Althea Johnson returns to Wilmington to run New Hanover County’s only FQHC
BY CHERYL L. SERRA PHOTO BY TERAH WILSON
Althea Johnson has come ‘home’ in order to help run an organization aimed at providing people of all ages access to a comprehensive variety of health care services they wouldn’t normally have, something she thinks is a right.
Johnson is CEO of New Hanover Community Health Center, Inc., doing business as MedNorth Health Center, the only federally qualified health center (FQHC) in the county, located on North Fourth Street.
A FQHC qualifies for federal funding and enhanced reimbursement from Medicare and Medicaid because it serves an underserved area or population, offers a sliding fee schedule, provides comprehensive services, and has an ongoing quality assurance program and a governing board of directors. Its safety net services are often provided in an outpatient facility.
Johnson had a circuitous health-related career before returning to Wilmington in 2004. Originally from the city, she left to go to Shaw University and then moved to New Jersey where she worked for 20 years for Plainfield Neighborhood Health Services Corporation, an FQHC in New Jersey, eventually serving as COO. She also earned a master’s degree in management from New Jersey Institute of Technology.
She then went to Atlanta hoping to do something a bit different in the healthcare field and earned another bachelor’s degree from DeVry University in information technology, thinking she would work in health-related informatics, which would help her run her own reports. She uses the skills she learned there today.
Returning to Wilmington because her father was ill, Johnson worked for the New Hanover County Health Department as a health planner. In 2007, Johnson started her position as MedNorth’s deputy director, a position for which her 20 years in an FQHC and her other experience “uniquely qualified” her, she said. Her title was later changed to COO and now she’s CEO.
She sees her job as eliminating barriers to health care, pure and sometimes not so simple. Primary care is – or should be – the appropriate entry point for health care, she says. From there, patients at MedNorth can access a range of health care services available to people of all ages: adult and family medicine, dental care, women’s health, pediatric services, on-site pharmacy, and prenatal care. MedNorth recently added podiatry to this menu of services and Johnson notes there is a large diabetic population in the area and many of them suffer from foot issues.
“Having everything here in the same building helps to accommodate what they need,” Johnson says, referring to the onsite facilities for lab work, dental and behavioral health services, to name a few. “I think if you had to go to many different places that might present a problem.”
In addition, for those who are seeking behavioral health help and are weary of the stigma attached to it, having the words “behavioral health” or something similar on the door might be off-putting. Under MedNorth’s model, a person who comes to visit a clinical provider can learn about behavioral health services and be introduced to providers; it’s an integrated, interdisciplinary team approach to providing healthcare.
Johnson points to the statistic showing that 27 percent of MedNorth patients have Medicaid, which many physicians don’t accept, as a way to illustrate what MedNorth does for the community. Nationwide, she says, many states expanded Medicaid eligibility; North Carolina did not. An individual or family can qualify for an FQHC discount if the household income is 200 percent of federal poverty level, currently at $20,780, or less.
There are many people in the Wilmington area who fall into that category, according to Johnson.
She talks about the Wilmington area having many service industry jobs at which folks make minimum wage or slightly above it. There are also many self-employed people, including those in the building industry and the arts. Many of them are responsible for their own health care costs.
“They’re not making enough money,” to pay for insurance, she says. “Gone are the days when your employer is paying 100 percent of your insurance cost; all of that cost has shifted to the employee.”
Johnson believes universal health care is the answer, ensuring access to health care to all, although she acknowledges this is a politicized debate.
Asked if she’s disheartened by the position so many people are in related to their health care, Johnson says there are a lot of aspects that health care providers can’t control, such as patients’ health care literacy and proximity to supermarkets that offer healthy food at affordable prices. So she focuses on what they can control, at least to a degree.
“I’m not disheartened,” she says. “There are a lot of different organizations that are working together to improve the health of residents.”
Dr. Mayra Alicia Overstreet Galeano and her family fled war-torn Nicaragua in 1985.
In 1985, Dr. Mayra Alicia Overstreet Galeano fled war-torn Nicaragua with her family. She was only 9.
