Amid severe disruption to our nation's healthcare system – acute workforce challenges, rural healthcare facility closures, and poor health disparities among under-resourced communities, to name a few – community health centers in Iowa and across the nation are also facing challenges that could make it impossible for them to continue providing quality, affordable care to the patients who rely on them.

The Community Health Center Program is the country's largest network of primary care providers. It is a vital part of our healthcare safety net, as health centers provide care to all who need it, regardless of insurance status or ability to pay. Over 14,000 community health centers across the U.S. now serve over 30.5 million patients, or nearly 250,000 Iowans, the highest number of patients health centers serve.

This national network of community health centers, which relies primarily on federal funding, is more vital now than ever, particularly as the nation grapples with overlapping health and economic crises that disproportionately impact the under-resourced communities health centers care for and support. In Iowa, nearly 90% of health center patients live at or below 200% of the federal poverty line, Medicaid covers 52%, and 17% are uninsured.

As Congress continues to debate government funding, health centers are facing extraordinary workforce, infrastructure, and financial challenges. Their funding has not kept up with inflation and increasing patient populations. From Fiscal Year 2015 to Fiscal Year 2021, total community health center funding only increased by 11%, while the number of patients served increased by 24%. The healthcare workforce shortage makes recruiting and retaining staff health difficult, and behavioral health, substance abuse, and maternal mortality crises are straining health centers even further. Health centers cannot continue to do more with less.

Health centers need significant and sustained funding to keep serving their patients. Federal funding for the Community Health Center Trust Fund, initially set to expire on September 30, has been extended until November 17, but this is simply a stopgap measure. Now is the time for Republicans and Democrats to work together to ensure increased and stable funding through the Community Health Center Trust Fund.

This investment is crucial for health centers like All Care Health Center in Council Bluffs to keep their doors open, provide comprehensive care, retain and build their workforce, and participate in innovative efforts that improve the quality of patient care. Health centers like All Care Health Center provide culturally and linguistically appropriate care and are at the frontlines during a local, state, or national emergency.

Health centers are the best investment you can make in health care. In 2021, estimates showed that community health centers saved $25.3 billion in the Medicaid and Medicare programs while providing economic growth to localities. Every dollar of federal funding invested in community health centers generates $11 in total economic activity through increased spending on related health service expenses, food services, transportation, construction, and more.

Right here in Council Bluffs, your community health center employs 81 and is the healthcare home to nearly 6,000 patients throughout southwest Iowa and the metro. All Care Health Center provides primary healthcare, mental healthcare, and dental care through two community health centers. Homeless men, women, and children receive healthcare services through direct partnerships with New Visions Homeless Services and MICAH House. For our local patients without transportation, All Care has provided over 700 rides to and from appointments just this year. Mobile healthcare programs for our community school students and large community employers are developing. All Care strives to create access to healthcare for everyone. 

The uncertainty around federal funding for health centers is unsustainable and hinders our ability to address the unique needs of our patients. I am calling today on Congress to provide robust health center funding through the Community Health Center Trust Fund Reauthorization to help our local communities thrive now and into the future. As the CEO of All Care Health Center, I speak on behalf of my colleagues throughout the metro and the state of Iowa, with hopes that Senator Chuck Grassley, Senator Joni Ernst, and Representative Randy Feenstra will show their support for a strong reauthorization of the Community Health Center Trust Fund. The time for bold action is now.

Breaking Barriers through Service Excellence

When a recent refugee from Afghanistan, came to All Care who could only speak Dari, Stephanie Vazquez-Serrano made sure the patient received quality dental care. The patient was suffering from an infected tooth that was in need of a root canal. Due to the complexity of the tooth socket’s location, the patient needed a referral to a specialist. Due to the language barrier, Stephanie could not simply refer the patient to another local dentist. To make sure her patient continued to receive care, Stephanie worked with the other dental office, to make sure the patient would have a Dari interpreter for the appointment. Not only did Stephanie take time to make this patient’s appointment, but she also offered her direct assistance if translation assistance was needed for this new patient.   

