the community health centers. What about the people that go there, and if they don't have insurance, can they still go there?

Deb Polun:

Yes, that is an excellent question. And as you mentioned in the intro, 420,000 patients across the state. That's one in every eight residents of our state. We have community health centers in every corner of the state, from way up in north Canaan in the northwest corner, down to New London, up through Putnam and Killingly in the northeast corner, and all the way down in Greenwich and all across the state, in the big cities, Rural areas and in suburbs, we serve everybody who needs care. So if you have a commercial health insurance plan, if you have Medicare, if you're on Medicaid, or what we call Husky here in Connecticut, or if you have no health insurance at all, you will not be turned away from a community health center. So how it works is, when you go in to receive care or you make an appointment, you either show your insurance and we bill your insurance, or if you don't have insurance, then you are served on a sliding fee scale. Based on your income level.

Nancy Barrow:

I gotcha. So it's, it works for people who are lower income, really? It that's an important faction, right?

Deb Polun:

It is. And actually most of our patients are low income, although you absolutely do not have to be.

Nancy Barrow:

Yeah, there seems to be, when I was introducing you, a recurring theme of community service in your business life and in you as an elected official, did you know you be doing this kind of work Deb?

Deb Polun:

I did not. You know my husband is a school principal, and he has known for most of his life that he wanted to go into education. He became a teacher right out of college. He taught for 17 years and then moved into administration. I, on the other hand, really had no idea what I wanted to do, and I sort of fell into public policy work. About 26 years ago, started working at the state Capitol building, learned about health care. I didn't have an academic background in health care policy, and my career has just sort of gone from there. Yeah, I'm also, as you pointed out, an elected official, and I believe very strongly in serving your community and whatever way works for you, whether that's volunteering or serving on a local board of directors for a nonprofit, or running for office or educating voters, whatever way is best suited to somebody's passions, I truly believe that getting involved in your community is a very impactful way to help support your own personal development and feel good about your space in in the world.

Nancy Barrow:

Are there any particular stories that stick In your mind about helping people that has sustained you throughout this work?

Deb Polun:

I would say that in the beginning of my professional career, working at the state capitol, we I had the opportunity to work with many state legislators on policies that have impacted a lot of people in our state, from Developing the Patient's Bill of Rights, helping to write the legislation that created our Office of health care advocate, and then, through my career and even working in nonprofits, having the implementation of the Affordable Care Act that has really impacted so many people who may not otherwise be able to get health care, and has also brought in Some changes as far as how healthcare is delivered, towards a focus more on quality and value and less on just getting people in and out. Yeah, right, yeah. So those things have been really important to sustaining my passion and healthcare policy, being able to see these changes and how they impact people in the real world.

Nancy Barrow:

And that is that what your public policy and advocacy is now?

Deb Polun:

We do we do state advocacy and also on the national level as well, because we want to make sure that community health centers, which have been around for 60 years, are still here 60 years from now, yeah. And as you pointed out earlier, health care is really expensive. It's expensive to deliver, and the reimbursement rates from Medicaid and from insurance are not always as high as they ought to be, yeah. And so it's a challenge. It really is a challenge to continue to provide the services that people need and deserve, but it is essential to ensuring that individuals live their best lives and also contribute to making Connecticut a healthy state now and into the future. What is your biggest challenge? The biggest challenge is reimbursement rates. For sure, about 60% of community health center patients are on Medicaid, and so the Medicaid reimbursement rates are the number one driving factor in being able to keep the doors open for community health centers and being able to provide services to all who need them. Yeah, so we've done some research. We know every time a Medicaid patient walks into a community health center in Connecticut and gets a medical visit, that Community Health Center is losing, on average $85 Wow, every time they get a dental service, the Community Health Center is losing, on average, $121 so how do we continue to provide these services and employ our valued health care staff, dental staff, behavioral health staff And the other people who help to keep the facilities up and running. Sure, administrative, yeah, your administrative staff, your your reception desk, people, billing, etc. It's really, really important that people understand policymakers, understand the Medicaid rates and how impactful they are for community health centers.

Nancy Barrow:

And as Chief Strategy Officer, what are some of your initiatives and goals for the community health centers? Like, is there something personal that you would like to do or that you're looking at in your job capacity?

