Roanoke Chowan Community Health Center: A Focus on Community Connection

Roanoke Chowan Community Health Center is not only a part of the North Carolina Community Health Center Association and the statewide health care safety net, but we are also a part of the OCHIN Collaborative, a national network of safety-net pro­viders. Over the last 10 years, this network has effec­tively tracked and compared the experience of access to care and quality outcomes among patients located in Medicaid expansion states and non-expansion states.1 It has been both frustrating and informa­tive to compare impact across states. The feeling of our patients being left behind has been profound. Gratefully, during COVID-19, so many folks were able to access Medicaid benefits, and the unwinding of these resources followed by Medicaid expansion has left just a few in the gap.

When we talk about concepts like Medicaid con­tinuous coverage unwinding, expansion, and man­aged care, it is important to remember that these words mean little to nothing to most patients. It’s even challenging to make sure all FQHC staff are well educated on these topics. So, at RCCHC, we created a phone number for patients to call with questions about Medicaid. The number is answered by three to five highly educated practice managers who have attended many trainings on unwinding and expan­sion, and have already been doing enrollment work for some time.

Our close-knit communities have been key to ensuring individuals know how to connect to our health center. Of course, social media and text mes­saging have been a great help, but most folks respond better to the personal call and referral. For people who might already know to come to us for help understanding eligibility, we have a special phone number with highly educated staff willing to help; for those who haven’t yet heard of us, we have ongo­ing outreach efforts including postcards and other mass media outreach. Through our staff, board, and patients, we are well connected to a network of reli­gious and community organizations as well as com­munity colleges that will help to get messages out. In fact, our staff and board are some of our best messengers; we are engaging in continuous educa­tion internally so that everyone can answer questions from friends, family, and neighbors.

The long wait for expansion has been trying, and keeping hope alive has been challenging. In Eastern North Carolina, we know firsthand about persever­ance and the bend toward justice. We look forward to positive health outcomes in our national network and tracking the impact of expansion in Eastern North Carolina.

Now that Medicaid expansion is really here, we’ve been asked: How many people will it impact? At RCCHC, we saw 16,740 unique patients in 2023. We expect some 1,500–2,000 people in our commu­nity to be newly eligible for Medicaid, but any time a change to insurance eligibility happens, some people come “out of the woodwork” who were already eligi­ble—so we may see even more enroll. We also know that children are more likely to get care if their par­ents have insurance, so even though kids have always been eligible, they may finally enroll now.

As we launch our own outreach campaign (for which no state funds have been allocated) we know there are a number of challenges, including the fact that many people do not know how to apply for resources in general, or how to apply for Medicaid specifically. There is a common belief that there are some people who do not like the idea of state assis­tance, but research has shown that this concern is relatively low in frequency2; we also know that those who have never had health insurance before will be hardest to reach. Getting folks into our system is good either way—we can help them get access to the resources they need, whether for social determi­nants of health, help from our Agricultural Outreach Team, or other resources. FQHCs like RCCHC offer a sliding scale so that patients can afford to pay for a part of their care that fits their income.

Our health center prioritizes the investment of time and financial resources for the rollout of Medicaid transformation. Dr. John Hatch, one of the early founders of the community health center move­ment, who recently celebrated his 95th birthday, said it best: “What gives me hope is the people who con­tinue the work with joy and peace….and a song!”.3 At Roanoke Chowan Community Health Center, our chorus of great care for every one, every day, rings loud and clear!

Bridging Health Care Gaps: CommWell Health’s Holistic Approach to Medicaid Expansion in North Carolina

In a significant stride toward advancing our mis­sion of the compassionate delivery of quality medi­cal, dental, and behavioral health services for all, CommWell Health is excited to support Medicaid expansion in North Carolina. This strategic initiative is designed to address gaps in health care coverage and extend essential medical services to more indi­viduals and families throughout the state.

Medicaid expansion in North Carolina aligns with our mission, reinforcing our dedication to providing compassionate and comprehensive health care solu­tions to our communities. This is a huge undertak­ing. We’ve identified over 20,000 potentially eligible patients in our communities, and we have a drive to help get them the coverage they deserve. We have even partnered with local Department of Social Services offices for education and feedback so that our program provides a quick turnaround time for our patients.

At the heart of our commitment is a dedicated team of certified enrollers who have been meticu­lously trained to guide patients through the intricate process of accessing health care coverage. They con­duct screenings and complete applications alongside patients, then assist in obtaining documentation when necessary. This screening process is integrated into our health care services: eligibility screenings happen during patient appointments, and if eligible the patient is referred to an enroller for further assis­tance. This proactive approach aims to ensure that all patients, regardless of the nature of their visit, are made aware of and screened for Medicaid and other programs at CommWell Health.

We have also expanded our outreach by hiring a dedicated team of community health workers. These individuals are actively connecting with local com­munities to listen to the needs of the people, allowing CommWell Health to tailor services to address those specific needs. Working together with our enrollment team, these community health workers ensure that patients are well-educated on their options for per­sonalized care. Our goal is to maximize awareness of and accessibility to essential health care coverage options, making the enrollment process as seamless as possible for everyone eligible for coverage.

CommWell Health is excited about the positive impact Medicaid expansion will have on communities in North Carolina. Our certified team of enrollers, in collaboration with community health workers, stands ready to assist individuals and families in navigating the complexities of health care coverage. This rein­forces our commitment to the compassionate deliv­ery of quality medical, dental, and behavioral health services for all.