Stephanie Vazquez earned the September Service Excellence Award for going above and beyond to advocate for this patient. Her colleagues share that it is routine for her to offer quality service to patients, without hesitation, and with a welcoming attitude that patients appreciate. Stephanie started her journey with All Care in November of 2021 and is one of the first faces that patients see when they enter; she works as a Patient Access Representative at the dental department's front desk. She also works as a Certified Dental Assistant. She was able to receive training and certification while working at All Care.

Stephanie has helped many Afghans through her work, as hundreds of refugees from Afghanistan have relocated to the Omaha-Council Bluffs metro since 2021. Afghanistan is a linguistically diverse country with over forty languages spoken. The primary languages are Dari and Pashto. All Care Health Center is able to help individuals of many languages, due to our Bilingual staff and our use of Martti. Martti stands for My Accessible Real-Time Trusted Interpreter; it allows All Care staff and providers to make video calls to certified interpreters. Over 250 languages are among those spoken fluently by Martti interpreters, including Dari. Martti also services those who communicate through American Sign Language.

Mobile Healthcare for Council Bluffs Community School District Continuing to Develop

As All Care continues to evaluate Council Bluffs Community School District students' needs, we are actively adjusting to meet those needs. As of October 31, 2023, Dr. Cristella Torres is committed to primary medical care at Thomas Jefferson High School, weekly, Tuesday-Friday, from 1 - 4pm. Exceptions will be made during school closures. Appointments can be made by calling (712) 325-1990. 

All Care's mobile healthcare clinic was created with parents in mind. With so many costs rising, healthcare isn't always first and foremost on the list of family priorities. But All Care is trying to help family members get their needed care. The mobile health clinic allows students to receive healthcare services without leaving work and missing valuable hours of pay. Families can also apply for the sliding fee scale.

To make the process easier for your student to receive care, parents should complete enrollment paperwork and turn it into their school nurse or All Care Health Center ahead of any needs. These forms can be found here. If not completed in advance, paperwork should come with your student when they receive services. 

Stay up to date on mobile healthcare events!

Sign-up to receive notifications for All Care’s mobile healthcare events like sports physical and immunization clinics. A simple questionnaire allows student families to choose specific event information they want to receive. The questionnaire also enables parents to request mental health service information and ask specific questions about All Care Health Center. 

Marketplace open enrollment starts November 1 and closes on January 15, 2024. All Care Health Center's enrollment specialists, Sandi Donehoo and Tiffany Peterson, complete annual Marketplace training through the Centers for Medicare and Medicaid Services. Suppose individuals do not have health insurance through a job, Medicare, Medicaid, the Children's Health Insurance Program (CHIP), or another source that provides qualifying health coverage. In that case, chances are coverage is available through the Marketplace. Even those who cannot afford their employer's insurance premium options should look into Marketplace.

Most people qualify for savings. Your savings depends upon your expected household income for the year and the number of people in your household. Sandi Donehoo states, "There's a reason it's called Affordable Health Care!" Curious? You can use this site to see if you qualify for savings.

All Care's. In that case, enrollment specialists take their time helping each individual to find which plan fits their specific needs. All Marketplace plans cover essential health benefits that include prescription drugs, emergency services, hospitalization, laboratory services, mental health, and substance use services. Marketplace plans include free preventive health services when delivered by a doctor or provider in your plan's network, as well as coverage for pre-existing conditions and chronic disease management. Plan participants will also receive coverage for outpatient care, emergency services, and hospitalization. New and expectant moms receive pregnancy, maternity, and newborn care that grows into pediatric services. Plans also cover birth control and breastfeeding support.   

While individuals can apply online, by phone, or through an agent, All Care can also help you in person. Free enrollment appointments are available by calling (712) 325-1990. Appointments are available at our 902 South 6^th Street location and the Florence M. Lakin Health Center at 1415 Avenue J, Suite 2.

