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In the field: Serving the poor provides health care lessons for all

By Scott Scanlon

Refresh Editor

Joanne E. Haefner is feeling pretty good these days.

The Neighborhood Health Center executive director just oversaw a $1.5 million renovation of the nonprofit’s headquarters on Lawn Street in Riverside and has watched two other locations – the Mattina center on the West Side and the Southtowns OB/GYN center in Hamburg – help a growing number of underserved patients from across Western New York.

Haefner, 48, a Riverside High and D’Youville Nursing School graduate, oversees a staff of about 130, including more than 20 doctors and nurse practitioners and seven dental providers, as well as mental health counselors, outreach workers, a registered dietitian and nursing, billing and administrative staff.

This kind of community-based health care team has been held up as a model in the Affordable Care Act, which spells out the need for more preventive and organized medical care.

“This place started as a place for young moms and kids who couldn’t get care. Twenty-six years ago, this was our story,” says Haefner, a nurse practitioner who continues to see patients as part of her job. “This is still the poorest city in the country to be a child and the third-poorest city in the country. That’s still the story of who we attract.”

Q. But your patient base has grown?

A. Last year, we served patients in 41 different languages between a live interpreter, other interpreters and written translation services. We’ve been able to take care of a much more diverse group of people than we were able to serve even when I came here seven years ago.

Q. What is it like for a patient who’s coming in here and not feeling wonderfully and can hear questions in his or her own language?

A. Imagine that we put you in downtown Paris in the best hotel that exists, but nobody speaks English and your tummy hurts the worst it ever has. Now you’re scared. Now put you in the middle of Buffalo and you’re from Somalia or from Thailand and have lived in a refugee camp, and you come here and, lo and behold, you’ve found someone who can speak your language on the phone. How much more comforting can that be?

We see people who come in and speak no English on their first visit and over the course of the year, we always ask them, ‘Do you still want to use the interpreter, yes or no?’ And we see people move off of using an interpreter and they want to try it on their own.

Q. So you’re really getting the sense of the new American melting pot here?

A. Absolutely, and helping to see people blend to be part of the community. … Our goal is to help open people’s eyes to other possibilities, consistency of health care and talking about the whole person. We talk about literacy in pediatric well visits, with every single kid. We make it an action item to talk to mom about reading and literacy and high school completion and its relationship to poverty.

Q. So you’re a community-based operation?

A. My board is always at least 51 percent patients, so you can’t get around how the community’s changing, and you can be more nimble about what’s happening. Our board and our patients tell us what’s going on and what we should be thinking about.

It’s a doctor’s office for everybody. You can see somebody who’s a professor and you can see a mom who’s pushing babies in a double stroller and took two buses to get here. Then somebody experiencing homelessness and a refugee who just settled. That’s the fun of this. … There’s really good physicians, nurse practitioners and dentists here who could work anyplace but who want to be part of that.

Q. Talk about the renovations.

A. This used to be the old auditorium (of Public School 79). When the center first opened, they never imagined we’d be seeing the number of patients we are seeing. We have 18 exam rooms. We used to have 14. We used to have 18 seats in our waiting room, and now we have 48. At the nurses’ station, if you were one of the last six nurses to get to work, you didn’t have a seat … so some of the renovations really made it a more humane workplace and a place where patients can feel proud of their neighborhood.

Q. How many patients do you see?

A. We saw 18,500 people last year. Our visits were around 66,000 between the three sites.

Q. What percentage would you say have health insurance?

A. Eighty-five percent of our patients have some kind of insurance for some of the year.

Q. Do you expect more patients as a result of the insurance exchanges and people being required to have health insurance?

A. We expect primary care to be more important in peoples’ minds now that they’ll be able to access health care with health insurance, so the issue is can we be prepared for the additional people who are going to want care?

The thing that keeps people out of prevention is that prevention’s not free, so people wait until they have an issue to deal with. So when there’s health insurance coverage that includes that, certainly people will see preventive health as a higher priority.


On the Web: Haefner talks more about the impact of the Affordable Care Act and how the health center connects with subspecialists at the Refresh Buffalo blog at