Purpose Spring 2023

Spring 2023

Dear friends,

On May 11, the three-year COVID-19 Public Health Emergency ends.

As I look back on this unprecedented time, I am proud of the care we provided our community. CCI has remained open since day one of the pandemic, March 16, 2020. “Open” has meant that all services remained available, and all employees, regardless of function, have remained onsite.

During the past three years, the demographics of those disproportionately affected by the virus also reflected our patients and WIC participants. We knew that showing up for them was about walking our talk. We pledged to work every day to achieve greater health equity for those populations that faced barriers to care and health disparities that would only worsen in a time of universal distress.

The stakes were high, and CCI’s response had to be mighty. Community is the most powerful force on the planet, and we unleashed the powerful energy of our community—a collection of committed interdisciplinary staffers—to ensure our neighbors had access to the care they needed to live a fully active life.

Access to quality care is an integral ingredient for health quality and outcomes. In this fiscal year, CCI served a record number of residents in our Refugee Health, Family Planning, and WIC programs. Our access plan now shifts to expanding our footprint in Montgomery and Prince George’s counties to serve more people.

The Montgomery County 2022 Health Survey was recently published, and and the findings are shown on the following page.

From medical, dental to behavioral health, CCI has services available for all the areas of need reflected in the survey, proving that we have our finger on the pulse of our service area and solutions for the problems that our communities face.

In this issue, you will receive updates on our space and partnership plans in Prince George’s County. In addition, you will learn about our outreach efforts and successful partnerships within our departmental programs. Enjoy!

Sonya Bruton, Psy.D., MPA CEO & President CCI Health Services

The Montgomery County 2022 Health Survey

Most important

Availability/access to insurance (12.8%) was the most important social/environmental factor.

Cost (33.3%) was the most important reason for not getting health care and 9.6% of respondents did not have health insurance.

75.9% of respondents have a primary care provider (PCP).

More than 75% (76.4%) of residents visited a health care provider last year.

Better Together: CCI’s Partnership with the City of Greenbelt

Community health centers are only as strong as the local leaders and advocates they can rely on. Thankfully, we can always rely on our friends in Greenbelt.

Our relationship with Greenbelt spans well over a decade. The partnership was kindled in 2006 when we decided the time was right to expand our service area to include Prince George’s County. Local leadership supported us from the beginning and wholeheartedly believed in what we wanted to achieve. So when we first opened our doors in the community the following year, it felt like a homecoming, even though we were new folks in the neighborhood.

Today, we deliver quality and affordable care to thousands of residents at our Greenbelt and Greenway health centers annually. Meanwhile, our bond with Greenbelt has only strengthened, leading to recent and upcoming initiatives that enable the city and its residents to thrive.

Taking on cost barriers

Greenbelt leadership believes in health equity, which is why they asked us to deliver services free of charge to residents without insurance while the city was pleased to cover the cost. We were immensely proud to be the only Federally Qualified Health Center entrusted by leadership with the proposal. Not surprisingly, it also meant a lot to our neighbors: over 260 patients have benefited from the free care.

Learning collaboratives

In 2021, a group of movers and shakers in Greenbelt wondered: what if local businesses and nonprofits had an avenue to collaborate? The Greenbelt Business Alliance (GBA) launched a few months later to do just that. Established by a volunteer steering committee featuring our Chief Strategy Officer, Jessica Wilson, the organization brings partners together (17 and counting!) to support long-term growth and sustainability in the city. Moreover, it’s an opportunity to exchange knowledge and ideas, as was the case this past March when our Digital Marketing Specialist, Thi Nguyen, presented to the group on best social media practices.

Connections to care

Thanks to the COVID-19 public health emergency (PHE) our neighbors with Medicaid in Montgomery and Prince George’s counties have not had to worry about losing their health coverage due to eligibility. But with the PHE ending in May, hundreds of thousands of recipients are now at risk of becoming uninsured because they no longer qualify.

We needed to get the word out about the change, so we reached out to a member in the GBA to secure a venue, free of charge, for our Medicaid Health Fair. Thanks to their help, we were able to hold the event in April at Beltway Plaza Mall. We provided our neighbors with health screenings, free groceries and gift cards, a chance to speak with four Maryland health insurance companies, and one-on-one appointments with our ACA navigator.