Deb Polun:

Yes. I mean, in addition to all the advocacy work that we just talked about, we're also looking at ways that health. Centers can be more efficient. Maybe share services, whether it's through group purchasing or even we are creating partnerships with organizations that might provide discounts on insurance or maybe some back office functions. So these are ways that we as a statewide association can help these individual 17 community health centers be more efficient, right, so that they can focus their efforts on providing this high quality health care. So those are some things we're working on. We're also planning a conference for November. We're very excited, because we haven't had an in person statewide conference since 2019 so it's been five years. There is a real hunger for people to come together, network, share best practices and learn from experts, and we're looking forward to doing that in November down in Mystic.

Nancy Barrow:

centers? Do you think you'll expand? Or do you think that you've really gotten to the point where you're effectively reaching everybody that you need to reach?

Deb Polun:

We are expanding all the time. Actually, I don't think we're going to have more than 17 community health centers, although it's always possible we could get another one or two, but each of those centers is looking to expand and create new sites. So for example, I mentioned North Canaan a few minutes ago, and that is our health center up in Torrington has been working for, I think, 15 years on opening this site in North Canaan, which finally opened this spring. So for for listeners who don't know where North Canaan is way up there is way up in the corner where Connecticut meets Massachusetts and New York. Yep, it's definitely what we call the health profession shortage area, which means there aren't a lot of other places to receive health care in that part of the state. And so opening up in north Canaan was transformational for not just North Canaan, but the communities around it, to provide a space for people to receive primary health care and as well as behavioral health care. Connecticut's a small state, but we have so many different types of areas, and so the northwest corner is it skews to an older population, obviously very rural, and I think there are a lot of people working in jobs in that part of the state that are in either smaller businesses or gig employment, as well as the healthcare field.

Nancy Barrow:

Yeah, it's interesting. And same as northeast, like, that's also a tough place. There's not a lot of health centers around there. So it's interesting that you're northwest and northeast. Like, those are the two areas that I always say are, you know, less populated?

Deb Polun:

Yes, we do have a health center up in the northeast corner. It's generations, Family Health Center, and they have their main site in willimanick, but they also have a couple of sites up in the northeast corner, Danielson and Putnam. And yet, we know that there's still need. We know that there's people who are not going in and getting a wellness check, getting the screenings done that they're supposed to be getting done. Huge need in dental there's actually been a drop in the number of dentists since covid fewer. There are more people who have left the field of dentistry, and fewer people entering the field of dentistry. Wow, that's really interesting. It's very tough for community health centers to be able to afford to keep these dentists on staff, but it's so important. So we are really working to improve access to dental care across Connecticut.

Nancy Barrow:

Are you working at all with UConn? Because, like, that's the school where they have dental you know, they have the dental school there.

Deb Polun:

We've actually just developed a new position in our office for workforce development. So we have somebody who, now 100% of her time is focused in on workforce development, so she's out creating relationships with all of the health profession training programs, including UConn, the CS use, Quinnipiac, Fairfield, Sacred Heart, all of these different institutions. We're also looking at different levels of of healthcare professions. So for example, we got a grant from the Delta Dental foundation to expand access to dental assistant training programs. So the dental assistant is the person who helps to clean the equipment, and kind of is around to help the dentist do the work, but is not the hygienist. So it's an entry level position, and it is a great way to enter the field of health care without needing to go to college and then additional training. So there we are looking to expand access to those programs. Right now, even under the Affordable Care Act, when the mandate was in place, you were not mandated to have dental insurance. So some people just don't have it, and they don't realize that they can go get their dental care at a community health center. So even if you are receiving your medical care somewhere else, you can go get your dental care at a community health center. Whether or not you have dental insurance, it's very affordable, accessible way to receive that care.

Nancy Barrow:

Oh, that's brilliant. I didn't. Know that that's really wonderful. Tell me about your vision for the future of community health centers, and are there projects that are in the works that you're looking at?

Deb Polun:

So I want to start off by making sure that people know that our community health centers are actually beautiful buildings where you can have your health care needs, and also you the health care needs for your kids and maybe even your parents all under one roof. So they are convenient. They're conveniently located, and they're up to date, high quality facilities. We've got the electronic health records, same as wherever you probably go for your health care, and the care is integrated. So what I mean by that is, if you're having a visit with your primary care physician and you mentioned, you know, I have been feeling down, or I've been feeling anxious, they're going to refer you to a behavioral health person, maybe right at that moment, they might leave the room and go get a behavioral health person right then and there. And so the care teams at the Community Health Centers work together to help ensure that you're getting all of your health care needs met.

Nancy Barrow:

And it is sort of a family atmosphere. I've I've been to 500 Albany avenue to their community health center. I'm actually going to their their annual health fair on August 8, so I'll be there doing that, and I've been there before. It's a beautiful building, and it's really amazing to see how the community really gets behind that community health center. They're really happy that they're there.

