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Silver

How to find a community health center

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Community health centers (CHCs) are located throughout the US. Most CHCs accept Medicaid and Medicare. Most CHCs also offer sliding fee or sliding scale services. They are NOT "free clinics," but they do slide their fees all the way down to a nominal charge based on income.

There is a national directory of CHCs located here. The lists can be a little long and confusing, because they list every site at which a CHC may offer services, and most CHCs also see people at local shelters and centers. Scan the list and look for something that looks like a "health center," "neighborhood health center," "health clinic," or "clinica del salud." If that doesn't work, a little telephoning will work.

Alternate option: good old Google, using "community health center" and your town's name.

The CHCs have paperwork requirements for financial eligibility set by the federal government. Ask on the phone what these requirements are, as having all your paperwork ready to go can really speed things up. If you want to be the shining star of patient organization, have all your 'eligibility' paperwork done and set up before the appointment. You have no idea how much easier this can make your life.

If your CHC is not taking new patients, ask about walk-ins. Given recent economic events, and the current state of Medicare, most CHCs are overloaded. Keep checking back. Show up. Bring a book. Especially if you live in an area with bad winter weather, show up on a day with lousy weather. There will be no-shows a-plenty, and they will probably be able to work you in.

All CHCs provide general medical care. Some CHCs also provide mental health care to varying degrees. If your CHC doesn't have mental health on-site, or can't provide long-term mental health care, they should have information available on how to link you to the local community mental health center (CMHC.) CMHs are a topic for a whole separate post.

Still, most CHCs will be able to provide you with some 'bridge' care until you can get linked in to psychiatry. It can be a little trickier when it comes to managing controlled substances, as GPs aren't comfortable with that, or with managing drugs that require monitoring, such as lithium and carbamazepine and Depakote, as GPs aren't always familiar with that. Having your former psychiatrist's contact information may help significantly.

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Thanks Silver! I go to a wonderful community center that offers partial hospitalization, med management, day programs, therapy, and various anonymous meetings. The only downside is that there is a quick turnover. I suggest that clients help in their paperwork, by giving their pdoc or tdoc notes on their symptoms, write out what meds have and haven't helped them in the past, etc.. Some of the staff are so overworked and have too many patients to keep detailed records.

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Community Mental Health Centers? Been there done that. Pillpushers. I got especially horrified when I heard they had a "shot clinic". I was there for years and when they wanted to get rid of me they sent me a letter rather than having me meet with my tdoc there. They were getting insufficient funds from the govt to "treat" me.

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G of J, CHCs do much more than give out pills (you yourself mentioned you had a tdoc, so I guess therapy happened, huh?). Besides which, plenty of people choose to get depot shots for their medication because it's easier. Having a "shot clinic" is not so unusual.

It's too bad that you didn't meet with tdoc but just got a letter. This probably happened because many CHCs are running low on funds, or having the rules changed about who they can and cannot treat.

I had a CHC for several years and while it was at times difficult and unwieldy, they treated me without insurance and gave me good care to the best of their ability, and I'm really grateful that they were available.

Anna

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I knew someone who got the shots AND was required to have a "nurse" come to her apt to watch her take more pills. Most of the shot situations were coercive (probably court ordered). Other people got their weekly "med boxes" filled there (less coercive). The "therapy" I got there was not worth much..it .generally felt like shooting the breeze for an hour a month. The pdoc read off a list every month to see how I was "doing". I was given the bum's rush after 7 years there and not so sad to see it go.

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