In May of 1977, Community Health Services Clinic (CHSC) sponsored by the ASU College of Nursing & Healthcare Innovation began delivering health services as the first federally funded, nurse-managed community health center in the country. While CHSC has experienced many changes in the past 30 years, its core mission as a Nurse-Managed Health Center remains to provide educational experiences for students, quality health services for the community, as well as to serve as a clinical site for faculty practice and research.
CHSC’s accomplishments in fulfilling its mission over the past 30 years are remarkable:
- 180,000 client visits,
- 1,250 nursing students educated in Community Health,
- 61,200 hours of student education and practical experience,
- 40 conference presentations, and
- 9 article publications
The evolution of the Community Health Services Clinic is a story in itself. It started as a volunteer-run demonstration project in partnership with the City of Scottsdale and Maricopa County Health Department to serve the needs of the nearby Yaqui Native American Community. The center became a permanent nurse-managed organization when a student community assessment project served as the foundation for a grant proposal submitted by Dr. Ellamae Branstetter, then a professor at the college. The Division of Nursing within the U.S. Department of Public Health awarded Dr. Branstetter a five-year grant which required the clinic to serve a broad base of underserved populations in the area.
Chris Lyons had a career path to the CHSC that is indicative of the influence it has had on lives. By 1989, Lyons had worked as an RN for 15 years in hospitals when she first talked to Dr. Branstetter, then Chairperson of the Graduate Program at the college. “In 1989, I was burned out and actually considering a career change when I talked with Dr. Branstetter,” Lyons explained. “She convinced me that there were many new opportunities in nursing, but I needed to continue my nursing education to realize them.” Lyons worked at CHSC while pursuing her masters degree in nursing, and later became the clinic director.
Students have been similarly impacted through their clinical education at CHSC. Senior II student Cherie Ianucci describes her work at the clinic as a unique healthcare experience. “The staff takes the time to assess patient options and educates them on how and where they can get help when they do not have insurance,” Ianucci said. “Being at the clinic didn’t seem interesting to me until I worked there. It taught me what preventive care is and how satisfying it is to teach people what they can do to prevent illness. I have enjoyed CHSC so much that now I hope to work there someday after I graduate.”
Senior I student Michelle Kastner has found a different value in her seven-week Community Health clinical experience at CHSC. “I go to the clinic for my own healthcare and encourage others to do the same,” Kastner said. “The clinic fills the gap for people in our community who otherwise would have no healthcare.”
According to Tine Hansen-Turton, executive director, National Nursing Centers Consortium, CHSC has had an impact far beyond its local community. “Community Health Services Clinic is an important pioneer which laid the foundation for other nurses to advance their mission of community service under the umbrella of Universities,” Hansen-Turton said. “It was the forerunner of the 250 nurse-managed clinics nationwide now.”
Despite its many successes, CHSC continues to face challenges to its financial stability. Grant funding or “soft money” supported the clinic for the first five years. Since then, the academic nursing center has sought revenue opportunities in the both the private and public sectors. Community outreach activities have become a significant source of clients and revenues. For example, CHSC staff made 2,500 community outreach contacts through screenings and immunizations clinics. Additionally, 900 off-site new admission physicals for a local hospital contributed to the 2006 revenues. Revenues from client fees and contracted services now account for nearly three-quarters of the clinic’s funding, but more is needed. Changing demographics, increasing costs, and increased competition from for-profit walk-in clinics are always challenges to overcome.
The client or patient mix at CHSC has changed dramatically over three decades. Fifty-eight percent of more than 8,000 client visits in 2006 still were on site at the small shopping center in south Scottsdale. However, the patient mix now includes few children due to the Arizona state Kids Care program and the adult patients are more transient and from further outside the neighborhood.
The clinic’s entrepreneurial spirit continues to help the practice remain open and serving the needs of the local community. CHSC remains optimistic about its future. Their wish list includes a larger, more modern space, more advanced clinic software, and expanded services through the addition of other health professionals.
Looking to the future, Associate Dean for Clinical Practice & Community Partnerships, Dr. Denise Link, has plans for CHSC that will increase the capacity for services and put the clinic on a more sound financial footing. “It is our duty to operate our entire system of nurse managed health centers in a fiscally responsible way so that we are there for those individuals and families who count on them for their health care. We also have a mandate as a university affiliated project to provide educationally sound clinical experiences for students and prepare the next generation of health care providers. Our nurse-managed health centers put into action President Crow’s plan for Excellence, Access and Impact.”