Looking forward

We’re taking our partnership with Greenbelt to the next level. Late in 2022, we announced that we had outgrown our Franklin Park health center and purchased a new facility on Ora Glen Avenue to house our current services and expand into additional ones, including on-site pharmaceutical care (more on p. 10–11). We’re also making significant progress on our family medicine residency program, which will operate out of our new location and begin to accept residents in 2024.

Much of what our team has accomplished in Greenbelt comes down to the relationships we’ve built in the community. We’re incredibly grateful to everyone who helped us make a difference for our neighbors. As we like to say around here: it takes a community to change a community, and we’re thankful to work alongside a city that embodies that motto.

Reaching the Community through Outreach and Service

While our name Community Clinic, Inc. has been shortened to CCI, it’s by no mistake that the word community comes first.

It is a core principle of our work and an essential part of what makes us a Federally Qualified Health Center. We are not just providing health services for the community. We also host educational events and provide on-site services in the community at public schools, neighborhood parks, recreational centers, and many other public spaces. By being in the community and allowing people to learn more about the work we do outside of a clinical office, we are expanding access to care to achieve greater health equity.

Candid Conversations: Cervical Cancer Prevention

For Cervical Cancer Awareness Month in January, CCI partnered with the Delta Sigma Theta, Inc. Potomac Valley Alumnae Chapter for a candid conversation on cervical cancer at the Casey Community Center in Gaithersburg, MD. CCI’s medical professionals Mia Riley, MD, David Holder, MD, Aastasshia L. Lacy, FNPBC, and Joe McKelvey, PA presented on the importance of cervical cancer screening and the impact this disease has on Black and Brown women. Guests played games such as word scramble and participated in an interactive trivia contest to increase their knowledge about the female reproductive system.

COVID Vaccine Outreach

With the end of the COVID public health emergency, many families are wondering where to get a booster or if they need one. This year, CCI used each outreach event as an opportunity to increase awareness of the COVID booster vaccine by providing them for free. CCI has also been a community resource for other organizations looking to partner with health providers that can offer the COVID booster. In February, CCI partnered with the Clifton Park Baptist Church in Silver Spring to offer COVID and flu vaccines.

St. Patrick’s Day Parade

Many events that CCI participates in are educational, but some are just for visibility. Staff from the marketing, WIC, clinical, and legal departments came to together to walk in the St. Patrick’s Day Parade in Gaithersburg. CCI joined a dozen other organizations including bagpipe bands, school groups, local fire trucks, and more.

Meet the Little CCI Community

The CCI team celebrated National Children's Dental Health Month in February with a few new friends! Beatrice the Bear, Fernando the Flamingo, and Sammy the Sloth made their big debuts in an outreach program called the Little CCI Community, which seeks to educate our youngest patients about dental hygiene.

Developed by our Marketing and Communications team, the Little CCI Community has already made its way to our dental clinics via several charming posters designed by CCI's Graphic Designer, Heather Sun. Each poster introduces a character from the community with their favorite lifelong dental hygiene habit.

There will be much more to come from the Little CCI Community. We look forward to reaching more kids and their parents with this fun program to promote good habits and healthy smiles.

Thinking Outside the Dental Clinic

The search for quality and affordable dental care for children is a significant stressor facing families in our area. Scheduling an appointment with CCI can make things much easier for parents, allowing them to breathe a sigh of relief knowing their children will receive care from a team of clinicians eager to make a difference. But, unfortunately, not every obstacle goes away.

Inequities exist in many forms for our service population. For example, can parents take time off of work for an appointment? Can they arrange transportation? Our integrative approach to care sometimes means patients and participants require several visits with different specialists to ensure an effective care plan. What happens if families just can’t squeeze in another appointment?

These challenges can be difficult to overcome, but our patients and participants can always count on us for support. We take pride in working with them to break down barriers, and there’s no barrier we can’t break down together. All it takes is a little resourcefulness and a lot of passion for equity.

Over the past three years, the CCI team has experimented with combining several services within a single scheduled appointment to secure wholeperson health for our patients and participants.

A notable example is our ongoing efforts to incorporate behavioral health care in annual physicals and CenteringPregnancy® sessions.

