The Community Health Centre model proposed for the Lower Columbia region
The Vision
The Lower Columbia Community Health Centre Network (LCCHCN) vision is to provide primary care access to all Lower Columbia residents by attracting and retaining providers to practice team-based care within an appropriate and sustainable funding model. The LCCHCN improves not only patient outcomes, but also provider satisfaction.
The LCCHCN is a not-for-profit Society that is community-governed and community-centered, ensuring diverse and enduring community representation. It actively addresses social determinants of health, strives to provide culturally safe care, and demonstrates commitment to health equity and social justice.
The Lower Columbia health service area (CHSA #1250) includes five municipalities and two electoral areas, has about 20,000 residents and is a natural demographic unit. The vision for the LCCHCN is four sites of self-managing teams whose autonomy is represented by a central operational committee comprised of team member representatives. The LCCHCN is built on a “flat” organizational structure where all voices are heard.
Innovative funding sources result in a stable budget and sustainable operations. Attractive compensation models for primary care providers, as well as scheduling flexibility and less administrative work, result in LCCHCN providers, and indeed all team members, experiencing high levels of job satisfaction.
The LCCHCN Service Delivery Model centers essential services around the patient and provider. Services include chronic and complex care, urgent care, outreach, and targeted programs. Targeted programs will be specific to the needs of the site community including the most vulnerable. Frequent community engagement sessions are conducted to determine community-specific needs.
Service Delivery Model Based On Community Needs
Based on the 2021 Needs and Assets study and community engagement visioning sessions conducted in 2022, the Lower Columbia CHC Network Service Delivery Model is designed around patients and providers to achieve four key objectives with a strong connection to community: Team-based Care, Access, Attachment, and Continuity of Care.
The service delivery model proposed has aspects of a patient medical home where patients benefit from longitudinal care; has the scope of full-service PHC with an interdisciplinary team integrated with specialist and regional services; has the features of a Primary Care Network, in which LC CHC Network acts as the health hub to help coordinate and navigate the complex health care system; and is integrated within the comprehensive concept of a CHC model.
Each of the LCCHCN services is designed to contribute to achieving these key objectives:
Attachment – incrementally increasing number of patients per provider due to effective delivery of team-based care; attachment to a regular primary care practice allows people to receive longitudinal, comprehensive, and timely care
Access – extended hours; provider options; virtual care/telehealth; settlement services; community services; practicing cultural humility
Continuity of Care – shared Electronic Medical Record (EMR) software creates seamless delivery of continuous care among team members; effective connection with community resources, including but not limited to, Home Health, Mental Health, Public Health, etc.
Team-based Care – patient and family input is integral to a team-based care model; providers utilize their full scope of practice, embrace overlapping scopes of practice with fellow team members, and provide access to the most appropriate team member to meet the patient’s needs; having a team of providers within the network reduces not only demands for specialty care, but also the use of the ER for non-emergency visits