By Tracie Issac –
(Editor’s note: This interview was conducted before Jordan Health Center employees, represented by 1199 SEIU United Healthcare Workers East, recently announced they’d accepted a federal mediator’s proposal to re-negotiate employee contracts, following months-long negotiations with the center. Jordan Health officials still have yet to respond to the proposal. SEIU workers have also announced a strike in recent days.)
The Jordan Health Center was one of the first community health service providers in America.
And, the purpose of a community-based health service center was to be close to the people who needed quality health care, in order to redirect this population from the emergency room, to a full service, family and individual-needs based center.
This concept was birthed over 100 years ago, beginning with Dr. Anthony L. Jordan’s legacy as a neighborhood doctor, who became the namesake of the health care edifice that was erected in 1973.
The Minority Reporter recently had an opportunity to speak with Dr. Janice Harbin, CEO of the Jordan Health Center, and Harbin has shared her insights regarding the future of the health services organization, its recent challenges with union employees, and its continued journey ahead.
Minority Reporter: Hi Dr. Harbin, please share what’s on your mind.
Dr. Harbin: Realizing that this is our 50th year, we are planning to look at how we solidify our foundation for the next 50 years.
I always say “Not under my watch are we going under. Not under my watch will we be anything but independent.” Because I think that being independent serves our community. First of all, we come out of this community. We understand our patients, neighborhoods and families, and know a lot of the issues they struggle with, which at times are no fault of their own.
Recently, I have been reflecting on the next 50 years. How do we get there? I want us to be a strong army to face the next 50 years. Unlike before, there a lot of things against just serving the community. There are a lot of mentalities that feel we are doing people a favor, as opposed to the thought that people are entitled to health care of the highest quality. That is not a favor. As a human being, at the very least that is what people are entitled to. The journey continues, and I keep smiling and keep going.
Minority Reporter: Does Jordan Health provide a bridge to connect people who do not have premium health insurance to services that someone with a top-shelf premium plan and income would receive?
Dr. Harbin: The beautiful thing about Jordan Health is that those who have that special health care card that allows them to go anywhere for health services, but they choose to come to Jordan; they realize that you really don’t get better care than at Jordan. We have wonderful collaborations and partnerships to provide our patients with any special care required. We have the relationships, and provide a warm hand-off, and follow up to ensure our patients are receiving excellent care.
Now, do we have all of the bells and whistles that you may find at some other fancy centers?
Not yet, but we are trying to get there.
We have a $3.3 million expansion currently going on.
We don’t have billions of dollars that other systems have, but we do have billions of dollars worth of love, concern and commitment that we give.
Minority Reporter: Can you address the issue that pay increases were received by senior management, but not received by lower clinicians and other support employees who felt they were due pay increases?
Dr. Harbin: I would say, first of all, that this issue is a falsehood. I came in the front door of Jordan Health over six years ago as a dentist. A week later, I was their interim dental director, and maybe two to three months after that, I was the dental director and chief executive officer, where I identified Dr. Mary Miller to become our chief dental officer.
We have done two significant increases for our clinicians, because we were not competitive with our clinicians. One of the people who may have been on the list for increases was our chief financial officer.
When you look on the grid, and at the range of community health centers, that person’s pay level was not even on the chart, not even at 0% on the chart. He may even currently be in the 10th percentile.
When you look at the mere fact that myself, my chief medical officer, and chief dental officer are revenue generating providers, that is not the norm in a community health center.
Most officers like us, across the country, are basically administrators. I generate revenue for the center, and even with the revenue I generate that offsets my salary, I am still underpaid by most other systems.
If you compare what I get paid with other health community centers across the country, I am still under the norm.
You don’t go into community health for the money.
Otherwise, 39 years ago I would have gotten out of community health.
We try to keep our administrative costs down to the 15 percent that the state of New York is counting as being good stewards of the incoming money.
Our audits have been clean, and we have been good stewards of our money.
No matter what other people say things to be, the truth is still the truth.
I am comfortable that our audits are clean, and I have made sacrifices to move closer to the goal post.
Unfortunately, we are dealing with two major health systems.
Every time we get closer to the goal post, they move the goal post.
Minority Reporter: So what is going on with your budget?
Dr. Harbin: This has been a deficit year. Major grants went away. I could have made the decision to cut staff, but I made the decision that, if indeed we are going to go from good to great, if we can figure out all the processes that we need to do; we need to build a solid foundation, and to determine what is the good mix of staff support and clinicians to serve our patients.
This is the year. I was grateful that the board trusted me enough to say, ‘This year, show me what you have.’
This is the year we have made some major changes so that we can increase the number of patients that we receive – which means more patients through our doors and service.
We control that revenue. I can’t control the grants. I can’t control that in Washington, they are talking about entitlements, Medicaid, Medicare, Social Security which represents 80 percent of our population.
If you want to attack entitlement, what does that do to our bottom line?
The only way we can improve our numbers is to control how we provide the services, so that we can maximize getting people in the door, out of the door and let them receive all of the services they need to receive.