Our success has encouraged us to explore bridging dental services with WIC through a pilot program launched in 2021. We chose these two services because they complement each other very well. Parents benefit from receiving oral health guidance as much as they do nutrition and breastfeeding counseling. And since our WIC specialists are welltrained in the connections between what we consume and overall dental wellness, adding dental hygiene resources was seamless for the team.

From December 2021 to February 2023, we asked our Gaithersburg WIC at CCI participants if they would like their children to receive fluoride treatment immediately following their WIC appointment. Our dental hygiene team set up shop inside the WIC center to make the process as smooth as possible for participants. Parents were happy to take advantage of the opportunity, and in the end, dozens of young children left with healthier teeth.

Our dental at WIC pilot showed a lot of promise. We plan to refine the strategy further to accommodate more patients and increase efficiency. It’s an innovative approach to improving accessibility, and it’s what our patients and participants deserve to maintain the healthiest versions of themselves without limits.

Removing the MEDICATION Access Barrier

Amid several pressing issues affecting our neighbors, medication non-adherence continues to concern us. It’s a public health crisis that disproportionately impacts our patient population.1 2 But we have a plan, and it starts with launching our first on-site pharmacy at our Ora Glen location in Greenbelt.

Understanding medication non-adherence and its prevalence helps put the importance of an on-site pharmacy in context.

Medicine non-adherence occurs when a patient fails to take their medication as prescribed.

It’s very common; roughly 20 to 30% of prescriptions in the U.S. are left unfilled by patients, and if they do fill their prescriptions, they are liable to take them incorrectly.3

Low adherence contributes to poor health outcomes and a decreased quality of life for patients. Even more alarming, more than half of hospital admissions nationwide are due to non-adherence, and it’s a cause of death for more than 125,000 people annually.4

Patients may agree to fill their prescriptions and follow the dosage when their clinicians are present, but whether they follow through once they leave the office is anyone’s guess. An on-site pharmacy removes some of that guesswork, connecting expectation of compliance with the opportunity to comply. And research proves they work.

A peer-reviewed study published in the Journal of Managed Care & Specialty Pharmacy found that an on-site pharmacy increases adherence rates and reduces hospitalizations.5

CCI patients will be able to fill their prescriptions in-office beginning in 2024. They can have their questions answered then and there by a technician or give us a call if any concerns arise afterward. That’s the kind of experience we are proud to offer, easing a sometimes complicated process by adding convenience and assurance.

Our on-site pharmacy compliments our patientcentered and comprehensive approach to care and enables clinicians, medical assistants, and patient representatives to work in collaboration to ensure patient adherence. We are committed to making on-site pharmacies a standard offering at every CCI health center so that we may empower our patients to take control of their health by helping them take control of their medication regimens.

Expanding Access to Care

CCI’s Family Planning and Infectious Disease Programs

These last few years have been a difficult time for community health centers like CCI as political unrest surrounding reproductive care threatened funding and made many people fearful of seeking out care. However, our family planning and infectious disease programs saw this challenge as an opportunity to increase access to care and form new partnerships.

Through our family planning program and Title X services, CCI was able to provide care for more than 11,000 patients in 2022, a greater number of patients served than in previous years. This means more people received access to our quality care related to STI testing and treatment, pregnancy testing and counseling, cervical cancer screening, and birth control at a time when reproductive health services were being heavily critiqued in the media. This accomplishment is a direct result of CCI’s ability to form thoughtful partnerships to reach populations that are often overlooked.

One partnership that stands out is with Upstream, a nonprofit organization committed to expanding opportunity and increasing access to contraceptive care. Through this new partnership, CCI and Upstream will work together to better integrate our family planning services with primary care by providing training for our clinicians on patientcentered contraceptive counseling and overall patient education and awareness.

Additionally, our infectious disease department is leading the way in connecting patients who have been recently diagnosed with HIV to care.

With an over 90% linkage to care rate, CCI has been able to address many barriers patients face when seeking HIV testing and treatment such as lack of insurance and access to primary care. Close to half of all CCI patients use Medicaid as a form of health insurance, the largest source of insurance coverage for people with HIV in the United States.

