Community Health Centers: Caring for Patients from All Walks of Life

Jen Tinguely, MD, MPH
President, South Dakota State Medical Association

June 3, 2024

Greetings! My name is Jen Tinguely and I am honored to serve as your SDSMA president for the next year. I am a family practice physician and public health professional who works for the City of Sioux Falls. My clinical practice is located within Falls Community Health which is a federally qualified community health center in downtown Sioux Falls. I consider our clinic a tiny gem in the community and I am using this platform as an opportunity to share information about the work we do at our health center as well as share information about what community health centers offer across the country.

Community health centers provide primary and preventative care services to patients from all walks of life regardless of their ability to pay using a sliding fee discount scale. Often seen as “safety net providers,” community health centers tend to care for patients who do not have health insurance or are underinsured. Of course, patients with insurance (both public and private) are welcome at a community health center. At our clinic, 43% of the 10,776 patients we saw in 2023 were uninsured. This was a very nice improvement from years past in which 50-51% of all our patients were uninsured. This is thanks to Medicaid expansion which took place in July 2023 and the growth of Marketplace options for patients.

Another spinoff as a “safety net provider” is that community health centers are frequently found in rural areas of the country and serve as a local healthcare resource for residents who prefer to receive their care locally versus driving to the “big city” to see their medical provider. In North and South Dakota, community health centers are located in 52 different communities and serve over 136,000 patients each year. There are community health centers located in every corner of South Dakota, including Faith (population 368) in the northwest; Martin (population 938) in the southwest; Aberdeen (population 28,495) in the northeast; and Elk Point (population 2,149) in the southeast. Rural Health Care, Inc. operates multiple community health centers in the central part of the state meaning that anywhere you look, you can probably find a community health center! In 2022, over 30.5 million patients were served by a community health center across the U.S.

Operational funding for community health centers is provided by the federal government through a base grant (Section 330 of the Public Health Service Act). While many issues in Washington D.C. are polarizing and challenging, community health center funding has thankfully had strong bipartisan support for decades. Dating all the way back to Lyndon B. Johnson’s War on Poverty, community health centers have been seen as instrumental in providing quality healthcare to local residents. The first two community health centers were started in 1965 in Boston, Massachusetts, and Mound Bayou, Mississippi. The clinic in Boston served a medically underserved part of the inner city and the clinic in Mound Bayou served a very rural and very poor part of the state.

Community health centers carry a proud legacy of caring for the most vulnerable residents in a community and you will find incredibly passionate staff working in community health centers. Many centers, like ours, enjoy having a myriad of services available to patients. There are often dental clinics embedded within the health center and many health centers also provide mental health and chemical dependency services. Our clinic has all of this along with dietary services, pharmacy services (including an on-site pharmacy for patients with no insurance), social work/care coordination and community health workers. Falls Community Health is the contracted agency working with Lutheran Social Services to provide medical care for our newly arrived refugees in the Sioux Falls area. This results in a very vibrant clinic in which you’ll hear multiple languages being spoken on any given day! Another unique aspect of our clinic is that our medical providers are comfortable providing medication-assisted treatment for patients who are struggling with substance use disorders. We take a lot of pride in the humanistic way we treat our patients who are working so hard towards sobriety.  

Over the next few months, I plan to talk more about the issues that matter to me which include mental health challenges (for both patients and providers), substance use disorders and the stigma that patients face, and social justice in medicine. And, of course, we can anticipate topics related to the legislative session that is just around the corner! It truly is an honor to serve as your SDSMA president and I look forward to meeting you as I visit our medical districts across the state.