Deb Polun:

Agree, and one of the ways that community health centers impact their communities, besides just providing the health care, is as non profit organizations, they have boards of directors, and by federal law, 51% of their board members must be patients. So if you have 11 members of your board, six of them are actually going to be receiving care at the health center. So that is empowering the community to help make decisions about how healthcare is delivered, where it's delivered, what the hours are going to be, and any expansion opportunities. It's another way to help ensure that community members feel tied to their community and empowered to make a difference in their community.

Nancy Barrow:

Why is that so important for Community Health Centers?

Deb Polun:

We talk about health equity, and that is sort of a buzzword over the last couple of years, but what people really need to understand is all of the research shows that people have either reduced access to healthcare or lower healthcare outcomes. And it's not always even tied to income. It's tied to race. We see disproportionate numbers of black women having maternal mortality or having infant death, and that has been tied to the way that physicians are trained. It's tied to structural racism and perception of pain that women are expressing, and particularly black and brown women are expressing so these are areas where we know that we can make improvements. Hispanic women and men as well are receiving care and having poor health outcomes. Some of it really is structural. It is where do we build the facilities that burn trash, typically in lower income neighborhoods. What does that do to the air quality? What about the quality of the buildings where people are living? There's mold. It enhances problems with asthma and other breathing issues. So there's a lot of work that we need to do to make these communities all across Connecticut, better experiences for the people who are living there. What we can do as community health centers is ensure that people have access to the best health care. So if somebody is coming in, a family is coming in and they are experiencing asthma or then we can try to give them the treatment that they need so that they stay out of the emergency room, are able to go to school and work and then also surround them with other resources, like, can we help you find a different place to live? And we do have that connection to the community resources. All of the health centers employ people who are sometimes described as community health workers or navigators. There's a whole bunch of different sure names for these folks, but what they do is they connect. They find out what's going on in your life, and how can we help you live a healthier life.

Nancy Barrow:

How do you attract great health professionals to work at these community health centers? Because it's hard. I mean, there's a nurse shortage. We all know that.

Deb Polun:

Some of it is mission driven. People do want to help other people, and people who go into the healthcare field, they want to feel they're making a difference. And so some people just strictly based on mission, want to work at a community health center. But we also have other programs that can attract people, one on the federal. Level is the National Health Service Corps, and there's a loan repayment program for people who serve their communities, either at a community health center or somewhere else in the in a community that is underserved. We also just recently began a state loan repayment program. We used to have this about 15 years ago. It went away. It just came back and 8000 people applied for the first round of state loan repayment. Wow. So this is going to provide again, state loan repayment for people who are health professionals who want to work in either a community health center or an underserved community. Now if you know anybody who has gone to medical school, nursing school, PA school, dental school, they come out, or social work school, they all come out with these massive loans. Yep. And so being able to have loan forgiveness $50,000 through the state loan repayment program can be really impactful. And what I think is once people get into the community health center world, they want to stay because they realize how much of a difference they're making in people's lives.

Nancy Barrow:

Yeah, sure, and that's why they got into it, right? You know, that's why you are in the health care field, because you do want to make a difference and help people. How important is your community outreach and education, to let people know about the services that are available at these community health centers because maybe people don't know that they get dental or behavioral health.

Deb Polun:

Unfortunately, I feel like we're the best kept secret, and we don't want to be a secret. We want people to know about community health centers all across the state. Some of it is word of mouth, some of it is advertising, whether it's through social media or some are doing billboards and going out into their communities during National Health Center week. Hopefully our community health centers will really be making a splash letting people in their communities know that they exist.

Nancy Barrow:

Yeah, I think that's important. I think a lot of people don't realize that that's available to them.

Deb Polun:

We see this every year during the mission of mercy Dental Clinic. I don't know if you're familiar with that, but that's coming up in November this year in Waterbury, and it is a wonderful service. It's a two day clinic where dentists and other dental professionals volunteer their time and provide dental care on site. Why are people waiting in line outside and sometimes not the best weather, because it's November so and it's Connecticut, it's Connecticut, right? It could be hot, it could be cold and rainy, could be snowing. Why are people waiting in line for this one time dental care when all they need to do is go to their community health center and make an appointment at their convenience to receive the this same or better dental care on a regular basis. So that is one way that every year I see, oh, we have a lot more work to do to spread the good word about community health centers and the services that they provide.

Nancy Barrow:

I agree with you there. How do you see Connecticut Paid Leave helping the people that you serve?