The Sandinistas had confiscated the family’s personal belongings. They left with just three suitcases and their parents’ advice: “The only thing that can’t be taken from you is your education.”
Galeano would make the most of her education in America, getting a scholarship to college and then going to medical school.
But it was difficult in the beginning. Galeano and her family settled in Tennessee with an aunt who helped get all the paperwork for them to come to the United States as refugees.
Going from a tiny island off the coast of Nicaragua to the mountains of Tennessee was a culture shock for Galeano. At the time, her family was one of only three Spanish-speaking families in the county. Her English was limited; she only had a few crash courses before beginning elementary school.
For Galeano, her elementary school experience was a great one. The school she attended was very accommodating to her family and they went above and beyond to welcome them. She remembers her principal giving her rides to after-school sports activities and even purchasing her a pair of running shoes.
Her family knew the struggles of being refugees and a low-income family. They had no insurance and it wasn’t until she was 15 that she had the chance to visit a dentist. With the encouragement of her parents, she and her siblings did very well academically and after graduating from high school she was awarded a scholarship to attend Duke University. At the time, she had not planned on becoming a doctor, but knew she wanted to serve families who struggled like hers.
Galeano graduated from Duke in 1999 with a degree in biology and had planned to do HIV research until an opportunity opened for her to work for the Children’s Environmental Health Initiative.
As a result of her scholarship to Duke, she met a faculty member that received funding from the CDC for a project to study lead exposure in children. There was a need for a Spanish-speaking person with a science background. As part of the job, they would be doing an analysis of data and also going into homes to collect samples of paint. A lot of the homes were lower-income, Spanish-speaking families. Galeano was perfect for the job.
During her time working with the Children’s Health Initiative, Galeano was studying the social determinants of health and trying to find ways to address them to change the outcomes for the underserved families she was working with.
According to the CDC, economic and social conditions influence the health of people and communities. These conditions are shaped by the amount of money, power, and resources people have, all of which are influenced by policy choices.
During the course of her work, Galeano noticed a need to address the immediate health care concerns of these underserved families and came to the conclusion that until these needs were met they would not be able to address the larger issues affecting their health.
The families she worked with were struggling with health concerns such as asthma due to mold in the home. The mold issue had to be addressed but asthma needed to be treated first. These pressing issues were stopping the families from addressing the cause of asthma.
“Being able to address the immediate health care concerns, I thought, would help me better advocate for addressing the social determinants of health,” Galeano said. At that moment, Galeano decided to go to medical school.
In 2011, Galeano graduated from the University of North Carolina Chapel Hill School of Medicine. She then began her family medicine residency at Oregon Health and Science University in Portland. She completed her residency in 2014 but stayed for one more year to do a faculty development fellowship. After completing her fellowship in 2015, she remained at OHSU and taught for a year until she moved to Wilmington in March 2016.
A few key factors led Galeano to Wilmington. “I grew up on an island so being close to the beach and seafood is really good,” Galeano said. “I get to, professionally, do the things that I want to do as well.”
Galeano wanted to be in a position where she could teach, do prenatal care and deliveries, and serve a population similar to the one she came from. She now teaches in the Family Medicine Residency Program at New Hanover Regional Medical Center and is a family physician at MedNorth.
“For me, I understood the importance of family health, understanding how my family was affected by the war and how the community affects your health as well,” Galeano said. “It’s been an important part of my career and my personal life. It’s incredibly rewarding.
“Health doesn’t come just from a pill. It really comes from your community and from a better understanding of how you fit in the world.”
Getting to know: Dr. Mayra Alicia Overstreet Galeano
Hobbies: Running, reading, cooking, Latin dancing, hiking
Bucket list: Traveling
Health care tip: “Taking care of yourself is one of the most important things you can do. Taking care of yourself, ideally, would include healthy eating, drinking water, staying active, and staying connected. Connected to your community but also to yourself, being aware of who you are, what’s important for your health, and what brings you joy.”
New Medicare cards are coming! Medicare is mailing new cards between April 2018 and April 2019. The new card has a Medicare Number unique to you, instead of your Social Security Number. Your new card will automatically come to you—just make sure Social Security has your most up-to-date address. For more information, visit go.medicare.gov/new card.
