By Michele Teitelbaum, Ph.D. 

I first walked into Mary’s Center in 1996 while evaluating Federally Qualified Health Centers (FQHCs) for the federal government. Mary’s Center had started up just 8 years before but was already earning a good reputation.   

The facility was impressive; staff were busy, helpful and kind; children were playing; parents looked relieved that they had found Mary’s Center. The founder, Maria Gomez, spent a generous amount of time with the evaluators. This was clearly a place where health care was regarded as a human right.   

FQHCs were started in the early 1970s when the Federal government realized that many communities in the U.S. were not adequately served by the combination of hospitals and private physicians. Despite the availability of public insurance, many individuals and families are only connected with healthcare with episodic emergency services. The hope was that FQHCs would change that by providing sustained primary care. 

In the 1980s, many FQHCs were severely challenged by increasing demands for services in mental health, drug abuse, HIV/AIDS, maternal and child health, and special needs of immigrants and other migrants. To encourage that work, the Government awarded grants to FQHCs, but they were never intended to fund services indefinitely. 

By the 1990s, some private insurers were willing to work with FQHCs, but it was more common for services to be paid by public insurance, like Medicaid, with most uninsured participants paying on a sliding scale. Mary’s Center has long excelled in serving a diverse mix of patients with different types of insurance and payment options, which contributes to their success. 

When Mary’s Center staff talk about success, they tend to attribute a lot of it to their Social Change Model, which includes interventions in health care, education and social services. Surely, providing educational opportunities for participants improves their prospects for good health and access to health services. Providing social services when needed can eliminate obstacles to health care, jobs, and good housing. 

In addition to being an evaluator, I am an anthropologist. I’ve spent a lot of time in Africa, Asia and Latin America, aiding countries building or improving their health systems. Through that work, I learned that successful health care depends on understanding and addressing the social and cultural factors that shape people’s lives. Those same principles are at the heart of Mary’s Center’s approach, and they are one of the reasons Mary’s Center—and other Federally Qualified Health Centers—have been so successful. 

Thank you to all the FQHC staff, including those at Mary’s Center, who have worked so hard to help their participants achieve success!