As a community health center, it is our job to provide quality care for anyone who walks through our doors. That is why we not only accept private insurance and Medicaid but also provide care for those who may be without health insurance or are underinsured.

Through our partnerships and innovative outreach methods, CCI’s family planning and infectious disease programs are working together to expand access to care that reaches far beyond the clinical office space but also into the community. Our staff is often leading educational sessions at local high schools, engaging young adults through our Youth Advisory Board, and performing on-site services such as HIV rapid testing on college campuses. This is the CCI way and we’re proud to continuously do this work each year.

Campaigns with a Purpose: A Public Cervix Announcement

January marked Cervical Cancer Awareness month and CCI used this as an opportunity to launch our Public Cervix Announcement campaign to encourage patients to schedule a Pap test, the procedure used to screen for cervical cancer.

The campaign featured a play on the traditional American assembly, the pep rally except CCI’s Pap Rally was aimed at encouraging patients to come in on a specific day to get a Pap test.

To accomplish this, we identified a list of patients who were eligible for a Pap test and reached out to them by phone to schedule their appointment. Through this outreach method, our clinicians were able to perform 16 Pap tests!

When patients entered our offices, they were met with festive décor and educational material about cervical cancer. Our first Pap Rally was just a starting point, and we can’t wait to continue the tradition next year!

A Gaithersburg SUCCESS STORY on Patient-Centered Care

Brianna was four months postpartum when she came to CCI for breast pain. She initially went to the emergency room concerned about breast engorgement and was diagnosed with mastitis. They gave her antibiotics and told her not to feed the baby on the affected breast. This was a red flag for CCI clinician, Ashley Dozier, who was overseeing Brianna’s care.

First, Ashley immediately went into educating Brianna on the cause of mastitis and what to do to relieve symptoms, including feeding the baby on the affected side, correct latch methods, and how to conduct breast massages in addition to prescribing antibiotics to clear the infection.

Next, Ashley performed a breast exam and asked Brianna if she was ever taught how to hand express her breast milk. Brianna replied “no” and explained that the ER was not helpful. Ashley saw this as another moment to connect with Brianna and showed her how to hand express her breast milk into a sterile cup. By the end of her visit, Brianna cried tears of joy to be relieved of pain. She was so happy and grateful.

At her two-week follow-up appointment, Brianna expressed how happy she was with the care she received. She communicated that she went to so many providers and did not receive half of the care that she received from CCI that day.

This kind of care is why I am here at CCI.

“I made the transition from bedside nursing and became a nurse practitioner because I wanted to make a positive impact in the primary care setting.

My love for breastfeeding and education has given me the drive to seek my certification as an International Board of Lactation Consultant (IBCLC). Having this certification will allow me to better assist my breastfeeding patients.

When I was at the bedside, I was a big advocate for my breastfeeding patients, and I remain the same as a clinician today.”

Ashley Dozier MSN, APRN, WHNP-BC Gaithersburg OB/GYN clinician

*Name changed to protect patient’s privacy

Black Maternal Health It Takes a Village

April 11–17 marked Black Maternal Health Week, a week-long campaign to build awareness and highlight the lived experiences of Black birthing people. CCI engaged in multiple activities that week, including entering and being selected as a finalist in HRSA’s Black Maternal Health Week Photo Spotlight and appearing on local television networks, such as DC News Now and WJLA to talk about Black maternal health.

However, an activity that stood out the most was our Black Moms Matter Too panel discussion with Zion Church in Greenbelt. As CCI clinicians educated attendees on topics such as prenatal care, fertility, and mental health, a theme started to arise: it takes a village. This adage is not new to those who identify as Black or African American. We often hear our elders say this when it comes to raising children because we know it is not something we can do alone.

And here at CCI, we aim to be a part of that village for anyone who walks through our doors. We know that constantly hearing about the rising maternal mortality rate can have a weathering effect on the mind and body.

However, we believe every expectant parent deserves quality care before, during, and after pregnancy. That’s why we have incorporated the CenteringPregnancy® program model into our prenatal care.

What is CenteringPregnancy®?

Centering is holistic, relationshipbased care that gives patients more time with their clinicians in a supportive environment with other parents-to-be. We incorporate this program into our prenatal care by bringing together a small group of expecting parents in the same pregnancy stage for a series of engaging and informative sessions on labor and delivery, breastfeeding, postpartum care and so much more!

