Carving a Niche in Community
Health Centers
(November/December 2003)
By Fern Aaron Zagor, ACSW, Chief Administrator, Community and Mental Health Services, Joseph P.Addabbo Family Health Center, Rockaway, Queens, NY
For over 30 years, Community Health Centers have been responsible for bringing doctors, basic health services and facilities into the nation’s neediest and most isolated communities. Health centers serve the working poor, the uninsured, as well as high-risk and vulnerable populations. In this setting, social workers have a unique opportunity to enhance human well-being and meet the basic needs of those coming for care. Consistent with our mission, we can focus on the holistic needs and empowerment of people who are vulnerable, oppressed, and living in poverty.
The Joseph P. Addabbo Family Health Center, where I work in Rockaway, Queens,
is the largest federally qualified and funded community health center in Queens.
We provide comprehensive ambulatory services to a Queens’ population that
has some of the highest rates of such risk factors as poverty, chronic illnesses,
substance abuse, mental illness, teen pregnancy, HIV/AIDS, domestic violence,
child abuse, and academic failure. At the Addabbo Center, social workers play
an important and influential role in the provision of care to our patients and
to the community as a whole. We have been able to help broaden the Center’s
mission from caring for the health and well being of the individual who comes
to us for health care services (which of course we continue to do) to caring
for the health and well being of the entire community.
Starting where the client is
Social work values guide the work we do at the Addabbo Center. We have a commitment
to quality services that respect the dignity and worth of the individual. As
social workers we have helped to develop a system of service that encourages
individuals to share their concerns in a non-judgmental environment. All our
services are integrated and offered through a “seamless system of care.”
In other words our community residents can come into our facility and know they
will be nurtured and cared for regardless of their problems or their socio-economic
status. Our social workers make sure that all needs are addressed – we
“start where the client is,” help empower the individual and connect
them to resources both within our facility and in the community.
Increasing importance of social work practice
Social workers and social work practice have taken on increasing importance
at the Addabbo Health Center. When I first started working at Addabbo, as the
Director of Mental Health, nearly thirteen years ago, there were four social
workers at our Mental Health Clinic and one part-time social worker at our medical
site. We now have five social workers at our medical sites (two sites with MSWs
and BSWs), eight at our Mental Health Clinic, two MSWs at our Children’s
Psychiatric Day Treatment Program, and six social workers at our Community Resource
Center. In addition I am now the Chief Administrator of Community and Mental
Health Services and a member of the Senior Management Team involved in the planning
and the operation of the Health Center.
The increased presence of social workers at the Addabbo Center reflects a change
in the perception of social workers held by Community Health Centers. Health
Centers are host agencies for social work practice. In these settings doctors
typically want to communicate with other doctors; administrators often view
social work practice as ancillary. Recognition of our value, and the status
that accompanies it, can be hard earned. However, this is changing. For instance,
we have just learned that the NYS Department of Health has recognized our value
by, under certain conditions, reimbursing social work practice and the provision
of psychotherapy in Community Health Centers. In another arena, the Clinical
Directors Network (CDN), an organization of clinicians providing services in
Community Health Centers, has just broadened its board membership. Until recently,
all board members were primary care providers – doctors and dentists.
This year CDN has decided to include clinicians from other disciplines and I
am the first non-medical clinician to serve on the CDN board, representing social
work and behavioral health care.
Promoting social justice
Social work values of social justice and community empowerment have influenced
the broader mission of the Addabbo Center in caring for the health of the entire
community. This is unusual territory for Health Centers, but absolutely vital
if we are to have long lasting impact on the high risk factors that effect our
residents. With this in mind, as Chief Administrator, I have been able to get
several grants that are designed to strengthen our community. Among these is
a $9 million federal grant over three years from the Safe Schools/ Healthy Students
Initiative. Our project, called Project for Rockaway Youth in Safety and Education
– PRYSE – is aimed at reducing youth violence and strengthening
families. We have funded ten agencies and over 24 programs in the schools and
community; and we have formed a coalition of over 50 stakeholders who are taking
ownership for our community and working to create a safe and healthy environment
for everyone. Community organization principles have guided us on this exciting
journey.
We have received a $2.4 million dollar federal grant over three years through
the Healthy Communities Access Program. This is a federal program designed to
reduce barriers to health care and increase access for the uninsured, underinsured
and undocumented. We are working with community health care, behavioral health
and social service providers, as well as community residents, to make sure that
the disenfranchised and poor have the same basic rights, protection, social
benefits, and opportunities to health care and related services as everyone
in Rockaway.
Clearly, Community Health Centers are a wonderful environment for social work
practice. Our professional principles and values are well reflected and guide
us in the work we do. In these settings we have an opportunity to bring about
real change in the interest of the individuals we serve. It’s certainly
an exciting time for social workers in community health centers.