Maria Gomez: Creating a Model of Social Change

In May, Maria S. Gomez, R.N., M.P.H., gave Trinity’s 110th Commencement address. Gomez is the president, CEO and founder of Mary’s Center, established in 1988 as a clinic to provide prenatal and postpartum care to vulnerable women in D.C., especially Latin American immigrants who had migrated there. In February, President Barack Obama presented Gomez with the 2012 Presidential Citizens Medal, the second-highest civilian award in the U.S., for her dedication to providing high quality healthcare to disadvantaged populations with an integrated approach to medicine, education and social services.

Trinity: You spoke in your Commencement speech about your experiences as an immigrant, and wanting to give back to the community. Was there one particular moment in your life that made you decide to focus on maternal health care initially?
Maria Gomez: While working at the D.C. Department of Health as a nurse I saw too many women who had suffered many injustices crossing the border into the U.S. from all over Central America. Many of the women I saw had been raped while crossing the border, others enduring hunger, homelessness and unemployment once they arrived in D.C. Both the women and their newborns suffered poor physical, social and emotional support. That was the urgency that got many of us started on this mission.

In 2011, 3,903 of your participants were screened for domestic violence, and of those, 262 were victims. How do you support these victims?
Much of this work is done in partnership with our sister agencies in the community. Whether Ayuda or the Children’s Law Center to mention just two agencies, collectively we work to keep women and men safe while continuing to work and care for their children. We make sure that families are supported so that they don’t become homeless during this period and that family unification is timely and appropriate. Very few of these services are paid for by public dollars at this time; therefore much fundraising has to be done to make sure we have the necessary staff to carry on these intensive services.

One hundred teens in Mary’s Center’s after-school program were promoted to the next grade level, and 100 percent of the teens that attended the after-school program did not get pregnant. Mary’s Center provides a full range of services, including education and social services. Why is it so effective to have these comprehensive services under one roof?
Because the staff in each department speaks to each other about the teen (doctors, nurses, the teen staff, social workers, teachers of the parents) and the teen staff can come up with a more precise care plan. This plan best addresses the teen’s and parent’s needs and is realistic to their lifestyle. They don’t get lost through a referral process where the family will have to get to know someone new.

Mary’s Center does so much good. What is your favorite story of a great outcome that happened with the help of Mary’s Center?
Seeing our teens that were born through our program and have been through many of our programs, including the teen program, get into college, come back and be part of running the teen summer program and continue to educate themselves, is golden. In one generation we are transforming an entire extended family because that first kid going to college drives the entire family, including younger siblings, to stretch their aspirations for a better life. Children with special needs who are happy and thriving because their families feel supported and are engaged in their community through the help of our many programs such as home visiting, the fatherhood program and many more. Changing the health, educational and financial opportunities of the families we serve takes families out of poverty – the biggest barrier to individual and community success.

Why is it so important that Mary’s Center be a federally qualified health center (FQHC)?
It brings opportunities for us to learn from other health centers in the country. It requires us to demonstrate an increased quantity of patients in need while delivering the highest quality of care. It provides the opportunity for us to get a higher rate of reimbursement for Medicaid patients, covers malpractice insurance and provides a grant that covers a small percentage of our uninsured. Most importantly, FQHCs are respected throughout the country by the public sector and so there is much support through the National Association of Community Health Centers to continue to make these centers strong and sustainable over time.

With more than one million immigrants living in the D.C. region, and more than 50 percent of children from immigrant families living in low-income households, what steps need to be taken to lift immigrants out of poverty?
As for all poor people, we need to provide excellent educational opportunities for low-income children where they can learn and thrive from the time of birth. Schools children love to come to where they are expected to be challenged and always perform at their best. These schools must be safe, kept clean, and have state-of-the-art curriculum and teachers who are constantly learning. We must provide families all the social and health opportunities to plan for their children when they are ready for them to prevent child abuse and neglect, the first barrier to learning. We must support a livable wage where parents are not always dependent on public benefits. And this country must celebrate the past and present contributions of immigrants that have brought us to be this great nation. Immigration reform in a just and humane way must happen in order to bring a significant class of citizens to cherish this great nation and continue to contribute at all levels of society.

