Amid Steward crisis, health centers are critical

Concerns continue to swirl this week about the viability of Carney Hospital, even as their corporate overlords at Steward Health Care claim they have a “significant financial transaction” in place to keep the Dorchester facility and its other Massachusetts assets open.

That’s good news, if it’s true. No one wants to see the Carney close, although there are plenty of people who’d like to see it change hands, especially given the opaque nature of Steward’s business dealings that has permitted it to skirt scrutiny from state regulators.

That has also led to uncertainty about just how well Carney and other under-funded, debt-laden hospitals in the Steward constellation can stabilize their operations— and for how long.

It’s against that murky backdrop that other health leaders must map out their next steps. And, in the local context, that very much includes Dorchester and Mattapan’s network of community health centers, which are already bracing for – and experiencing – what a Carney meltdown might portend for their facilities.

Once upon a time, Carney was a partner of the community health center movement in our neighborhood and, in fact, was the fiscal agent for a few as they started up in the 1970s and 1980s. But that was long before the Steward era. Over the decades, Carney has lost its direct affiliation with health centers that once served as a vital feeder-network for the hospital. As Carney falters, it’s now the health center system that is stepping up to absorb the potential overflow.

Health centers, as presently constituted, can’t replace all of the services that patients need and can typically find available at Carney’s emergency department, for example. But they are already meeting critical demands for urgent care appointments, dental visits, vaccinations, pre-natal care, and even filling prescriptions. They’re also essential hubs for hosting primary care physicians (PCPs) in an environment where that’s becoming hard to find, even in a scenario in which Steward is operating as “normal.”

Michelle Nadow, CEO at Dot House Health in Fields Corner, says the Steward crisis and what it could mean for Carney is very much on their minds at DotHouse: “We’re empathetic and concerned about the patients and staff, of course. It’s been a local resource for so many people, for the convenience and the access, plus the language access that they offer.”

She reports that her facility is already seeing an increase in demand.

“Urgent care is seeing tons of folks and it’s far outpacing what we had budgeted for volume at this point in the year,” said Nadow. “There’s a huge crunch with people trying to see PCPs.”

DotHouse Health is one of the places where there’s legitimate hope for meeting that demand. Nadow and her team have nine new physicians on their roster who are taking on new patients. It’s the result of DotHouse Health planning for this model for several years, investing in its building, and getting the financial support it needs with “foresight from our board,” Nadow says.

DotHouse and other key health centers in and near Dorchester – Harvard Street, Codman, Uphams, Neponset, Whittier Street, Harbor Health, Mattapan, Bowdoin Street – are essential to the system in Boston’s neighborhoods and we’re fortunate to have them, particularly in this moment.

As we witnessed in real time throughout the Covid crisis, no response to a public health emergency in this Commonwealth will be effective without including community health centers as a central part of the plan. It’s critical that policymakers at the city, state, and federal level keep this in mind as they think through their strategies to address this ongoing Steward crisis.

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