Dr. Jonathan Castro in his office at the Greater Hudson Valley Family Health Center in the City of Newburgh.
Physicians such as Dr. Castro were honored during National Health Center Week, which recognizes health centers and their staffs for their contributions to community care. Times Herald-Record/CHET GORDON
By Christian Livermore
Times Herald-Record
August 10, 2008
NEWBURGH — Dr. Jonathan Castro was studying to be an architect when his mother extracted from him a promise on her deathbed.
That promise changed the course of his life, and the lives of many of the patients he cares for at the Greater Hudson Valley Family Health Center.
On this first day of National Health Center Week, which pays tribute to health-care centers nationwide, it seems fitting to highlight the contributions of a doctor who provides the kind of care the week is meant to honor.
Payments secondary
When he was 20, Castro's mother, Florita, died of cancer.
As she lay suffering, she made him vow he would abandon his architectural studies and instead become a doctor.
"She made me promise I would take away for people that pain that she felt," said Castro.
Castro, now 38, is fulfilling that pledge at the Family Health Center's Newburgh facility, where he serves double duty as chair of the internal medicine department and as an endocrinologist.
The center provides care for people regardless of their ability to pay. Many of its patients have had spotty medical care before coming to the center, and by the time they walk through its doors, many have developed chronic and sometimes dangerous conditions — among them diabetes, hypertension and heart disease — that complicate their treatment and put them at greater general risk. A diabetic, for instance, is four times more likely to die of a heart attack or stroke.
The financial condition of many patients only makes matters worse.
Some work more than one job and can't get to their doctor's appointments; others must wait to get paid before buying medications; and some simply have trouble understanding their condition and what they must do to get better.
Sometimes, Castro admits, it's depressing. But it's the patients who follow his advice who keep him going.
"I usually thank them," he said. " 'Thank you for making my job count.' "
Costs are lower
Health centers in the United States serve 17 million people, many of them uninsured and many who live in medically underserved areas, according to the National Association of Community Health Centers. Having such "medical homes" to coordinate care improves long-term health and cuts costs, according to the association.
The average annual cost of care at a health center is $515 per patient, 10 times less than the average per capita spending on personal health care, according to the association, and centers save Medicaid roughly 30 percent a year per beneficiary because of lower specialty care referrals, fewer ER visits and hospital admissions.
A rewarding profession
More health centers and less- expensive medications would improve patient care tremendously, Castro said. More staff so that Castro and other doctors could spend less time on paperwork and more time with patients would help, too.
"If, as a provider we could free him up to see more patients, that's our long-term goal," said Family Health Center spokesman Ken Mackintosh.
Still, to Castro, it's all worth it.
"I like the fact that when I go to Wal-Mart, people who can't otherwise get the best care, they know me, and I know them," he said, "and I was able to help them."
County's health is deteriorating, especially among children
"Healthy Orange" campaign has long way to go.
By Christian Livermore
Times Herald-Record
August 01, 2008
NEWBURGH — Once a year, as a requirement of its federal funding, the Greater Hudson Valley Family Health Center must assess the unmet healthcare needs of the community.
It takes the assignment seriously, not just as a bureaucratic step on the funding ladder. As it happened, some 60 business and community leaders thought it was equally important.
They gathered for breakfast recently to swap information, and what they found disturbed them.
The area’s rates of asthma, diabetes and hypertension were all elevated, and many people – and, increasingly, middle-income people – can’t get the care they need because they don’t have health insurance, or even more basically, can’t get a ride to the doctor.
“We continue to be reminded that barriers to care result in no care for many people,” said Family Health Center President and CEO Linda Muller.
Poor nutrition was also a big problem – children getting either not enough calories or too many – so it was decided a better wellness program for children was needed.
“That kind of issue trails a person through his entire life,” Muller said.
Also alarming, the adult smoking rate was higher than that of surrounding counties, and much higher than goals set in the national health objectives publication Healthy People 2010, reported Jean Hudson, commissioner of the Orange County Department of Health.
The national goal for 2010 is a 12 percent adult smoking rate. Orange County’s is 24.3 percent.
Taken together, the anecdotal evidence led virtually everybody to one conclusion, Hudson said.
“The one thing that was mentioned by all parties commonly in what they said was universal access to health care,” she said.
