Duke Focuses On Community Health In N.C.; Baltimore Mental Health Agency's Practices Raise Questions; Mass. Clinic's Efforts To Curb Diabetes Highlighted

The Washington Post reports on Duke University's experiment with community health centers: "Duke University has been focusing closer attention on the neighborhood that surrounds it by forming a partnership with Durham's Federally Qualified Health Center. It's an experiment in community care that began well before health care became a heated political battle. It's one that has been closely watched by the Obama administration as a model for its vision of widespread reform. And perhaps most significantly, it's one that could survive and even thrive if the new law is never fully implemented or is ultimately repealed, as some newly elected Republican members of Congress advocate. The project's aim is simple: reduce chronic illnesses that plague the uninsured to keep them from making expensive visits to hospital emergency rooms."

"In the longer term, experts say, such experiments in delivering community care — as well as medical schools and federally qualified clinics in at least eight other cities — have the potential to reduce overall health-care costs and even help heal other festering wounds such as race relations" (Fears, 11/6).

The Baltimore Sun reports in a series of stories on Baltimore Behavioral Health Inc. and mental health diagnoses: "Addicts who step into BBH from the city's drug-racked streets are three times more likely to be deemed mentally ill than are addicts treated at other centers across Maryland, state records show. And BBH has long funneled patients into the costliest outpatient treatment programs available to poor Marylanders — programs they would not qualify for without a diagnosis that they have a psychiatric illness. In some years, state data show, the West Pratt Street center has swallowed up 85 percent of the taxpayer funds spent on intensive outpatient mental health care across Maryland. ... But former patients and employees, as well as outside doctors, say BBH has been diagnosing mental illness — and collecting public money to treat it — in some patients whose main affliction is drug addiction" (Calvert, 11/7).

The Boston Globe reports on intensive efforts by a local health center to curb diabetes in Massachusetts: Caregivers at the Codman Square Health Center in Dorchester have developed "a multi-pronged program aimed at changing attitudes, exercise, and nutrition habits. They've also changed the traditional doctors' visits for diabetics. Instead of the typical 10- or 15-minute session with a physician, diabetics are organized into groups of 10 that meet with caregivers for a three-hour visit, allowing each more time with specialists, but also with a group of kindred spirits. ... The center launched cooking and fitness classes tailored for diabetics. It opened a gym, with funding from a private partnership, that allows physicians to write free prescriptions for exercise for diabetics and others with chronic diseases. Another partnership pays for prescriptions for diabetics to get free fresh fruits and vegetables at the center's farmer's market" (Lazar, 11/8).

Bennington (Vt.) Banner: "Tasked by the Vermont General Assembly to create three proposed solutions for universal access to health care in the state, Dr. William Hsiao presented his preliminary findings and the difficulties moving forward to members of the Vermont Medical Society at their 197th annual meeting Saturday at the Equinox Resort in Manchester. Laying out the goals and principles of Act 128, legislation enacted earlier this year which seeks potential routes toward universal heath care coverage in Vermont, Hsiao acknowledged his audience's role in deciding the future of health care in the state and appealed for their input as he moves toward developing the final proposals, due Jan. 1" (Wright, 11/7).

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