On Tuesday February 6, hundreds of advocates will be in DC meeting with Congress and demanding a fix to the Health Center Funding Cliff. On that day, we are calling on all Health Center Advocates to wear red in support of health centers.
Over four months ago, Congress failed to extend funding for Health Centers and fix a 70% funding cliff. This failure to act has put 9 million patients, 50,000 jobs, and nearly 3,000 health center sites at risk. The time is now for Congress to act and extend critical funding for health centers. Read the latest on the health center funding cliff on NACHC’s blog.
What can you do on 2/6 to add your voice to the millions of patients, staff, partners and supporters that depend on health centers?
Join the #RedAlert4CHCs Thunderclap. By joining the Thunderclap, you and others will share the same message at the same time, spreading a call to action through Facebook, Twitter, and Tumblr that cannot be ignored.
Use local media to spread the word. Access templates to share a media advisory or press release or publish an op-ed to share your health center’s plans for the Day of Demonstration.
Wear red! Don’t have a red shirt? Wear a red scarf, pin, hat, or other accessory.
Ask your friends, partners, colleagues and others to wear red too. Email them here so they know how critical this act of demonstration is.
Post to social media. Get a group together to take a photo with this sign (click here for PDF version), and Tweet or post to Facebook with #RedAlert4CHCs #FixTheCliff #ValueCHCs. Sample Tweets are below along with images you can share.
MedNorth offers nurse practitioner opportunity to help where he helps people who have no other health care options.
By Terah Wilson StarNews Correspondent
From a very young age Erin Williamson knew exactly what he wanted to do with his life.
“I wanted to be a nurse practitioner serving medically underserved people. Ideally, lower-income people who have limited access to health care,” Williamson said. “It is the dream job that I’ve had since I was 16. Mainly because growing up poor we got to learn what it was like to have limited access to good health care. You don’t know how that feels unless you are in that situation where you’re treated differently.”
Williamson is the seventh of eight kids. He has six older sisters and one younger brother. He loved growing up in a big family but quickly learned there were hardships that went along with it. His family’s income challenges made his access to quality health care difficult.
Williamson attended Laney High School where he took health occupations classes. He graduated with a Nursing Assistant certificate and went straight to work. Due to the hardships he faced as a child, getting a job right out of high school was very important to him. His first health care job was at Liberty Commons Nursing Center where he worked the midnight shift. He met his wife, Rachel, and continued to work there while she finished her college degree.
Williamson and his wife then moved to Greensboro where he attended the University of North Carolina at Greensboro, graduating in 2004 with a degree in nursing. After graduation, the couple moved back to Wilmington where Williamson took a position with New Hanover Regional Medical Center on the adult inpatient surgical floor. He held the job for five years while he worked on his master’s in nursing at UNCW.
Toward the end of his master’s studies, Williamson had to choose a practice where he would complete the clinical part of his training. With careful consideration he chose MedNorth Health Center, which at the time was still called New Hanover Community Health Center.
MedNorth receives federal grant funds from the U.S. Department of Health and Human Services’ Health Resources and Services Administration to provide a full spectrum of primary and preventive health care services (including ancillary and enabling services) to medically underserved populations, in New Hanover and surrounding counties in Southeastern North Carolina. Patients receive services regardless of their ability to pay. Services are designed to cover prenatal, pediatric, adolescent, adult and geriatric life cycles.
Williamson knew this was the right place for him. “I liked the community health center because being downtown we get an interesting mix of homeless people, professors, other professionals that work downtown, and a lot of people who have no other place to go for healthcare,” he said.
In 2009, when Williamson finished his master’s, Williamson went to work at MedNorth. “I went straight from being a student to being a nurse practitioner,” Williamson said. “I’ve been there ever since.”
He splits his time between the downtown clinic and MedNorth’s clinic at First Fruits Ministries, 2750 Vance St., on Thursdays. His favorite part of his job is providing the compassion and care that many lower-income people never get to experience.
