Families First Helps People in Coastal New Hampshire and Southern Maine Reduce Medical Debt

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By: Matt Walker
Published September 23, 2020

Medical debt can drastically alter one’s quality of life.

For millions of Americans who live on tight budgets — including 38 million who earn less than the federal poverty threshold  — an unexpected medical expense can quickly derail a quest for financial security.

In fact, about 40% of Americans would not be able to cover an unexpected expense of $400 without going into debt.

That’s why, perhaps now more than ever, it’s extremely important for U.S. residents to not only be able to access reliable health care but to also be able to afford it.

Families First Health and Support Center, in Portsmouth, New Hampshire, is one of a number of community health centers across the country helping people accomplish both of these things through its integrated care model suitable for all income levels.

“Providing services, regardless of the ability to pay, is a big part of our model,” said Families First Communications Director Margie Wachtel.

The organization, which is part of Greater Seacoast Community Health, that also includes Goodwin Community Health and Lilac City Pediatrics, a network of community health centers, serves the Seacoast region of New Hampshire as well as portions of Southern Maine.

The health centers provide a host of health services, including primary care, pediatrics, dental care, prenatal care, and behavioral health counseling. They also offers substance use disorder treatment, mobile health services, WIC nutrition services, social work services, a pharmacy, parenting classes, playgroups, and home visiting, according to the organization website.

Wachtel gave us a rundown of how community health centers operate and what they offer that private health care often does not. “There are two big differences between the community health center and a private medical practice,” Wachtel said. “The first one is affordability. The second one is, really, diversity of services and trying to meet the needs of the whole person.”

This is demonstrated by the fact that Families First and its partner health centers offer behavioral health care, substance abuse treatment, and a dental center — in addition to general wellness services — all under one roof, she said.

The health center also has two vans that provide home visits and mobile health care for the homeless, as well as a family center focused on parent education and support.

“Our model is about acknowledging that there are many factors that go into keeping people healthy,” she said. “It’s not just getting people medical care when they’re sick, but also social services and preventative services.”

Families First’s vision is to provide everyone in its community with the opportunity to live a long and healthy life.

“To all of us at Families First, you’re more than just your medical problems or test results,” according to the not-for-profit organization’s website. “Many things go into making people healthy and families strong, so we provide a lot of them right here to treat you as a whole person and make it easy for you.”

For those in the Seacoast area of New Hampshire and in Southern Maine who may not be familiar with Families First, the organization’s website offers a wealth of information about the services they offer and how residents can obtain them.

As Wachtel explained, affordability is one of the main differentiating factors between community health centers and more traditional health care options that can lead to crippling medical debt.

“We get government funding, grant funding, and donations that help us be able to serve patients, sometimes for a very nominal fee, depending on their income,” she said.

First, the community health center will attempt to help the uninsured acquire health insurance, and the underinsured expand their coverage to get the services they need, Wachtel said.

“Families First is here to help New Hampshire residents learn about options for affordable health insurance through the New Hampshire Marketplace and Medicaid,” according to the organization website. “Both programs help pay for regular checkups, prescription drugs, ER visits, hospital stays, specialist visits, and mental health and substance use treatment. Our enrollment counselors will work with you to figure out which health insurance coverage you may be eligible for. Our enrollment counselors will work with you to figure out which health insurance coverage you may be eligible for.”

Patients who are ineligible for insurance coverage can apply for discounted medical services.

To be eligible for the Families First sliding scale payment options, patients must fill out a short form and provide proof of income within 30 days of their visit. The community health center offers its discounts based on family size and household income.

Once approved, patients will be eligible for the approved discount for one year, at which point they will need to submit proof of income again.

“No one is ever turned away from Families First due to lack of health or dental insurance or inability to pay,” according to the organization.

In the face of the COVID-19 pandemic, Families First has had to shift some of its services to a telehealth model.

“We now offer telehealth for most types of medical visits and behavioral health (counseling) visits, as well as for some dental visits,” according to the website. “If you would like your visit to be by phone or video rather than in person, just let us know when you schedule your appointment. We strongly recommend telehealth visits for patients who are over age 60, or over age 50 with a chronic health condition.”

Wachtel said that, while the benefits of telehealth for patients have long been recognized, until recently most insurance companies would reimburse providers only for in-person visits.

“It’s been a positive thing that’s come out of COVID because telehealth was always a good idea, but it was not reimbursable by a lot of insurance providers,” she said. “It was something that was talked about, and now with COVID, they just made it happen.”

Having access to a medical care team is easier than ever via telehealth services.

“Patients and providers can communicate online or over the phone, letting each patient connect with their healthcare team from home,” according to the organization.

Even while navigating the challenges presented by the COVID-19 pandemic, Families First is helping people avoid debt and striving to fulfill its mission to “deliver innovative, compassionate, integrated health services and support that are accessible to all in our community, regardless of ability to pay.”

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