Our expecting parents walk away with free maternity supplies, access to healthy nutrition, and resources they’ll need along their parental journey. As a result, more than 91% of CCI parents in our program delivered a baby with a healthy weight in 2022.

Through our CenteringPregnancy® program and the supportive services we offer, CCI is proud to play a vital role in our community’s village.

Choose Community. Choose Culture. Choose Care.

CHOOSE CCI

Employee Profile: LESVIA GALO-VELASQUEZ

Lesvia Galo-Velasquez has been a member of the CCI team for over ten years. During her tenure, she has collaborated with a plethora of different staff and community members and served in many different roles within the organization.

She is both proud of her individual growth as well as the growth of the organization.

Lesvia first came to CCI as a medical assistant, and since then she has had the privilege to oversee the Refugee Health Program.

In the last couple of years, the Refugee Health Program has worked with the Maryland Department of Health to assist Afghan and Ukrainian people to get assimilated into the state of Maryland. Under Lesvia’s guidance, CCI has conducted the most assessments in the state during the 20-21 fiscal year.

Her achievements haven’t stopped there. In late January, Lesvia received her Bachelor of Science in Nursing from Chamberlain University.

She is excited about CCI’s expansion efforts, and the future of the organization. “We have grown a lot in the past ten years, and we will continue to prosper.”

CCI staff comprises hundreds of skilled and mission-driven clinicians and professionals. They could work anywhere they want in the health care field. But they choose to serve their community. They choose a culture of growth. They choose to deliver patient-centered care. That’s why they choose CCI.

If you’re ready to focus your abilities and experience towards improving the lives of your neighbors, you’re ready for CCI. Visit ccicares.org to learn more about our career opportunities.

My favorite thing about CCI is the population we serve and our mission.

MEET OUR BOARD

MARGUERITE LUCEA

Our newest Board Chairperson, Marguerite Lucea, has been around the public health space for years. Marguerite is a professor of Public Health at Towson University and a registered nurse. She stumbled across the board almost by chance. After a recruiting pitch by her neighbor Beth Durham (another board member), she signed on.

“Being able to use my expertise to help address the health of a community on a larger scale was a huge selling point for me,” says Marguerite.

Lucea is passionate about public health and equity. She believes in accessible health care for everyone.

“I am very interested in ways to provide equitable health care to all populations. As a public health nurse, I realize how many aspects of our life contribute to our health and well-being,” she says.

As a three-year board member, she has seen CCI change and grow exponentially since 2020. She envisions CCI as a household name and a prominent player in the health care space.

She sees purpose as her true north that steers her in the right direction. As a single mother to two boys, her purpose kept her grounded as the COVID pandemic hit.

Marguerite lives by the quote:

by

Scan here for more information if you or someone you know is interested in joining our Board of Directors.

Never underestimate the power of a small group of committed people to change the world. In fact, it is the only thing that ever has.

-

Margaret Mead

Transportation: A Vehicle to Wellness

Each year, 3.6 million people in the U. S. do not obtain medical care due to transportation barriers. Lack of transportation can result in missed or delayed health care appointments, poorer health outcomes, and increased patient health care costs. Patients who walk or use public transit to access medical care are less likely to establish routine care and more likely to miss appointments.

Offering transportation to patients is a game-changer.

In July 2021, CCI was fortunate to receive a grant from the Local Initiatives Support Corporation (LISC) to offer Uber Health rides to our patients so they could receive the COVID-19 vaccine and education. CCI is doubly grateful that LISC has renewed their support of CCI and our patients in 2023.

In partnership with Uber, LISC has made grants to community-based organizations to support health equity by addressing transportation barriers to accessing services. This grant will support access to essential health care and other services for individuals and communities disproportionately affected by transportation barriers, particularly BIPOC and Latino/a residents living on low-incomes, to reduce health disparities and advance health equity. Nearly all CCI patients (98%) fall below 200% of the Federal Poverty Level and for more than 70% of our patients, English is their second language.

Access to transportation is necessary to receive ongoing health care. CCI is so grateful for the continued commitment and generosity of LISC in helping to remove transportation as a barrier and helping patients into a vehicle of wellness.