CCHN. Photo by Ellen Jaskol

The healthcare landscape has changed drastically over the last few decades, and officials from Aurora-born Stride Community Health Center say the program has risen to meet the needs of metro area residents.

Once a relatively obscure alternative for desperate residents, Stride has moved into a prominent place in the metro area to provide health services for tens of thousands of patients, many of whom have other choices.

The veteran health network has grown from operating out of a small house with mostly volunteer doctors to 18 locations across the metro area with paid medical staff.

They now serve more patients than any other federally qualified health center in the state.

In 2018, Stride reported 45,848 medical users, 15,840 dental users and 6,560 behavioral health users.

These centers offer comprehensive primary care and preventive health services to people who can’t afford it. The organization also provides some specialty services through no-cost partnerships with area specialists. Care is offered to individuals regardless of insurance coverage or ability to pay.

According to the National Association of Community Health Centers, there are nearly 1,400 health center organizations with more than 11,000 locations in urban, suburban and rural communities across the nation.

The program has seen significant growth since Obamacare became law, which expanded coverage options for low-income patients.

Laura Larson, vice president of development at Stride, said that before Obamacare, nearly 60 percent of the organization’s patient population was uninsured. After the Medicaid expansion, nearly 50 percent of their patients are now covered under the federal health insurance.

CCHN. Photo by Ellen Jaskol

Three decades of practice

The nonprofit organization celebrated their 30th anniversary in April and a name change from Metro Community Provider Network. Under Ben Wiederholt, who was hired as CEO in 2017, the company began searching for a new, more descriptive name.

“We felt like ‘stride’ was the right word,” said Communications Manager Erika Oakvik. “We’re taking strides together toward better health. We’re walking, it’s active, it’s movement.”

The network partnered with Aurora and community activists in 1989 to provide care for the large population of uninsured people in the area. At the time, most patients had to go to Denver General Hospital to receive care. The hospital was owned by Denver, which began turning away non-residents who were uninsured because of the financial strain.

The agency started out of a small house on 13th Street and Helena Street with only a couple of doctors and nurses who mostly worked as volunteers.

The clinic was instantly popular. Former city council member Barb Cleland said there was always a line out the door.

Cleland and other council members began granting money to the organization early on through an aid to agencies fund, which it still does to this day. This year Stride was awarded $48,479 from the city.

The organization has now changed its staffing model to employ full-time, paid medical staff. Stride operates outside of the city of Denver. They have locations in Aurora, Arvada, Englewood, Lakewood, Parker, and Wheat Ridge.

The organization has graduated from serving mostly low-income patients to providing broader health care. Oakvik said the next step for Stride is opening a clinic at Golden High School, scheduled for this fall.

Providers see patients from around the world and speak more than 115 languages. The health centers also provide care to new immigrants and refugees. Their Elmira Refugee Health Center in Aurora is solely dedicated to that population.

Karin Rohleder, is a pediatric physician that works at numerous Stride clinics. She said the organization regularly changes to help non-English speakers and those who recently arrived in the country. Providers attend a cultural awareness training and translation is available.

“The families are open and welcoming, and so are we,” Rohleder said. “We’re very open to all cultures.”

CCHN. Photo by Ellen Jaskol

A rare provider of addiction treatment for patients desperate for help

Under their new name, Stride continues to provide specialty services like women’s wellness, pediatric medicine and substance abuse treatment.

Substance abuse treatment is important. According to the National Institute on Drug Addiction, in 2017, there were 578 overdose deaths— involving opioids in Colorado — a rate of 10  deaths per 100,000 people. This is slightly below the national average rate of 14.6 deaths per 100,000 people.

When Colorado’s largest treatment provider for drug and alcohol treatment, Arapahoe House, shut its doors in January 2018, many patients went to Stride for care.

Kelly Schaffer, the Medication Assisted Treatment project manager for the organization, said they were uniquely qualified to deal with the problem.