Unhealthy Orange
Poverty rates exceed 25 percent for families with children younger than 18 in Middletown, Newburgh, Monroe and Port Jervis, according to Orange County Community Health Assessment 2005-2010, making it difficult for many families even to afford a doctor’s visit.
Nearly one quarter of mid-Hudson Valley households have a member who has not had continuous health insurance coverage in the past year, while 15 percent have at least one child who has experienced a gap in coverage over the past year, according to Many Voices One Valley 2007, a survey by the Dyson Foundation and the Marist College Institute for Public Opinion.
“The middle class is getting squeezed and getting squeezed, and increasingly have no choice,” Muller said.
Filling unmet needs
The Family Health Center doesn’t just treat low-income people – their patient list straddles the income spectrum – but their mission is to make sure everybody gets the care they need, regardless of their ability to pay.
For John D’Ambrosio, president of the Orange County Chamber of Commerce, that’s the biggest unmet need of all – finding ways to provide healthcare for people who can’t afford health insurance.
He cited rough figures indicating the cost of living has gone up 17 percent in the last five years, while the average cost of health insurance has gone up 78 percent.
“What that translates into is more and more people who are going to end up without insurance because they can’t afford it,” he said, “and we’re going to have, more and more, a need for places like the Family Health Center that can take care of their health.”
Health center in charge of grant for second year
By Christian Livermore for the Times Herald Record
July 20, 2008
NEWBURGH — The Greater Hudson Valley Family Health Center has been chosen for the second year to administer a $23,000 grant for the Miles of Hope Breast Cancer Foundation Medical Gap Grant program in Orange and Rockland counties.
The Medical Gap Care Fund was established to help individuals in treatment for breast cancer with financial emergencies.
For more information, or to see if you qualify, county residents can contact Regina McGrade at 220-3152.
National HIV testing Day 2008
Hudson Valley Press
July 2nd, 2008
Newburgh - National HIV Testing Day (NHTD) is an annual campaign produced by the National Association of People with AIDS to encourage at-risk individuals to receive voluntary HIV counseling and testing.
Locally, the Greater Hudson Valley Family Health Center invited the community to get tested. Carolyn Saldana, Director of HIV/AIDS Services at the Family Health Center, organized the event said, "It’s important to raise awareness in the community about AIDS and HIV. People have to take the first step, and get tested."
She points out that knowing your status is important. "Once you know your status, we can focus on keeping you safe."
According to the Centers for Disease Control and Prevention (CDC), approximately 180,000 to 280,000 people nationwide are HIV-positive, but are unaware of their status.
"An early diagnosis could mean the difference between life and death," urges Paul Kawata, Executive Director of the National Minority AIDS Council (NMAC). "Those who know their status can get into care and treatment earlier, improving their chances for long term survival. They also can learn how to protect their partners and stop the further spread of the disease."
Testing for HIV remains a vital combatant in the fight against the HIV/AIDS epidemic. HIV counseling and testing enables people with HIV to take steps to protect their own health and that of their partners, and helps people who test negative get the information they need to stay uninfected.
One of the goals for the day was to reach out to communities at increased risk of HIV infection, including African-American and Latino populations, both of which are disproportionately affected with HIV when compared to other demographic groups in the United States. Though each represents only approximately 13% of the U.S. population, African-Americans and Latinos account for over 70% of all new HIV cases reported each year to the CDC.
Rates of HIV infection are on the rise among Asian and Pacific Islanders and Native Americans as well. "Social, economic, educational and political disenfranchisement have helped fuel HIV infections in communities of color nationwide," says Ravinia Hayes- Cozier, NMAC’s Director of Government Relations and Public Policy. "Yet unchecked rates of HIV could undermine their very future. We must promote culturally competent and consistent prevention, testing, and treatment messages to those most at risk."
May 8, 2008
Mid-Hudson News.com
Schumer backs legislation to provide adequate dental care for children
WASHINGTON – With 115,000 children in the Hudson Valley lacking dental insurance, U.S. Senator Charles Schumer Wednesday said he would back legislation proposed by Senator Sherrod Brown of Ohio that would provide grants to community health centers to expand dental care and offer tax credits to dentists who treat Medicaid, CHIP and uninsured patients.
