Photographs of trees, birds and sunsets decorate the salmon and beige walls of the Sacramento Native American Health Center on 21st Street, a color palette intended to evoke both the outdoors and the community’s philosophy of balance. The theme will soon spill onto many more walls as the center adds to its medical, dental and mental health services this winter.
The clinic is in the midst of a major 15,000-square-foot expansion that will triple its exam rooms, double its dental offerings and bolster its mental health and lifestyle programs. The renovation, which began this summer and will continue through spring 2016, is part of a larger effort to widen the city’s safety net as more Sacramentans become insured under the Affordable Care Act.
“If you’re low-income, if you’re homeless, to walk into a space that has been made beautiful for you makes a person feel valued in a way that’s really important,” said center executive director Britta Guerrero.
After opening in 2007, the Native American health center won a federal designation that gives clinics higher Medi-Cal reimbursement rates for treating low-income people. Since then, the center has worked alongside networks such as WellSpace Health and Elica Health Centers to provide affordable care options. Recently, those clinics have been inundated by new Medi-Cal enrollees – 57 percent of newly insured Californians get their care at community health centers, according to data from the California Primary Care Association.
“The safety net is growing, but it’s still small,” Guerrero said. “Six safety net clinics won’t be able to handle (the enrollee surge). We need more.”
21 percent increase in patients between 2012 and 2013 at Sacramento Native American Health Center
Currently, the center has six exam rooms, one psychiatry office, seven dental operatories and a staff of more than 90 people. Appointments are booked four to five weeks out, and the walk-in clinic is often packed, said Allie Budenz, former director of operations for the center. The number of patients served annually increased 21 percent between 2012 and 2013, to 5,459.
Following the expansion, the center will have 19 exam rooms, two psychiatry offices, 14 dental operatories and a 151-person staff that includes seven care coordinators. It will also run two nutrition therapy offices, a phlebotomy suite, an optometry suite and a dental lab. In total, the center expects to be able to serve 15,000 patients in the coming year.
The center now occupies two stories of its building at 2020 J St. but will move into neighboring 2030 J St., using the former space of the Shingle Springs Tribal welfare-to-work program. The renovation is estimated to cost $3.8 million, which has been partially covered by the Shingle Springs Band of Miwok Indians and Anthem Blue Cross River City.
Carmela Castellano-Garcia, president and CEO of the California Primary Care Association, said community clinics are at a “critical juncture” as they struggle to keep up with the influx of new patients and recruit and retain staff.
“Major players realize that providing people with primary care is really the most financially sound investment you can make,” she said. “They recognize that by investing in primary care in Sacramento, they’re going to reduce unnecessary emergency room utilization and cut down on patient expenses down the line.”
Having a larger staff and more services will also make way for preventive care rather than just treating symptoms, Budenz said. The center hopes to continue being a “health home” where people can access behavioral health services such as substance-abuse treatment and anger-management courses in addition to basic medical and dental care. New nutritional counselors and a space for healthy cooking demonstrations will encourage patients to make healthy lifestyle changes.
“Changing the model is huge,” Budenz said. “Patients are coming here with a lot of problems, and they’ve only got a 20-minute appointment. Being able to have a patient tell their whole story to a team in the same place, that makes a big difference.”
The expansion comes as the center sees fewer of its traditional American Indian/Alaskan Native patients, and more white, Hispanic, black and Asian Pacific Islander people. Even with the native population making up only 30 percent of the center’s user base, native philosophies regarding respect, kindness and awareness of the cultural needs of others are central to care at the facility, Guerrero said.
“Every person has different cultural and traditional beliefs,” she said. “We try to respect anyone’s tradition and where they came from, be them native or not. We think that’s a really important aspect of finding wellness.”