Mary’s Center has a long list of partners in the D.C. area that includes schools, hospitals, federal agencies and more. What other partnerships are you hoping to form in order to make your services even more inclusive?

We want to continue to partner more with advocacy and agencies that represent clients in the legal system to guarantee basic rights such as food, housing, employment, safety and basic human rights. We also want to partner with the public sector to make sure that the Affordable Care Act is successful and that it thrives for years to come. We are looking for more opportunities to do research in areas that are our strength, such as primary care, family literacy and family support models, and to publish such cases to spread the work of our social change model. Last but not least, we also want to partner with investors who want to see social change in action and who would like to change the paradigm of poor people through our model of health care, social supports, education and job training.

Mary’s Center began in D.C. and expanded services into the D.C. suburbs. What are the particular challenges of suburban populations?
D.C. has been extremely progressive in making sure that, as populations were in need, systems were created to address their needs – such as the D.C. Healthcare Alliance to cover the undocumented population. They have also streamlined their health care process so that clients don’t ever have to enter a wrong door. Through one assessment they can be directed to many public services. This is not always true in the suburbs especially when it comes to health care services. The different modalities of payments have the clients going to different places to become eligible for their assistance. Some counties have no payment system in place for the uninsured and so patients are at the mercy of places like Mary’s Center to take care of their needs. This system is less efficient and less data is gathered to truly understand the extent of the problem of the uninsured.

Tell us more about your “social change model.”
It is pretty simple, but we know that it works. We can support families throughout their life cycle to guarantee that they are healthy and ready to learn and contribute to their highest ability. This is done through our family literacy and job training programs in partnership with the Briya Charter School that is housed in our centers and completely integrated in all of our programming. Our social service department guarantees that families are supported through a variety of services such as home visits, counseling services, assistance in getting public services and getting training to move up the economic ladder. We know that if families feel supported and feel a sense of trust that there is no stopping them in learning and reaching for the stars for themselves and for their families.

What is Mary’s Center’s biggest challenge?
We are constantly trying to meet the financial needs of the ever-increasing uninsured, nearly homeless and overburdened families that need more of our attention in order to succeed. Our well-trained staff is now being lured to highly sophisticated health systems that are now interested in seeing the poor under the new Affordable Care Act. These health systems are also trying to cherry pick all of the insured patients leaving us to serve all of the remaining uninsured patients that will continue to be uninsured even after the Affordable Care Act is implemented, unless immigration reform is passed.

How do you achieve a balance between participants who can pay their own way or are insured, and those without insurance?
This is a struggle because once patients show up at our doors, we must see them whether they have insurance or not. The balance comes from fundraising, with corporate, individual and foundation donations to make ends meet. This is getting harder and harder because with over 35,000 patients, 400 employees and a budget of $40 million, we cannot depend on the private sector to always help us meet the gap.

What do you imagine the future looks like for Mary’s Center?
In spite of the challenges we face, I still see this organization continuing strong and relevant to the changing community for the next quarter century. With health care reform and hopefully immigration reform there are many opportunities for growth at Mary’s Center. The model has transformed thousands of lives of people who now are providing a better future for the next generation. We have trained staff that carries that commitment, knowledge and drive to do well and good by our society’s most vulnerable. I think it is this model that makes us unique and that has enabled us to have the support from our clients as well as our donors all these years. So I don’t envision that the model will need much changing, but rather a strategy to fund it to a sustainable level so that the leadership can concentrate on strengthening existing programs and continue to expand the model throughout the country by providing the knowledge and skills to those who are interested in the model. And maybe that is one way to sustain existing programs: by charging to assist others to start this social change model.