The Greater Hudson Valley Family Health Center operates a dental clinic that is taxed to the limit, said spokesman Kenneth Mackintosh.
“Here in Newburgh, the Greater Hudson Valley Family Health Center has been providing dental care for 14 years and almost from day one, we’ve been at our capacity with a long waiting list for service,” he said. “Any program that will expand access to care for the uninsured and the under insured is both welcome and sorely needed. The consequences of inadequate oral care, poor nutrition, immune deficiency, increased vulnerability to other infectious disease, are very serious.”
Schumer said the kids who need dental care the most – those who live in cities, rural towns and small, underserved communities – “are being left out by a system that is plagued by rising health insurance costs and a limited number of dentists to provide care.”
April 30th, 2008
Methadone program recognized
Newburgh - Last Tuesday New York State Office of Alcoholism and Substance Abuse Services (OASAS) Commissioner Karen Carpenter-Palumbo visited the Methadone Maintenance Treatment Program in Newburgh for a ribbon cutting ceremony.
The methadone clinic is run by the Greater Hudson Valley Family Health Center. Since 2006 they have been running the Center for Recovery. When St. Luke’s Cornwall Hospital said it would be shutting down the methadone clinic, Family Health Center stepped in to ensure there would be no lapse in treatment.
Linda Muller, President and CEO of the Greater Hudson Valley Family Health Center said adding the methadone clinic meant it could expand their services to treat people through their entire range of health needs.
Carpenter-Palumbo said the methadone clinic is the type of place the state wants to see across New York state’s health care system. The concept is to treat the whole person.
That concept was originally mandated by former Governor Eliot Spitzer and continues with current Governor David Paterson. The mandate was to integrate services into a cohesive system whereby the whole person could be treated.
Carpenter-Palumbo said that’s important because too many patients are asked to go from one service provider to another. A network like the Greater Hudson Valley Family Health Center tries to provide as many services within its network to better treat the whole person.
When the center opened in January, there were 204 patients. It now has about 240 patients and is licensed for 300. Carpenter-Palumbo said, "We know that there are over 2.5 million people with an addiction. Last year over 9,000 were served right here in this region."
That’s why Karen Carpenter-Palumbo attended the ribbon cutting on Tuesday, saying the facility is greatly needed. She was joined at 3 Commercial Place by local service providers, politicians and government employees. They all see the need for the service.
Muller says chemical dependency is no longer limited to drug addicts. More and more people are getting hooked on pre scri ption pain killers after surgery.
"When you look at chemical dependency, any one of us is a day away from being there. This is not just a disease that happens in the bowels of an inner city," Muller said.
Methadone clinic fits well in health network
By Doyle Murphy
Times Herald-Record
April 23, 2008
CITY OF NEWBURGH — Once set to close, a Newburgh methadone clinic has become the type of place the state wants to see across New York's health-care system.
What makes it interesting isn't so much the clinic itself but its place in a larger network of doctors, dentists, mental health workers and therapists.
The Greater Hudson Valley Family Health Center took over the clinic in January after St. Luke's Cornwall Hospital announced plans to shut it down. The nonprofit also had run the Center for Recovery since 2006. Adding the methadone clinic meant it could fill a piece missing in its plan to treat people through their entire range of health needs.
It's a concept of treating the whole person that Karen Carpenter-Palumbo said has become a priority in New York. Carpenter-Palumbo is the commissioner of the state Office of Alcoholism and Substance Abuse Services.
Former Gov. Eliot Spitzer and Gov. David Paterson mandated that state departments such as Carpenter-Palumbo's begin integrating services into a cohesive system.
That means more networks like the one Greater Hudson Valley now operates at 83 Commercial Place. About 70 service providers, government employees and politicians gathered there yesterday to celebrate its opening.
Chris Loscher, director of the Center of Recovery, said the methadone clinic opened in January with 204 patients and now has about 240. It's licensed for 300. Statewide, about 1 in 7 New Yorkers deals with some sort of addiction.
Methadone is used to help break a dependency on opiates. That used to be almost exclusively heroin addiction, Loscher said, but increasingly includes the patient who gets hooked on prescription pain killers after surgery.
