This column originally appeared in the Albuquerque Journal on Oct. 8, 2015 - by Upfront Columnist Winthrop Quigley

First Choice Community Healthcare, founded 43 years ago in the rectory of St. Francis Xavier Catholic Church on Broadway south of Coal Avenue, has concluded it has failed in its mission to improve the health and wellness of the communities it serves.
First Choice provides excellent medical care in its nine clinics. More than 54,000 patients visited First Choice clinics 163,000 times last year
for medical, dental and behavioral health care visits. A quarter of them were children, 97 percent had incomes below 200 percent of the
federal poverty level ($48,500 for a family of four), and 23 percent were Spanish-speaking. Diabetes was controlled, children were immunized, high cholesterol was treated, teeth were cleaned.
“After 43 years, we still don’t see population health,” First Choice CEO Bob DeFelice said.

Public health studies consistently show a link between social determinants and population health. A 2011 National Center for Health Statistics study found that a college graduate in the United States could expect to live nine years longer than a high-school dropout. Infant mortality rates experienced by mothers with less than a high school education are more than twice as high as rates for mothers with a college education. Although 30.4 percent of children in families earning less than 100 percent of the federal poverty level ($24,250 for a family of four) are reported to experience less than “very good health,” that’s true of only 6.9 percent of children in families earning more than 400 percent of the federal poverty level, or $97,000 for a family of four. Adults living in a family with an income less than 100 percent of the federal poverty level are almost four times more likely to suffer from a chronic disease that limits their activities than are adults with a family income greater than 400 percent of the federal poverty level.

These kinds of social problems are entrenched in the South Valley.

A 2014 analysis published by the state Children, Youth and Families Department reports that from 2008 through 2012, South Valley unemployment was almost twice the rate of all of Bernalillo County. Almost 19 percent of South Valley residents have incomes less than the federal poverty level, compared with 16.4 percent of all Bernalillo County residents. The 2012 high school graduation rate in the South Valley was 66.3 percent, compared with 86.3 percent in Bernalillo County, according to CYFD.

It should come as no surprise that CYFD’s analysis showed health outcomes in the South Valley in areas like infant mortality and premature births are much worse than in Bernalillo County as a whole.

To improve South Valley health, First Choice will invest what DeFelice expects will be $25 million over the next five to seven years to create a collection of businesses and activities on its existing South Valley campus off Isleta Boulevard to attack problems of inadequate education, joblessness, poor nutrition and other social determinants of health. The money will come from several sources, including grants, partnerships with other organizations, donations, and revenue generated by businesses that will be located on the expanded campus.

“People get high-quality care here, but they return to a community without resources,” DeFelice said. A diabetic who can’t get to a store that sells enough fresh fruits and vegetables can’t stay healthy. An obese child whose neighborhood is too dangerous to walk in can’t get exercise. South Valley residents will be able to find the resources they need at the First Choice campus, a place where they already seek care and which they already trust.

Along with existing clinics and other services, a 30,000-square-foot Health Leadership High School, established by the Center for School Leadership, will prepare as many as 400 students a year for health careers. A 15,000-square-foot wellness center will house fitness programs, pain management clinics, physical and occupational therapy and diabetes education. A 6,200-square-foot child development and day care center will be built. There will be a 4-acre farm, help for South Valley farmers trying to reach markets and a farm-to-table restaurant. Walking trails will be installed. In addition to the 400 people First Choice employs today, another 140 jobs will be created.

“We are going to create a wellness ecosystem,” DeFelice said. “We are going to produce a product called wellness in our community.”

UpFront is a daily front-page news and opinion column. Comment directly to Winthrop Quigley at 823-3896 or [email protected].

By Michelle Melendez, First Choice Community Healthcare Development Director

All the talk about hubs in and around Albuquerque lately is an exciting indication that more and more sectors are collaborating for higher impact.  Health hubs are no exception, as we adopt principles of shared space, shared goals and effective communication as cornerstones of true collaboration. More and more, the South Valley Health Commons is emerging as a health innovation hub.  The South Valley Health Commons has long been a center of health promotion – with public health, primary medical, dental, behavioral health care and WIC services. Recently, First Choice Community Healthcare has revved up its creativity and collaborative partnerships in order to thrive as a business that serves a population that is sicker than most, and largely uninsured – and to make a larger impact on the health and wellness of the people it serves.