“We offer addiction treatment as part of primary care services, because we really recognize it’s a part of whole health, and it impacts everything,” s Schaffer said. “We don’t want to silo people away to other places. We want to take care of them where they’re at.”

Schaffer previously worked for Arapahoe House before taking a position at Stride. She said she appreciates how the health center stepped up to fill the gap left by Arapahoe’s closure and long waiting periods at other treatment centers.

Stride works in conjunction with All Health Network, Aurora Mental Health Center and Jefferson Center for Mental Health to provide counseling and medical treatment for opioid addiction, including programs that use Suboxone. The prescription drug has been successfully used to treat opiate addiction because it reportedly curbs cravings and prevents the user from getting high from other opiates like oxycodone, fentanyl or heroin.

However, the ability to prescribe the drug requires a special license and additional training. Suboxone treatment programs are much harder to come by than methadone centers, providers say.

Stride has also recently worked out a deal with Medicaid to provide Vivitrol injections for alcohol addiction, Schaffer said. Although the program started only a year ago, it’s been a success thus far. More than 50 individuals have been enrolled in the program.

“We see these patients in our clinic, it’s connected to their health and wellness and we want to prevent people from dying,” Schaffer said. “That’s exactly what we’re doing.”

Looking forward, Schaffer said the organization is excited to work with Gov. Jared Polis and the Colorado Office of Behavioral Health.

Over the last two years, the state office has received two significant grants from the Substance Abuse and Mental Health Services Administration that will help with funding of things like prevention, treatment and harm reduction.

In June 2016, the Colorado Legislature passed Senate Bill 16-202, which expands available funds for managed service organizations like Stride. The bill requires the centers to use money from the Marijuana Tax Cash Fund to cover costs for addiction services not covered by insurance.

That means more beds for intensive residential services, recovery services for homeless and dozens of more projects will receive funding.

“We’re so glad that they are expanding access to substance use and addiction services,” Schaffer said. “We will partner with them however we can.”

CCHN. Photo by Ellen Jaskol

More insurance funding, more growth

In 2017, Stride received the bulk of their funding from patients. The organization accepts some private insurances, but the majority of their clients are on Medicaid or uninsured.

Oakvik said clinic staff work with uninsured individuals to determine where they fall on the sliding fee discount program, which is based on family size and income. Co-pays range from $15-$35, depending on where individuals or families fall on the scale.

In 2018, they provided more than $15 million in charity care through their sliding fee discount program.

Concern about the burden of the uninsured on taxpayers has been at the forefront of the health care debate for years. Community health centers help mitigate some of this cost by treating people for minor illnesses and injuries early, before a hospital visit is necessary.

These centers don’t just save money for struggling patients. According to Colorado Community Health Network, research shows that these organizations save the national health care system $24 million annually.

Specifically in Colorado, health centers care for 27 percent of Medicaid enrollees at a total cost of only 3 percent of the state’s Medicaid budget.

Stride also receives federal, state and private grants to meet their financial needs. This month, the network was awarded the second-highest grant from the Department of Health and Human Services for $115,000.

Maureen Maxwell, senior manager at Colorado Community Health Network, said that despite arguments in Washington over healthcare in recent years, community health centers enjoy bipartisan support.

Health centers received bipartisan support for a two-year extension of the Health Center Fund and for the American Recovery and Reinvestment Act. The latter aimed to meet the needs of increased numbers of uninsured due to job losses during the 2008 recession.

Maxwell said there is some risk in relying on federal grants. Government shutdowns can have adverse effects on health centers, such as hiring and raise freezes, delays in construction and “hard decisions about whether to proceed with programs and new initiatives.”

“As a healthcare provider, Stride and other community health centers do have to plan ahead for program expenses, staffing, recruiting and supplies during these times,” Maxwell said.

While elected officials debate solutions for health care, community health centers across the country are already addressing the most pressing concerns on the ground, supporters say.

“Our mission is to partner with the community to provide excellent, culturally-sensitive health services to meet the needs of each individual,” said Oakvik. “The organization consistently reviews community needs and analyzes where services would create the largest impact.”