by Nicole Rodriguez-Robbins
For over 40 years, the Charles B. Wang Community Health Center (CBWCHC) has provided high quality, culturally sensitive and affordable care to the Asian-American community in New York City. The health center was started by community members who identified a large disparity in access to medical care among the Asian immigrant population in NYC and the need for bilingual and bicultural healthcare services. Through aggressive recruitment and on-the-job training programs, CBWCHC has been able to meet the community’s need for health care professionals who can effectively serve this population, while also creating needed jobs within the community; the health center has cultivated the growth of multiple generations of community health staff in clinical, social service, administrative and other professional service fields.
At the core of CBWCHC’s health care philosophy is its emphasis on recruiting and retaining bilingual and bicultural staff who can serve patients in their native language. Most of CBWCHC’s patients emigrated from China or other parts of Asia and 88% of patients in 2011 reported they were best served in a language other than English. In addition, most patients have incomes below 200% of the federal poverty level. The health center acts on the belief that providing linguistically and culturally appropriate services to these patients improves access to care, quality of care, and ultimately, health care outcomes.
CBWCHC has made it a priority to nurture new leaders and to recruit and retain staff who come from the same communities as their patients. For example, in 1975, the health center established Project AHEAD, an internship program which motivates college students to pursue careers in healthcare and to serve the community. The health center also provides volunteer and service learning opportunities for high school students.
Over the years, the health center has also been awarded various work force development grants to train its frontline staff (e.g. receptionists, medical assistants, care coordinators, health educators) who generally do not participate in formal health careers training programs. CBWCHC believes that a skilled and stable frontline workforce is critical to ensure high quality care and service delivery. The frontline staff trainings take place during work hours and cover topics such as providing excellent customer service, using computers and electronic health records, working in multidisciplinary practice teams, supervising and managing people, as well understanding the healthcare system.
I recently spoke with Grace Wong, the Front Desk Reception Manager at Flushing Queens, which is one of the health center’s four service sites, about her experiences at the center. Grace described the unique challenges involved in serving CBWCHC’s patients. The patients are primarily immigrants to the New York area who hear about CBWCHC through word of mouth. Over the past few years, neighborhoods in Lower Manhattan, Brooklyn and Queens have experienced a large surge in the Asian immigrant population and consequently a greater demand for health services. The population faces the typical stressors experienced by new immigrants, and lacks the time to get preventive care. They are often dealing with chronic illness while adjusting to new jobs with long hours, learning a new language, and providing for their families. “It is hard to get these patients in for an appointment or for follow-up care because of their work demands,” Grace explained. As a result the CBWCHC offers services 7 days a week to accommodate patients with long work hours and varying work schedules.
Compounding the language and cultural barriers, patients are also limited by low levels of formal education and poor understanding of how their lifestyle and eating habits may affect their health. Their lack of familiarity with western medicine and the U.S. delivery system also creates anxiety and fear. The CBWCHC helps to ease those anxieties while providing essential services and helping their patients achieve good health outcomes.
Relating her own experience, Grace explained that she emigrated to NYC from Hong Kong with her family as a child. She recalled her initial struggles with learning English and adjusting to a new culture. She identified with her patients’ concerns as new immigrants and commented that there is a high level of understanding and trust between patients and staff when they speak the same language and have similar cultural and ethnic backgrounds; she understands what a difference it makes in the quality of care when patients are able to communicate effectively with their providers.
Grace described to me how CBWCHC has taken an interest in her professional growth and equipped her with the skills to do the best job she can. She first came to Charles B. Wang Community Health Center after working as a receptionist at a private pediatrics practice in Queens. When she transitioned to a position at CBWCHC, her responsibilities increased significantly. Her duties included intake, registration, phone calls to patients to remind them of their appointments and communicating with doctors at the center. It was a big adjustment from her previous position, but she accepted the challenge and is now an emerging leader at the center a result of her newly acquired skills. Two years ago, Grace was promoted to be the Front Desk Manager. In her current position, Grace manages more than 15 people who staff 3 different patient services floors in the Flushing site. Grace noted that her job can be stressful; her team includes colleagues with longer tenure at the center, and there are arrays of complex policies and procedures that must be followed to maintain patient confidentiality while ensuring appropriate flow of patient information. She confided that she was initially intimidated by her new role: “I was afraid that my staff would not accept my direction because of my age and lack of supervisory experience initially.” As part of her work, Grace recently participated in a three-day training on how to be a better supervisor. The training gave her insight into how to communicate effectively with her staff and how to help them manage and prioritize their workload in a fast paced and demanding environment.
Reflecting on her role at the center, Grace explained that her commitment to her work at CBWCHC is rooted in her desire to contribute to her community, a commitment that is shared by the health center’s staff and management. “I was an immigrant myself and know how hard it is for newcomers in this country. You have to have your heart in this work because it is very stressful with a big workload. You are always overworked. .” She described the center as a resource, providing New York City’s Asian American community with quality and affordable care regardless of financial resources or immigration status. The health center has also supported her professional growth and equipped her and her colleagues with essential skills and learning opportunities. Grace’s story is one of many that illustrates how CBWCHC is more than just a medical home for patients; it is an integral part of the community and has an investment in the welfare of future generations of both patients and staff.