This year, on the 50^th anniversary of Community Health Centers, First Choice South Valley Health Commons finds itself going back to its roots more than ever – and being recognized for doing so.  Our founders have always recognized that health is about more than access to medical care. Our community-based Board of Directors knows that health is shaped by early childhood experiences, education, access to healthy, affordable food and places to be physically active, and good paying jobs.

During National Community Health Center Week in August, we celebrated our legacy and our future as local engines of change by inviting our partners to co-design our South Valley Community Commons Expansion Project.

It is no surprise that First Choice is an innovation hub. Innovators in healthcare delivery, education, food systems and wellness have found a willing partner to pilot test and prove their concepts – giving rise to new programs such as the  unique La Cosecha CSA (Community-Supported Agriculture); the region’s first Mobile Farmer’s Market; the nation’s first year-round children’s feeding program in a health center; a community health worker screening tool called WellRx; Spanish-language yoga, meditation, massage and personal training classes; and healthy cooking classes, all of which have attracted the attention of MCOs and the NMDOH’s System Innovation Model Redesign team.

A recent national conference of medical schools featured field trips to First Choice’s South Valley Commons as a “model that we need to spread.”

“We need to be moving towards a goal of improving overall health, and not just providing healthcare. First Choice is way ahead of the rest of us in moving towards that goal. It’s all the more important because it is a Family Medicine training site. The doctors that graduate from this program will adopt and spread this new way of doing things,” said Daniel J. Burke, Associate Vice Chair of Educational Program Development at University of Colorado School of Medicine.

First Choice South Valley Commons is a partner in numerous, recent national grants, awards and initiatives, including the Project ECHO-IHI system transformation initiative, the SCALE Pacesetter Initiative, the CDC REACH project, the BUILD Health Challenge and more.

It has been especially gratifying to our board, who stayed the course over the years when funding was slim to none to support anything but the actual doctor’s exam, to finally come full circle. We are just happy that the awards and incentives are finally catching up to what we have always valued – prevention and wellness, in communities, over “sick care.” We have more to do as a nation to improve health of communities, but the system is pivoting in the right direction.

First Choice's South Valley Community Commons Expansion Project will be major part of a three-year, $2.9 million push to improve racial health equity in southern Bernalillo County. First Choice Community Healthcare is just one of multiple community-based organizations, in partnership with Presbyterian Healthcare Services and the Bernalillo County Community Health Council, to be impacted through the CDC grant.

The $2.9 million REACH grant from the U.S. Centers for Disease Control, awarded to Presbyterian Healthcare Services, will address healthy eating, active living and prevention of chronic diseases in the South Valley and International District, where inequities have persisted for decades because of factors including poverty and access. 

First Choice Community Healthcare is a major partner in the grant and will be working with other clinics and community organizations to advance its South Valley Community Commons, an expansion project that brings a wide array of prevention-related initiatives together to complement its existing primary care center. First Choice will hire a South Valley Community Commons coordinator with part of the funds.

The South Valley Community Commons prevention-related initiatives include a new early childhood development center, a permanent campus for Health Leadership High School, a Wellness Center, a community garden with an indoor/outdoor learning center and grower's market, a local farm-to-table-style restaurant and an enterprise lease space.

Presbyterian Healthcare Services is the backbone organization for the grant, and the Bernalillo County Community Health Council is the coalition leading the overall effort. Some of the other partner organizations in alignment with the REACH Community Action Plan include:  City of Albuquerque Department of Senior Affairs, Share New Mexico, Bernalillo County Place Matters, First Nations Community Healthsource, Agri-Cultura Network, Farm to Table New Mexico, Bernalillo County Office of Health and Social Services, New Mexico Department of Health, Mid-Regional Council of Governments, and The University of New Mexico Prevention Research Center.

The Racial and Ethnic Approaches to Community Health (REACH) award is part of a U.S. Department of Health and Human Services (HHS) initiative to support public health efforts to reduce chronic diseases, promote healthier lifestyles, reduce health disparities, and control health care spending. The Centers for Disease Control and Prevention (CDC) will administer the grant, which will run for 3 years, subject to availability of funds.