Member Spotlight: Texas Association of Community Health Centers

By Perdita Henry

A doctor’s visit involves so much more than just making an appointment and showing up on a day at a specific time. For someone like me, who has access to health insurance, there are questions like is the doctor in network? Are they a person of color? Does this physician have a cultural understanding of what visiting the doctor is like for a Black person? Am I going to be forced to sit through a fatphobic lecture about my weight? These are just a few of the concerns I have every time I walk into a doctor’s office, despite the privileges of having health insurance, a reliable car, and a job that provides paid sick leave as a benefit.

But what happens when you are working poor and don’t have insurance? Or access to a car? Or the internet? Or childcare? What if English isn’t your first language or you can’t afford a prescription? What if the nearest clinic is miles away? What if all these things are true and you have a chronic health condition? Every answer to each of those questions will impact your likelihood of receiving healthcare and accessing the care you need.

All those challenges facing patients are factors considered by the Texas Association of Community Health Centers (TACHC) as they work with clinics around the state to improve women’s healthcare. Formed in 1983, the private, non-profit membership association represents federally qualified health centers (FQHCs) throughout the state. “FQHCs provide a wide array of primary and preventive care services including medical, dental, behavioral health, and vision services” says TACHC Deputy Director of State Affairs, Daniela De Luna. “The 73 health centers in Texas operate over 575 clinic sites located in 134 counties across the state.[i] FQHCs provide services to people who may otherwise lack access to care due to where they live, lack of insurance, language barriers, income level, or their complex health care needs. Health centers are a cost-effective primary health care option for Texas women, and provide integrated services like health education, transportation and case management.”

TACHC has members from across the state working in rural areas, metropolitan areas, and everywhere in between. What are some of the challenges facing rural clinics when it comes to assisting women obtain healthcare access?

Health centers provide comprehensive primary healthcare services to women in all stages of life including pre-conception, prenatal, postpartum, and preventive care including cancer screenings. Eligibility and covered services in state programs for women vary greatly depending on their stage of life. One of the biggest challenges for all health centers is extending limited funds to make sure women can receive care regardless of insurance status or ability to pay. In addition to coverage limitations, women in rural areas may also face distance and transportation barriers to access a nearby health center.

Your membership includes behavioral health, medical and dental clinics. What are some of the ways TACHC assists them in tackling social determinants of health?

All health centers provide integrated enabling services to help address social determinants of health. Enabling services include health education, transportation, case management, and referrals to other programs and community organizations. Each health center addresses social determinants of health based on their staff resources, referral infrastructure, and partnerships with different organizations. For example, some health centers have on site food pantries for patients with food insecurity. Other health centers have partnered with organizations to set up an online referral system and track outcomes. In the next year, TACHC will review health center approaches and proposals by organizations to identify notable practices that can be applied across health centers. TACHC is also collaborating with other stakeholders including associations representing providers and health plans, as well as foundations to promote a meaningful and coordinated approach to social determinants of health in the healthcare delivery system.

Why is it important for your organization to be a TWHC member?

Community health centers are critical partners in serving the millions of uninsured and underinsured women in Texas. We want to ensure the perspective of safety net providers throughout Texas is shared with other TWHC members and policy makers to continue to improve health access and coverage for women. We also appreciate the opportunity to collaborate with other groups and rally together to address policy changes that can impact women’s health.

What does an ideal future for women’s health look like according to TACHC?

TACHC looks forward to a future where women have access in their community to the healthcare they need. Starting with eligibility, women should have a seamless process to obtain coverage whether it’s through a state program, Medicare, or another payor as they transition through different life stages.

Women would have access not just to comprehensive care services, but also a trauma informed care approach. This approach helps create a physically and emotionally safe environment in the delivery of care that recognizes potential trauma triggers and promotes resiliency. TACHC is already working with several health centers to drive practices towards trauma informed care. We also believe social determinants of health should be included in any conversations about the future of women’s health. Addressing food, housing, and economic hardships is key to improving the overall health of all Texans.

Will you advocate during the upcoming 87th legislative Session? If so, what are some of the policy priorities you plan to champion?

In this upcoming legislative session, TACHC plans to support efforts led by other groups to ensure the current economic climate does not have a negative impact on services and programs including women’s health programs and public health programs. We’re also working with other stakeholders to improve continuity of coverage, expand health insurance coverage, and promote social determinants of health in Medicaid.

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[i] National Association of Community Health Centers (NACHC). Key Health Center Data by State, 2020. Federally-Funded Health Centers Only. Available at: https://www.nachc.org/wp-content/uploads/2020/09/2020-Key-Facts-by-State.pdf