The Larry Combest Community Health and Wellness Center: A Response in the Nation’s Health Care Reform Agenda

By M. Christina R. Esperat, RN, PhD, FAAN
Professor and Associate Dean for Clinical Services and Community Engagement
The School of Nursing, Texas Tech University Health Sciences Center
Lubbock, Texas

One of the drivers of the current health care reform movement is the lack of access to primary health care, particularly for vulnerable populations within American society. This is an opportune moment for nurse-managed health centers, a largely unheralded group of primary health care providers, to accept responsibility for shaping the health care reform movement, thereby improving health care for their consumers. A model for the nurse-managed health center is a full service primary health care clinic administered by nurses and whose services are essentially provided by advanced practice nurses. In Texas, the Larry Combest Community Health and Wellness Center (LCCHWC) is one such clinic located in a medically underserved area in East Lubbock, providing what are primarily health promotion and disease prevention activities within the city of Lubbock’s most economically deprived area. Clinic patients come from diverse backgrounds, but predominantly, the typical profile is that of a low-income, working family with members who do not have health insurance coverage. Majority belong to minority ethnic groups, predominately Hispanic, with a significant population of African-Americans.  Administered by the School of Nursing at Texas Tech University Health Sciences Center, the academic nursing center essentially has three operations: 1) the primary care clinic; 2) the American Diabetes Association-certified Diabetes Education Center; and 3) the Senior House Calls Program, a primary care service for home-bound elders. 
 
In March of 2009, the LCCHWC achieved status as a federally qualified health center (FQHC). It has thus joined the ranks of a very few of the nation’s nurse-managed health centers which are recognized FQHCs. It achieved FQHC status as a public entity model, and this further sets it apart from the vast majority of the traditional private, non-profit FQHCs. The Center is managed and care is provided by Advance Practice Nurses.   The Executive Director is a doctorally-prepared nurse administrator, and the clinical providers are Family Nurse Practitioners as well as one Women’s Health Nurse Practitioner. The LCCHWC further improves access to quality health care services for residents of its catchment areas by providing home visitation services through the Nurse-Family Partnership Program and the Patient Navigator Program for chronic disease self management. As one of Lubbock’s best-kept secrets, the LCCHWC is truly a “light under a bushel”!

Editor's Note: The National Nursing Centers Consortium has organized the first-ever "National Nurse-Managed Health Clinic Week" this year from October 3-9. This blog was submitted as part of this week-long celebration.