Patients bring with them a variety of medical concerns along with the addiction, Loscher said. A person in the middle of a daily heroin habit might not care about regular dental visits but, as they begin to recover, things like healthy teeth and jobs start to seem more important, Loscher said.
Greater Hudson Valley tries to provide all those services within its network.
That's important, Carpenter-Palumbo said, because too many patients are asked to bounce from one service to another in a disjointed system.
"What happens then is, we lose the person," she said.
Cheers
April 28, 2008
To the Greater Hudson Valley Family Health Center for taking over the Newburgh methadone clinic and helping make sure its patients also get a chance to take part in the larger network of doctors, dentists, mental health workers and therapists. Treating the whole person is a goal of the state Office of Alcoholism and Substance Abuse Services.
PRESS ADVISORY
FOR IMMEDIATE RELEASE: FOR MORE INFORMATION:
April 17, 2008 Regina McGrade
Director OF Development
845.220.3152
845.667.4243 cell
OASAS COMMISSIONER TO RECOGNIZE
The GREATER HUDSON VALLEY FAMILY HEALTH CENTER’S
METHADONE MAINTENANCE TREATMENT PROGRAM
Newburgh, NY. Community and governmental leaders will join many of the region’s health and human service representatives this Tuesday, April 22, 2008 in recognition of the opening of the Greater Hudson Valley Family Health Center’s Methadone Maintenance Treatment Program.
Karen Carpenter-Palumbo, Commissioner, New York State Office of Alcoholism and Substance Abuse Services, will be keynote speaker addressing New York State priorities for substance abuse treatment and new policies and principles for providing these critically needed services. Commissioner Carpenter-Palumbo will be available to speak with the media.
Location: The Center for Recovery
3 Commercial Place, Newburgh, NY
Time: 12:00 – 3:00 PM
Lunch and refreshments served at 12:00
Program to begin at 1:00 PM
Date: Tuesday, April 22, 2008
Directions: New York State Thruway (Rte. 87) to Exit 17. Left onto Rte 17K left East/ 17k turns into Broadway into Newburgh to 9W South. Right onto Route 9W South to Dickson Street. Turn RIGHT onto Dickson Street to Commercial Place. Left onto Commercial Place. The Center for Recovery will be on the left.
By Barbara Bedell
Times Herald-Record
April 14, 2008
The Greater Hudson Valley Family Health Center Inc. will celebrate the opening of its Methadone Maintenance Treatment Program from noon-3 p.m. April 22 at 3 Commercial Place in Newburgh. The open house will welcome Karen Carpenter-Palumbo at 1 p.m. as guest speaker. She is the commissioner for the state Office of Alcoholism and Substance Abuse Services. For information call 220-2146, ext Zero (0).
By Doyle Murphy
Times Herald-Record
April 04, 2008
CITY OF NEWBURGH — The staff will lock the door after the last patient leaves tomorrow. The moving trucks come Sunday.
Six months after a dental office opened in Newburgh to treat the region's most vulnerable, it will close. Small Smiles Dentistry of Newburgh had barely gotten started. The practice treated patients in a blank-faced office complex southwest of Delano-Hitch Park and specialized in treating Medicaid patients 20 years old and younger.
Employees learned the center would close when one of their corporate bosses showed up last week to deliver the news. Staffers knew too few patients had come through the doors, but they had hoped for more time.
Jo-Ann Cammorato remembers when she heard — "It was like the floor fell out from underneath me."
She'd taken her 4-year-old granddaughter, Joneesa, to five dentists, from Poughkeepsie to the Bronx. Joneesa hated them all. They scared her so much, she wouldn't let them near her decaying teeth, destroyed by baby bottle syndrome. The staff at Small Smiles spent 30 minutes just talking to Joneesa and finally won her over.
"You don't find that," Cammorato said; she doesn't want to start looking again.
There were so many others who needed their help, employees said. Many private dentists won't accept Medicaid patients because the reimbursement is a fraction of what they'd normally charge. Linda Muller, executive director of Greater Hudson Valley Family Health Center, said their dental center in Newburgh has been busy for years with Medicaid patients and patients without insurance. She said the need in and around Newburgh is great.
A big part of the problem came when Forba Dental Management, Small Smiles' parent company, wasn't able to secure a deal that would have opened the office to Affinity Health Plan customers. Forba Vice President Todd Cruse said the loss of those customers was a major blow to the Newburgh office.
