The Integrated Healthcare Policy Consortium (IHPC) held Congressional Briefings in Washington DC on June 8, focusing on the intersection between "integrated care," patient-centered medical homes (PCMH), and Community Health Centers, also known as Federally Qualified Health Centers.The briefings were planned by Janet Kahn PhD, former Executive Director of IHPC, who was appointed by President Obama to the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health.
Kahn is also a massage therapist and medical sociologist, who describes herself as "passionate about seeing to it that people, no matter their income, have access to the basics of health (clean air and water, love, touch, good food) and to the health care approaches they need and prefer."
The IHPC is comprised of a broad coalition of healthcare professionals, patients and organizations driving public policy to ensure all Americans access to safe, high quality, integrated health care. IHPC was initiated at the request of legislators who support integrated health care and need an organization that represents the consensus voice of the integrated healthcare communities.
Kahn described her ideas about the role of acupuncture in integrated care as follows: "Most people in the US who use acupuncture and Asian medicine also use allopathic medicine. In this way, there is no separating acupuncture from integrated healthcare; it is inherently integrated with Western medicine already. The question then is whether we are leaving the integration to the patient, or whether we are, as responsible health care practitioners, going to work to have their care be truly holistic and integrated by being in good communication with the others on the care team. Acupuncture, of all systems, should understand this. Integration is a manifestation of the balance and the full circle view we seek. It is the antithesis of reductionism, although reductionist science certainly has its place in care."
Briefings were open to members of the U.S. Senate, House of Representatives, and their staffs. The Affordable Care Act, signed into law in March 2010, is a complex piece of legislation with many moving parts, some of which have already been enacted (e.g. prohibition against denying healthcare to adults because of pre-existing medical conditions), some of which have been hotly contested and some of which will be enacted in the next few years. Sections 3501 and 3502 encourage the use of the patient-centered medical home (PCMH) model for people with chronic illnesses and stipulate that those PCMHs are to be supported by inter-disciplinary community health teams that may include licensed complementary and alternative medicine providers. This aspect of the law has yet to go into effect although it has been instituted in Vermont, prior to its inclusion in the Affordable Care Act.
Craig Jones, MD of Vermont Blueprint for Health discussed his state's experience with PCMH's, focusing on costs, logistics, and coordination of care. As a successful public-private partnership, Vermont Blueprint for Health relies on multidisciplinary health teams to assist primary care providers. Tom Trompeter, MHA of HealthPoint, Seattle's 13-center Federally Qualified Health Center, described the experience of integrating conventional, complementary and alternative health care in a PCMH environment. I myself provided information about ways in which integrated community health teams can support PCMH's. Pathways, where I work, provides no-cost care to people with HIV/AIDS and to military veterans and also works with insurers and managed care networks that include acupuncture in their covered services. Services are also covered by patients' self-pay that includes a sliding-scale system.
Senators whose offices attended the briefing included Baucus (D- Montana), Begich (D-Alaska), Boozman (R-Arizona), Carper (D-Delaware), Harkin (D-Iowa), Johnson (D-South Dakota), Kerry (D- Massachusetts), Leahy (D-Vermont), Menendez (D-New Jersey), Mikulski (D-Maryland), Murray (D-Washington), Rockefeller (D-West Virginia), Sanders (I-Vermont), Wyden (D-Oregon). Members of the Senate Budget and Finance Committees also sent representatives to the briefings.
In the House, Representatives' offices who attended included Hultgren (R-Illinois) and Welch (D-Vermont).
Attendees also included individuals representing a number of organizations, including the Association of Chiropractic Colleges, American Public Health Association, Center for Natural Medicine and Prevention, Dana Farber Cancer Institute, Hyland's, National Research Center for Women and Families, the New York State Society of Medical Massage Therapists and the Samueli Institute.
Following the presentations, questions and discussions ensued. A local acupuncturist who attended the Senate briefing provided the perfect clinical illustration of the value of integrated health teams. She reported about working with a client who lives with diabetes and is currently undergoing cancer chemotherapy. Because the biomedical focus has been on providing cancer treatment, the patient's other health needs were not being addressed. In the course of the acupuncture treatment, after taking off the patient's socks, the acupuncturist realized that the patient's foot health required immediate medical attention to avoid further infection. Because she works in an integrated clinic, she was able to get the patient's needs addressed immediately and successfully. Her story illustrated acupuncturists' role in triage and ability to provide a significant point of contact with health care allies.
The fate of the Affordable Care Act is being discussed in the Supreme Court and should be made public by the end of June 2012.
Click here for previous articles by Elizabeth Sommers, PhD, MPH, LAc.