To measure how far we have come we first have to look at where Community Health Centers started 50 years ago. It began with a cause, and then an opportunity. The cause was lack of access to basic healthcare among the poor, and the opportunity was President Lyndon B. Johnson’s major War on Poverty initiatives in the mid 1960s. Doctors Jack Geiger and Count Gibson, then affiliated with the Preventive Medicine Department at Tufts University School of Medicine, submitted proposals to the federal Office of Economic Opportunity to establish health centers in medically underserved urban and rural areas. Funding for the first two “Neighborhood Health Centers” (as they were then called) – one in Boston, Massachusetts, and the other in Mound Bayou, Mississippi – was approved in 1965. The health center which opened its doors in Boston’s Dorchester neighborhood a few months later was Columbia Point Health Center. Establishing a health center in Columbia Point made sense for a lot of reasons. The Department of Preventive Medicine already had a longstanding relationship with the Columbia Point Housing Project in that neighborhood. Fourth year medical students had been providing care to residents since 1954. Also, the demand for care was overwhelming. According to the book, “Community Health Centers: A Movement and the People Who Made It Happen” (Bonnie Lefkowitz), even though the housing project was four miles from major hospitals, visits to them took an average of six hours, including travel and waiting time. Once the health center opened for business, as many as 200 patients per day received services.
Columbia Point also launched a local grassroots movement that saw eighteen more health centers established in Boston by 1971. The collective success of these health centers in delivering healthcare services gained the notice of local and national leaders, including Massachusetts U.S. Senator Edward Kennedy. Now, 50 years later, the re-named Geiger Gibson Community Health Center is one of the founding members of the larger Harbor Health Services, Inc., which administers five Community Health Centers in three counties in eastern Massachusetts.
“Clearly much has changed in 50 years but much has remained of the original ideas,” says Dan Driscoll, President and CEO of Harbor Health. Driscoll has been with Harbor Health for 38 years, and visited Columbia Point in its early days. “The vision that Jack Geiger and Count Gibson had for a ‘pre-payment plan’ to finance care has become a capitated arrangement for Medicaid patients. Their concept of community participation is now a fully empowered and legally responsible community board of directors. Geiger and Gibson always saw the health center mission as more than medical care. Today, those services include outreach using community residents, financial counseling, domestic violence advocacy, substance abuse treatment, medical – behavioral health integration, case management and the provision of career ladders for staff.”
Indeed, addressing the whole health of the person and the factors that may contribute to illness, rather, the social determinants of health, is one of the hallmarks of the health center movement and a key to its record of success in reducing healthcare costs, unnecessary hospitalizations and visits to the hospital emergency room. Harbor Health Services stays true to that mission and also continues to focus resources on the needs of the local community. In addition to providing services to 27,000 patients, including 10,000 dental patients. Harbor Health also saw the need for delivering services to the growing numbers of elderly who were homebound. They offer an Elder Service Plan, which now cares for 450 people. They also run a Women Infant Children Nutrition Program for more than 3,000 women and their children.
“The scope and size of the health center program nationally is most likely larger than either Jack Geiger and Count Gibson had dared hope for, but today the Columbia Point Health Center/Geiger Gibson Community Health Center remains, along with our rural cousin, Delta Health Center in Mound Bayou Mississippi, as lasting signs of the resiliency of the movement and its mission,” said Driscoll.
Help us celebrate the 50th anniversary throughout the month of June by telling us about your health center’s journey.