Of the 70 Small Smiles offices across the country, Newburgh's will be the first to shut down.
Times Herald-Record
February 10, 2008
NEWBURGH — After several years of uncertainty when the county's only methadone clinic was closing without a clear replacement, services were transferred from one facility to another without a gap in treatment.
The Greater Hudson Valley Family Health Center opened its methadone treatment center Jan. 27, one day after St. Luke's Cornwall Hospital closed it.
St. Luke's announced in 2005 that it was discontinuing the methadone and substance abuse treatment programs it had been running, leaving a gap in some services and officials scrambling to find somebody to fill it.
Three months later, Family Health Center said it would be willing to take over the programs.
Several years and a bunch of regulatory hurdles later, it has.
"When it became clear that St. Luke's would no longer be operating the program, we felt it was critical that a provider step up to keep the program going, because the need for this program in the county is huge," said Family Health Center President and CEO Linda Muller. "Because of what we do as a primary care provider, we felt we would be able to treat people not only for existing substance abuse problems, but also provide comprehensive medical care that could help them even more to become fully healthy and productive people once again."
Clients come in first thing in the morning — usually 6:30 — to get their daily dose. A small percentage judged to be further along in their recovery can get a few days' or a week's supply. The center also provides counseling and medical care for clients.
Right now, the center treats 204 people, and should be certified for up to 300 soon, but the New York State Office of Alcoholism and Substance Abuse Services, which provides oversight, licensing and much of the center's funding, found that 1,098 people in Orange County actually need treatment, said Barry Hawkins, director of chemical dependency services for the Orange County Department of Mental Health.
The next nearest treatment center is in Rockland County. Another in Kingston is more than an hour's drive for most people.
Methadone treatment
Methadone is a synthetic drug used to quell addictions to heroin, OxyContin and other pain medications. It mimics some of the effects of the drugs without the high.
Study after study has shown that methadone treatment carries a host of positive effects, notably reducing crime, especially burglary, lowering health-care costs and improving birth weights among infants of pregnant women.
The earliest support for methadone treatment came from the Nixon administration as a way to reduce crime.
One of the first studies of the results of methadone treatment, based on New York City police department data from 1971 to 1973, found that as about 19,900 addicts entered treatment, about 77,000 fewer drug-related arrests were made for burglary and grand larceny, said Mark W. Parrino, president of the American Association for the Treatment of Opioid Dependence Inc.
"This is what really sprung past and said, you know what, regardless of the way we feel about people who use methadone, we need to expand treatment," Parrino said.
Methadone clinics nationwide have often drawn opposition.
People argue that a treatment center will drive down property values; they say the clients are troublemakers who loiter and even deal drugs outside clinics, and object especially to people coming in from other communities for treatment.
Several methadone clinics have led to lawsuits from neighbors and in some cases, attempts by legislators to give local governments more power to stop them from moving in.
The Newburgh treatment center does not prompt complaints, said Lt. Charles Broe of the City of Newburgh Police Department.
A recent spate of methadone overdoses has led many to decry its use.
Parrino said most of those deaths were "outside of the clinic system."
"They were generally driven by prescribing large quantities of the medication without proper oversight," he said.
Parrino doubts that more than 8 to 10 percent of people in methadone treatment get more than a daily supply of the drug.
Combatting perceptions
The boogeyman image of the methadone client is the heroin-thin, chronically unemployed, turn-on-tune-in-drop-out scarecrow who lives for their daily fix.
According to advocates, many of these perceptions are just plain wrong.
"When we started learning more about the kinds of people who were affected by addiction to opioids, drugs like Vicodin, and OxyContin, and heroin, too, we realized that the clients of the methadone program come from every walk of life, every social strata," Muller said. "There are unemployed folks, professional folks, kids and grandmas, too; people who are struggling to put their lives back together after dealing with all of the really difficult consequences of having these drugs take over your life."
An untreated addict costs about $50,000 a year in theft, security, health care and other costs, Parrino said. Locking up an addict costs about $25,000 per person per year. Treating an addict costs about $5,500 a year.
"So the question for the culture," Parrino said, "is where do you want to spend your money?"
clivermore@th-record.com