Deb Polun:

The Connecticut paid leave can help both the people that we serve and the people that we employ. So community health centers across the state employ about 5000 people, and that's some of the health professionals that we've spoken about. But it's also, as we said, the people who are running the it in the background, the people who are HR professionals, front desk, staff, the community health workers, billing and finance staff. So there's a lot of those professionals as well who are working in community health centers and then also our patients. So Connecticut was really on the forefront, as you know, in creating this paid leave program, we want to make sure people know about it, because it will help them take care of themselves and also take care of their family members without worrying about, how am I going to pay the electric bill, or how am I going to pay my rent this month?

Nancy Barrow:

I know, and I do love the caregiver leave. I think it's so vitally important, and people don't really know about that. And we also give income replacement for addiction treatment and mental health as serious health conditions, and the community health centers offer behavioral health services. Have you had to expand these services? Have you noticed an increase, especially since covid? Because I do think behavioral health, mental health, was so important, and everybody was suffering, really, during thatCovid.

Deb Polun:

We still see that. Yeah, you look at the national data on this, and statewide data, and we see this from kids all the way up through adults and older adults are experiencing mental health issues, whether it's as you mentioned, depression, anxiety and beyond, and the community health centers are there to provide the services needed. We are expanding these services. There have been some state funds and federal funds put into expanding behavioral health services. So that's really important. And I think one innovation that has been really important in behavioral health is telehealth. A lot of people either don't. Feel comfortable or they don't feel it's worth setting aside the time to go and physically meet with somebody once a week. But if they can sit at their computer, either at home or even from work on their lunch break, and do that, check in, that touch base with a behavioral health professional, I think people are way more likely to seek the care that they need and deserve, to try to improve their mental health and well being.

Nancy Barrow:

August, 4 through the 10th is National Health Center week. What are you hoping that this podcast and the week does for Community Health Centers?

Deb Polun:

I think a couple of things. One is really to get the word out about community health centers. We want to make sure everybody in Connecticut knows that Community Health Centers exist either in or right near your community and can be accessed for health care services regardless of your age, regardless of ability to pay, insurance status, et cetera. So that's one piece is really just to get the word out, and the second is to build support and passion for these institutions of our community, and to make sure that that our policymakers and our community members can support community health centers so that they can continue to provide these services.

Nancy Barrow:

Yeah, it's really vitally important. What would you like people to know, as we sort of wrap up this podcast, what would you like people to know about community health centers that we haven't talked about?

Deb Polun:

I would say you should go see if you have one near you, and you can look for a list of community health centers on our website, which is www, dot, C, H, C, A, C, t.org, www, dot CHC, act.org you can map out where you live, where your closest Community Health Center is, and give it a try. You know, walk in, see if you want to go, have an appointment there. Tell your friends. We can also help you get signed up for insurance. If you don't have insurance, we do that right on site as well, whether it's Medicaid or through access health or a new program called covered CT, we can help connect you to services. So those are some things I want people to know. This is a convenient way to receive the best health care that's being provided in our state. All of the health centers are doing staff appreciation events that week. There's also focus days. So there's a day to focus in on people who are experiencing homelessness, people who live in public housing, et cetera, through the week. So we're going to be getting the word out about all of the wonderful activities that the health centers are doing and all the great services that they provide.

Nancy Barrow:

Any last thoughts about Connecticut paid leave and how it intersects with community health centers?

Deb Polun:

I think that Connecticut Paid Leave again, being on the forefront of this across the country demonstrates that Connecticut as a state can be a leader, and we are hoping that the Connecticut will continue to be a leader, both for protecting workers but also for providing the health care. So again, I come back to what do we need? Is we need better reimbursement rates for Medicaid, and that will help us provide the very best health care that we can to people all across our state.

Nancy Barrow:

is it going to your website?

Deb Polun:

Easiest way is going to our website? Www, dot CHC, AC, t.org, wonderful.

Nancy Barrow:

Deb Polun, Chief Strategy Officer at the Community Health Center Association of Connecticut that deals with all these wonderful Connecticut Community Health Centers. Thank you so much for all the information today, and thank you for being on The Paid Leave Podcast.

Deb Polun:

Thanks so much. Nancy.

Nancy Barrow:

For more information or to apply for benefits, please go to ctpaidleave.org This has been another edition of The Paid Leave Podcast. Please like and subscribe, so you'll be notified about new podcasts that become available. Connecticut Paid Leave is a public act with a personal purpose. I'm Nancy Barrow, and thanks for listening.

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