The story of Sixteenth Street Community Health Centers began almost 50 years ago when a small group of Milwaukee residents opened a health center in a rented space on the city’s near South Side. It offered education, referrals and basic services to people in the area who didn’t have access to traditional care. Over time, the clinic grew to meet the vast, complex needs of its patient population by leveraging community support, expanding facilities and hiring full-time physicians and staff.
Today, Sixteenth Street Community Health Centers has six locations and several hundred employees. Its health centers provide comprehensive medical, behavioral and dental care, along with extensive social services to Milwaukee’s underserved neighborhoods. As a federally funded community health center, it serves nearly 40,000 people and is the only source of care for much of the city’s low-income population.
“People living in poverty have more difficulty with their health, and it’s more difficult to advance out of poverty if you’re not healthy,” says President and CEO Julie Schuller, who has been a physician at Sixteenth Street for more than 20 years. “The community health center movement was started as one of the ways to address that.”
Community health centers were first introduced as part of President Lyndon B. Johnson’s “War on Poverty” and still play a critical role as the country struggles to support its most vulnerable citizens. Today, many Americans lack access to needed services, and recent efforts to repeal and replace the Affordable Care Act have threatened to scale back coverage even further. Amid these challenges, Sixteenth Street has continued to grow, committed to healthcare as a fundamental human right.
A Community Health Approach
Sixteenth Street’s mission is to provide care “free from linguistic, cultural and economic barriers.” As of 2016, 55% of their patients are enrolled in Medicaid, and 19% are uninsured. The medical centers offer services in both Spanish and English and maintain rigorous standards for quality and cultural competence. Of course, a person’s health does not begin and end in a doctor’s office. “We provide great medical care within the four walls of the clinics,” Schuller says. “But it’s the work we do outside the walls of the clinic that makes us different and adds to what we can do to really improve people’s health.”
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Clinic employees don’t just recommend ways for patients to improve their health; they work alongside them to make those recommendations a reality. For instance, staff will conduct home visits to help people manage chronic illnesses or to help pregnant women prepare for parenthood. Social service specialists connect people with key resources and information, and the Healthy Choices program makes it easier to pursue good nutrition and exercise close to home.
This community-based work is funded largely by donations and grants (since it can’t be billed like a traditional doctor’s appointment) and enabled by collaboration with local organizations, families and even businesses. “In one example, our Healthy Choices program was teaching people about quinoa, but then realized that quinoa’s not available in any local grocery store,” Schuller explains. “So, they talked with the grocery store owners and advocated to have that stocked as a new item, then went into the stores on busy days, set up a table and taught people what quinoa is and how you can use it.”
Reducing Lead Poisoning
Another longtime focus of the clinic, in partnership with the city health department, is childhood lead poisoning prevention. For the last 20 years, staff has gone door-to-door throughout Milwaukee’s near South Side, offering free blood lead level testing for children under 6 and educating families on how to manage the issue. During this time, the rate of lead poisoning in young children in the area has fallen from 32% to 6%. That initiative grew into the Environmental Program, whose projects now include the revitalization of the Kinnickinnic River and surrounding areas.
“They are one of the few health centers in the country that actually steps back and [asks], ‘What’s the environment in which our patients live, and what’s the health impact on that patient?’” says Paul Nannis, a healthcare consultant and former executive director of Sixteenth Street. “It’s important to look at the whole picture, because otherwise you’re always just treating the symptoms.”
In every sense, Sixteenth Street is part of the community it serves. Its medical centers are located in the neighborhoods where patients live, and it has clinics in St. Anthony School and at the United Community Center’s Senior Center. Sites are often staffed by neighborhood residents, and as is required of community health centers, more than half of its board members are clinic users.
This immersion helps leaders know exactly what their patients are facing and where to put their resources next, and recent developments reflect that. In the early 2000s, Sixteenth Street introduced an HIV department and added new space for physical therapy. When BadgerCare Plus extended coverage to childless adults, the clinic accommodated an influx of new patients—many of whom had chronic illnesses requiring long-delayed treatment and tests. Recently, behavioral health and alcohol and drug abuse services have expanded in response to the opioid epidemic. Also, plans for a new bilingual clinic on the far south side are currently underway.
Nannis, who also served as Milwaukee’s health commissioner for 10 years, predicts that Sixteenth Street will continue to broaden its reach and provide excellent care where it’s needed most.
“As long as the need is there, the clinic needs to continue to grow,” Nannis says. “They have the wherewithal. They have the trust and respect. And they move forward every day.”
