30 years later, what’s changed (and what hasn’t) at the Community Health Care Clinic
Thirty years ago, a group of people in Bloomington-Normal did something that Congress and the White House couldn’t do: They made it easier to get health care.
The Community Health Care Clinic (CHCC) in Normal is now marking its 30th anniversary. The mission is the same as on opening day – a free clinic for the uninsured – even as they’ve greatly expanded in size and scope of services provided. The patient base has also evolved, as the clinic adapted to seismic shifts in the healthcare landscape and found new ways to bulldoze barriers to care.
“It’s not a mom-and-pop operation. It functions as a highly sophisticated primary care office, and seeing patients, directing them where they need to go, and helping them,” said Dr. Paul Pedersen, a primary care physician who was a CHCC co-founder and still its volunteer medical director.
Back in the early 1990s, there was increasing concern nationally about cost and access to healthcare, including the Clinton administration’s failed effort to provide universal health-insurance coverage, said Bob Reardon, who along with his father, Dr. Robert Reardon, was on the volunteer team that created the CHCC.
“We determined that there was another population out there that wasn’t on Medicaid, that wasn’t insured, and sort of fell through what was a fairly large crack at the time,” Reardon said.
Their small group in Bloomington-Normal had a big idea. They toured a free clinic in Joliet and wanted to bring the concept to McLean County.
“This is an issue for our community. And if Bloomington-Normal can’t solve it, I don’t know who can,” Pedersen said.
They started meeting. Lots of meetings. They wrote bylaws. Consulted lawyers and accountants. It took about two years.
“It was like a full-time job, is what I remember,” said Laura Reardon, Bob’s wife. “The stress did land (him) in a hospital. I don’t know if that was directly related, but it probably didn’t help much.”
They struck a grand bargain with Bloomington-Normal’s two hospitals, which had an incentive to keep uninsured people from using their emergency departments as de facto primary care doctors. (Pedersen said a study found that CHCC saves the community about a $1 million a year by treating people with diabetes who avoid complications and hospitalization. And that’s just one ailment.)
“Instead of coming to you (hospitals) for a sore throat, they’re gonna come to us. But we want something in return for that,” Pedersen said. Then and now, the volunteers and staff at CHCC are able to refer patients to the hospital systems for specialty care and hospitalizations.
At first, Pedersen said CHCC’s founders thought the patient base would be people who were progressing and regressing – improving their health and returning to the workforce to get insurance, or falling out of the workforce and needing care before going on public insurance.
The actual patient base includes more working uninsured people than they expected – some with two or three jobs but no benefits, even if their kids qualify for public insurance.
The demographics have also shifted. Twenty years ago, about 10% of patients were Spanish-speakers. Today, that’s 87% – which current executive director Mike Romagnoli chalks up in part to the clinic providing increased access to interpreters.
Eventually, Congress did pass significant healthcare reform in 2010 – the Affordable Care Act, or Obamacare – even though it stopped well short of universal coverage. Initially, Romagnoli said that led to some existential board-level conversations about the future of the CHCC.
“There were some very real conversations about the need for a facility like this,” he said.
Turns out, the need was (and is) still great. In fact, all of the public discourse surrounding the ACA led to a few years of “monumental” patient growth at CHCC as people started thinking more seriously about their own healthcare, Romagnoli said. “The Affordable Care Act times were pretty wild,” he added.
Those needs have evolved. CHCC completed a $1.7 million renovation of its new facility at 900 Franklin Ave. in 2016. Three years after that, CHCC added a dental clinic, which has now been used by around 75% of their patient base. In 2020, the CHCC became a recognized Patient-Centered Medical Home – a model of care that’s rare for free clinics to achieve. A full mental health clinic is next, Pedersen said.
What makes CHCC unique is not just the cost (which is free).
The clinic even dispenses medication differently. It provides patients with pre-counted, pre-filled, day-specific pill boxes – bought from a discount store – to make it as easy as possible for a person to take their medication. Pill boxes help in myriad ways – like empowering older patients who now can control their own meds, or removing the need to read labels for those with limited literacy.
“The word ‘noncompliance’ is not one that we use around here. It’s very rare that somebody does it (skips their meds) on purpose,” Romagnoli said.
That creative, personalized approach is a purer form of healthcare that can be attractive to CHCC’s volunteer medical professionals, like Pedersen. There’s no billing or insurance. There’s less paperwork.
“Which makes it a lot easier and really enjoyable for people to come here and see patients,” Pedersen said.
There are challenges, chief among them funding. CHCC is privately funded, with individual donors the largest funding source, plus grants, foundations and businesses, Romagnoli said. General operating dollars are getting harder to come by, he said, and that’s important to pay for the CHCC’s 10 staff members. The clinic also relies heavily on volunteer licensed medical professionals and translators.
“The grant world has gotten very different, especially post-COVID. There are fewer pots, and there are more hands in them,” Romagnoli said.
There are lessons to be learned from the CHCC’s founding that could be applied to other big challenges facing the community.
Bob Reardon was working at State Farm in the early 1990s when he got involved. The first step, he said, is to get to know your community and what resources are available to solve a problem – including learning from those who have a background you don’t. The second step is to bring that community together, ideally with people from each aspect of the solution.
“And there’s that day you all sit around the table for the first time,” Reardon said, “and you’re smiling at each other and it’s like, ‘Well, what do we do now?’ And then you gotta push.”