All Care's specialist, Tiffany Peterson, stresses, “Patients and community members who make an appointment do not have to commit to a plan that day.”

Individuals should plan to bring proof of ID, social security numbers, and birthdates for all household members who will be included in a potential plan. Previous Marketplace users should also bring their past username and password. For coverage that starts January 1, 2024, plan to enroll by December 15 and by January 15 for coverage that starts February 1, 2024.

Walk-in COVID-19 Immunization Clinics

All Care Health Center’s pharmacy is hosting walk-in COVID-19 immunization clinics on November 11 and December 2 from 8:00am–11:00am. Both clinics are being held during regular Saturday clinic hours at All Care’s 902 S. 6^th Street location. All Care’s Clinical Pharmacist and Pharmacy Director, JoLynn Ahmann, states that the rate of individuals requesting and receiving COVID-19 vaccinations has picked up this last month and is higher than last fall. Patients and community members attending the clinic should bring their insurance cards. Most insurance will cover the cost of the vaccine and administration of the dose. There will also be flu shots available for those wishing to complete both vaccinations at the event.

This is supported by The Health Resources & Services Administration’s 2023 COVID-19 Bridge Funding to sustain fair access to COVID-19 testing, vaccination, and treatment. 

All Care Receives Mental Health First Aid Funding

The Southwest Iowa Mental Health and Substance Abuse Fund, overseen by the Community Foundation for Western Iowa, has approved a $2,200 grant for All Care's Mental Health First Aid Training. The funding will cover tuition for an All Care provider to receive training to be an adult instructor of Mental Health First Aid. After receiving training, the instructor will train patient-facing staff members of All Care in Mental Health First Aid. 

Mental Health First Aid is a course that teaches participants how to identify, understand, and respond to signs of mental illnesses and substance use disorders. The training will give All Care staff the skills needed to provide initial help and support to someone who may be developing a mental health or substance use problem or experiencing a crisis, even if they are not a mental health provider. Mental Health First Aid takes the fear and hesitation out of starting conversations about mental health and substance use problems by improving understanding and providing an action plan that teaches people to safely and responsibly identify and address a potential mental illness or substance use disorder.  

All Care's Mental Health Supervisor, Amanda McCormick, recognized the need for staff to receive training. When patients arrive at All Care, the front desk interacts with a patient first. The training will begin with this team and continue until the skills are taught to all patient-facing staff. Mental Health First Aid will become a part of onboarding new employees as All Care grows.  

All Care intends to share Mental Health First Aid educational opportunities with its closest partners.

Students can Share Education through Art

How can students wrap up their love for art, science, and public service in a single project? Enter All Care Health Center’s COVID-19 Vaccination Art Contest!  

The contest challenges students to convey a message through art. The task is to create a piece of original artwork that will educate the community about COVID vaccines or inspire community members to get vaccinated. Artwork can be a drawing, painting, photograph, or mixed media in two dimensions.  

Students in the Council Bluffs Community School District in grades K – 12 are eligible. Entries should include the student’s first and last name, grade, and school. Entries can be dropped off or mailed to All Care Health Center, at 902 S. 6th Street, in Council Bluffs, by December 1, 2023. Entries may not be returned.

Winners will be chosen from contest divisions of grades K-5; 6-8; and 9-12 and will receive a poster print of their artwork. Posters may shared in our community and on social media. Winning entries will be featured inside the mobile medical health center.   

Funding for this project is provided by the Health and Resources Services Administration (HRSA) through Expanding COVID-19 Vaccination (ECV) awards made to health centers to increase access to, confidence in, and demand for updated COVID-19 vaccines within their service areas. The purpose of the ECV funding is to educate the community about COVID-19 vaccines and to encourage vaccination in the community, with an emphasis on outreach and education, community engagement, and coordinated partner events that increase updated COVID-19 vaccinations among underserved populations.

Visit the Centers for Disease Control and Prevention (CDC) to learn about COVID-19 and vaccines.

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