Minority Reporter: Do you have a vision for when Jordan will be able to increase staff compensations, and when will that be?
Dr. Harbin: We have put that on the table from the very beginning. We understand the cost of living, and that it costs people to live. We have been very fair. A few years ago, when the state was doing a survey, and asked how would $15 per hour affect your organization, I know some of my real brothers and sisters stated that would put us out of business. That is not the case for Jordan, because, very quickly, many of our staff are hitting that $15 per hour or more rate. If they are at that rate in a short period of six months to a year, they will cross that threshold.
We stated that, in this transition year, whatever you would have received this year we will add to Jan.1. We have never deviated from that, and never deviated from the fact that one-fourth of my workforce is union.
This is a family, I can’t just look at the one-fourth. Whatever I do, I must look at the whole.
We are all in this together.
The decision I made, to put an offer on the table, was to give us this year of 2018, and we shared that whatever was put on the table in 2018, we are going to add that to January of 2019, so you don’t feel like you are so much behind the eight ball.
I felt that was a better decision than to say I need a break-even budget.
You can’t build, have grants cut, and not get rid of something unless you have faith.
This is my year of faith, by saying I want to hold on to the staff, I want to educate, and get us prepared so that, when patients pick up that phone, they feel like they are calling a major system.
That is an investment, and this is a year of investment which I think is more critical to our sustainability, versus an artificial percentage increase, and hope that things work out. I had to say let us take the money we do have, and invest in “us,” so that we are ready for the future.
I don’t know if that makes sense to others, but that is where it is.
Minority Reporter: What about the issue of the employee who stated that she was terminated as retaliation for reporting fraudulent activity?
Dr. Harbin: That is not true. Ms. Ferry was fired, and I am the one that terminated her. She reported to me, and was fired for just cause. It was no doubt that it was for just cause, and that her claim that she made was proven to be false. If you bring something to me regarding any location, I have an open-door policy, and I will tell anyone if you bring something to my attention. I now must address it. I won’t respond and say, “Ok, you let me know that but don’t talk about it.”
Once I am aware that there is a concern, I must investigate the matter.
At the end of the day, I have to be at peace. I must ask, is there any foundation to the matter?
There was absolutely no foundation to her claim.
That was totally separate from why she was terminated, which was for just cause.
The paperwork which she received indicated why she was separated, and I gather she waited two years, and responded just before she could not make any claim, which is why she decided to bring this matter up. If you read the claim, she is not stating what happened, she is just stating that she was terminated because she said something.
That was not the case, and I would not hesitate to terminate in that situation again.
I was raised to believe that right is right, and that right doesn’t wrong anybody. She is no longer with this organization, and that is where she should be – no longer with this organization.
Minority Reporter: Where do you feel the status of the strike is at this point:
Dr. Harbin: We have put a truly fair offer on the table. I think I have been very clear about where we are as an organization. This is our transition period, and we have made it clear that we are in the healthcare business. I kind of heard some things floating around.
Why would people not have health care? We have continued to make our payments to the national benefit fund, as if everything is in place, because we believe that people should have health care.
I guess it is in the court of 1199. I think 1199 has to make a decision that, if they truly want to be a partner with Jordan, they need to help see us through, or at least build a foundation to see us through the next 50 years.
It is a no-win situation.
I am hopeful that 1199 takes us at our word that we are trying to be sustainable, and to move forward with a solid team that we continue to invest in.
The employees play a role in Jordan being here, and I thank them every day for what they do.
So, none of this is a reflection of disrespect. It is a reflection of sustainability, and what makes good fiscal sense. Otherwise, what about tomorrow? If am only worried about today, then what happens if tomorrow actually comes?
Minority Reporter: What are some of the achievements Jordan Health has accomplished over the years?
Dr. Harbin: Number one, I think it’s an achievement that we are still in this community after 50 years as a Federally Qualified Health Center (FQHC). We are one of the first five FQHC’s in the nation, and we stand today with 1,200 centers like Jordan serving 27 million people.
When you look at our roots, and the fact that we came out of the Rochester Neighborhood Health Center, that’s another 20 years of being in this community.
When you look at our foundation, from Baden Street Settlement, we are going back over 100 years.
Each time, our achievements have been based on what efforts enhance the health care of that community, whether our name was Baden Street, or Rochester Neighborhood Health, Anthony L. Jordan, or now Jordan Health.
That is a big accomplishment – that we sit ten centers strong, serving two counties that, besides the two major health systems in 13 counties, Jordan is number three as far as service to unique patients.
I believe that we have to do a better job at telling our story. We are looking to be a very connected voice in the community.
Jordan Health is an independent FQHC, with Level III Patient-Centered Medical Home (PCMH) designation through the National Committee on Quality Assurance. Jordan Health receives funding from the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services, and is a network of outpatient primary care offices with providers who follow a panel of patients.
While independent, Jordan Health actively collaborates with the major hospital and healthcare systems in our operating area to provide a total safety net of healthcare services.
Jordan Health also has Federal Public Health Service (PHS) deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals.