Community Health Programs Berkshires – or CHP – is a healthcare network that serves over 30,000 residents across largely rural Berkshire County, insured or not. In addition to its nine locations, it also offers mobile care service for those who face financial or logistical challenges to receiving in-person care. This summer, Bethany Kieley took over CHP as its new CEO. Kieley had been COO of Cornell Scott-Hill Health Center in New Haven, Connecticut – like CHP, a community healthcare practice – and began her career in healthcare at Sumner Pediatrics in Springfield back in 1997. CHP’s last permanent CEO was Amelia "Lia" Spiliotes, who stepped down in 2022 after seven years. Kieley spoke with WAMC about her plans as CHP’s new leader, as well as the unique challenges posed by providing care in a largely rural community.
KIELEY: In large part, it's simply geography and being sure that folks in all parts of the region are able to get access to care. We'll probably talk a little bit more as we go along about our mobile healthcare, and that's a critical part of our mission. Certainly, being in fixed locations in predictable places on an ongoing basis is great for many people. But making ourselves available to meet people where they are, quite literally, is a really key part of the work that we do to be sure that folks who have maybe family commitments, work commitments, health conditions that prevent them from traveling, can still get good access to care.
From your perspective at the top of the organization, can you talk a little bit about the kind of community that you see CHP serving?
I think we're really unique for health centers in many parts of the country in that we're a resource for all members of the Berkshire community. So, it's not unusual for the bulk of a health center's patient base to be either uninsured people or people on Medicaid. And here, we really take care of, absolutely, people who are uninsured or underinsured, for people who have MassHealth. But many of our patients have employer-sponsored healthcare, Medicare. So, we're really taking care of all members of the community, and filling a need given our rural nature.
Let's turn to the aforementioned mobile health units. Talk to me about that- What is this program like? And what's it going to look like on the ground for folks who are better served by something on wheels as opposed to a foundation?
So, we have been increasing our use of mobile health over the past couple of years. Certainly, the pandemic part was part of why that became more prominent. But now that we're through those days, we've really found the value of it. So, we currently have two mobile medical units that are on the road most days serving folks out in the community. One of them is our original unit, which is called Bob the Big Orange Bus, you may have seen it around, and then our newest is a smaller mobile health unit that we affectionately called Chip. And then we've recently also added a refrigerated van that we use to do a lot of our food distribution into many of the areas where we're providing mobile health, we're also doing food distribution. And that van has been super helpful to keep food fresh and really be sure that when people come to get it, it's sort of right off the, right out of the refrigerator and into their refrigerator. Coming up next, we are adding a mobile dental unit that will be our first mobile dental unit, we expect that to be up and running within the next 45 to 90 days. Ist will pull into our parking lot around October 1st, and then we'll do all the setup and get it licensed and get it ready to go out into the community.
I wanted to ask you about COVID and its impact in healthcare. We're seeing surges around the region right now, and it's been, obviously, the dominant public health story for years now. From your perspective, what's the impact of the pandemic been on the kind of work that CHP does?
CHP really stepped into support, again, so many different parts of the community, as many health centers did. I think that CHP really made themselves physically available to folks who needed it, as well as being a critical resource for information for a lot of people. As we know and we all experienced, there was a lot of changing information, and trying to find reliable sources for what the best practices would be, and CHP really embraced that. Obviously, they've been very active, continue to be active in testing people who maybe have been exposed or have symptoms, and obviously, filled a huge role on the vaccine side, continuing to vaccinate people at all of our sites and on our mobile units, and gearing up too for sort of the next round, when the newest version of the vaccine comes out this fall.
What are the biggest challenges that you see coming into CHP beyond just the rural question of transportation and accessibility?
I think all healthcare organizations, and particularly in an area like the Berkshires, our biggest challenge really is staffing. And there's more demand than can be met today by the existing providers of healthcare, whether that's doctors, dentists, hygienists, nurses, all of the above really. It's difficult. We have a finite labor pool in the Berkshires and, attracting new folks into the Berkshires- It's not that it's challenging, it's a beautiful place to live. But often people have to have sort of a tie here to want to come here. So, again, not unique to CHP, and luckily, we do see some sort of lessening of what felt for a while like a crisis in staffing and healthcare. Obviously, a lot of providers and support staff really burned out a lot during the pandemic, and we feel like we've sort of come out on the other side of that. But it's still a challenge. It's a rural area, finite workforce, and we're sort of competing for the same pool of staff. So common across the country, but particularly challenging, I think, in a rural area like the Berkshires.
Lastly, I wanted to ask you that equity in the healthcare world. When you think about that concept, what comes to mind? Is that something you're prioritizing as you take over CHP?
Absolutely. That is, first and foremost, the mission that community health centers share and that CHP embraces. We see our role as being accessible to all. And that can mean all kinds of different things. When we think of equity, it's sort of people having the same access, it's having the same quality providers, it’s having the same access to other services beyond just primary care or the services that we offer, but helping people connect to other resources in the community, other types of healthcare providers, having food access, having security when it comes to their rent. We really embrace a model, in part through our family services and other members of even our medical care teams, of really whole person care, and thinking beyond just, you're here today to get one health condition treated, but what else is going on in your life? Is there housing instability? Is there abuse in the home? And really, we really look holistically at the many factors that influence health and wellbeing and look for ways that we can support our patients and the community in addressing all of those, not just that health condition that they wanted to come in and talk to us about today.