“I love what I do because I get to serve other people and I get to stay up-to-date with newer technology, medicines, and research,” he said. “Healthcare is always evolving so I get to stay on the cutting edge of things like that, but at the same time I get to sit down with somebody one-on-one and talk with them about how they can improve their health and improve their life.”
There are less than 10 more days (and fewer legislative days) before we lose 70% of federal funding to Community Health Centers. NC’s most vulnerable people could lose access to health care. We need to turn up the volume on emails, calls, and personal visits to congress.
It takes 7 minutes to make a difference in the lives of Community Health Center patients by calling and emailing your elected officials.
3 minutes: Call Senator Burr’s office 1-866-456-3949.
Say: Community Health Centers are about to lose 70% of their federal funding. This will lead to more than 200,000 North Carolinians losing access to healthcare services and more than 1500 people losing their jobs. [If you think you may be one of them, say that, too!] I am asking Senator Burr to fix the health center funding cliff before September 30th. Don’t delay it!
2 minutes (It’s quicker once you have the hang of it!): Call Senator Tillis’ office 1-866-456-3949.
Say: THANK YOU to Senator Tillis for being a leader in support of Community Health Centers and for signing the Community Health Center support letter. Now, I am asking him to make sure a long-term solution to the Community Health Center funding cliff is reached before September 30th.
2 minutes: Call your Representative’s office (1-866-456-3949 will link you based on your zip code).
Say: Community Health Centers are about to lose 70% of their federal funding. This will lead to: More than 200,000 North Carolinians losing access to healthcare services and more than 1500 people losing their jobs. [If you think you may be one of them, say that, too!] I am asking Representative [INSERT] to cosponsor HR 3770, the bill that would extend Community Health Center funding, and make sure to fix the health center funding cliff before September 30th. Don’t delay it!
Over 50 events around North Carolina are planned as part of National Health Center Week (NHCW). The national campaign runs August 13-19th with the goal of raising awareness about the mission and accomplishments of North Carolina’s community health centers and those across the country over the course of more than five decades.
North Carolina’s community health centers play a vital role in our state’s healthcare safety net. They are innovators in healthcare delivery and feature a patient-centered medical home model that utilizes care teams and enabling services to help patients address their medical and social needs. Today, they play the following role in NC:
Serve more than 480,000 patients (41% uninsured, 26% Medicaid, 13% Medicare and 20% private insurance).
Offer sites in 85 of North Carolina’s 100 counties
Provide medical, dental, pharmacy, behavioral health and substance abuse services
Participate in new delivery systems, such as Centers for Medicare and Medicaid Services’ Accountability Care Organizations and a Health Center Controlled Network that analyzes patient data to improve care
Generate & support over 3,400 jobs across the state
Have the staff expertise & outreach ability to help patients as the state moves through its Medicaid transformation
Nationally, community health centers:
Produce $24 billion in annual health system savings
Reduce unnecessary hospitalizations and unnecessary visits to the emergency room;
Treat patients for a fraction of the average cost of one emergency room visit
Maintain patient satisfaction levels of nearly 100 percent
Serve more than one in six Medicaid beneficiaries for less than two percent of the national Medicaid budget
Health centers not only prevent illness and foster wellness in the most challenging populations, they produce innovative solutions to the most pressing healthcare issues in their communities. In North Carolina, where our state did not expand Medicaid coverage to uninsured adults with incomes at or below $138% of the federal poverty level, community health centers remain one of the few healthcare providers willing to treat the
uninsured. They reach beyond the walls of conventional medicine to address the factors that may cause sickness, such as lack of nutrition, mental illness, homelessness and addiction. Because of their long record of success in innovation, managing healthcare costs, and reducing chronic disease, leaders in Congress have declared health centers a model of care that offers a “bipartisan solution to the primary care access problems” facing our nation.
There are NHCW events scheduled across North Carolina and the country, including health fairs, press conferences, back-to-school drives, community breakfasts, patient appreciation events, free health screenings and dental cleanings, visits by members of Congress and state officials and much more.
To learn more about NHCW and the listing of events please visit: www.healthcenterweek.org.
You can also follow the conversation using #NHCW17 or #ValueCHCs on Twitter, Facebook, and Instagram.