Jim Hunt and Community Health Care: Combo That Spells Success - and Promise

On the lip of a historic and yet contentious vote in the U.S. Senate on a health care reform bill that would extend health benefits to about 31 million uninsured Americans, James W. Hunt Jr., longtime president and CEO of the Massachusetts League of Community Health Centers, a cornerstone of the health care reform push, is reminded of a comment from an old friend, the late Sen. Ted Kennedy: "If we didn't have community health centers, we'd have to invent them."

Community health centers were conceived in 1965 with the foresight of two physician-activists, H. Jack Geiger and Count D. Gibson, Jr., who launched the American Community Health Center Movement with the founding of the nation's first two centers: one in the Columbia Point section of Dorchester; the other in Mound Bayou, Mississippi. In Massachusetts today, 52 community health centers provide high quality care to almost 800,000 residents through 285 sites statewide.

Community centers nationwide serve more then 17 million—in many cases, says Hunt, the difference literally between life and death. More than 65 percent of Massachusetts health care patients, for example, are ethnic or racial minorities who are "disproportionately affected by chronic diseases like diabetes, asthma, cancer, depression, and HIV/AIDS," he adds. In addition to providing wide-ranging health services to underserved people, the centers are at the "leading edge of addressing some of the most vexing problems of our health care system, including facilitating access to insurance coverage for low-income residents and eliminating health disparities," states the Massachusetts League of Community Health Centers.

Put simply, as Hunt's forever-Irish mother Grace (Phelan Eaton) would say, "Without your health, you have nothing."

And so, the Massachusetts League of Community Health Centers offers, beyond all measure, a cornucopia of riches in a model of health care—providing technical, regulatory, policy, and financial assistance to center administrators, clinicians, board members, and other agencies that support community-based treatment and preventive care. In this sticker- shock milieu of health care expense, where the Senate version of health care reform is expected to cost $848 billion, community centers are a bargain of enhanced treatment. "For every dollar you invest in community health care prevention and early treatment, the system will save three to four dollars," says Hunt. "We have the evidence to prove it."

Any way you count it, health care reform does not come cheaply in maneuvering through treacherous political minefields, but the price of doing nothing—as measured in additional stress on the health care system, premature deaths, and the cost of more invasive treatments resulting from lapsed care—is staggering. The current system of health care provision, many would argue, is dead on arrival ,with insurance premiums rising 129 percent in the last decade. And while critics of reform insist that government agencies will have a disproportionate voice in determining what medical treatments patients receive, the bottom line comes down to a philosophy, a moral commitment, says Hunt, quoting Kennedy again: "Health care ought to be a right, not a privilege!"

With more than 50 million Americans uninsured and millions of others without proper access to care, the on-going reform debate, Hunt says, ought to focus on slowing the escalating cost of care, encouraging investment in efficiently run quality community health centers, and reinforcing the need for more primary care physicians and aides. "We need a sustained amount of energy and resources for this," Hunt, former president of the National Association of Community Health Centers, says from his the tenth floor of his Court Street office.

With Kennedy now gone from the health care front, a great deal of energy as well as resources will be needed to sustain the cause. Hunt, 60, a second-generation Irish American with strong family ties to County Mayo and County Leitrim, is infused with fresh vigor. He has been credited with securing millions of dollars in relief to financially-strapped health centers in Massachusetts, has worked diligently to retain state-based reimbursements for the care of uninsured individuals, and has obtained millions of dollars from federal, state, and city governments for center capitalization and renovation. A community activist and public policy leader at heart, Hunt, perhaps as much as anyone in a close circle of Kennedy advisers, shares the late senator's vision for equitable health care for all. In that endeavor, and in politics, access is everything. Last May, Hunt sat with Kennedy at a Kennedy Center tribute to him.

All eyes were on Hunt as a young boy. Dorchester born and bred, he still lives on Pope's Hill in St. Ann's Parish. His father, James Sr., one of seven, rose to become assistant to the postmaster of Boston, and his mother, Grace, a housewife committed to social and church causes, hailed from a family of ten. Such prolific offspring seemingly foreshadowed a large brood, but Hunt is an only child. Perfection, he jokes, can be completing.

Raised in a working-class neighborhood on Houghton Street, Hunt thoroughly enjoyed the attention and affection his childhood status brought him, but the vigil kept him on guard. He even caught Boston Mayor James Curley's attention on April 23, 1949—always on the lookout for a new and faithful constituent.

"Allow me to congratulate you upon the birth of a future citizen, baby James Williams," wrote Curley to his parents in a letter framed on the wall of Hunt's office. "Health, happiness and that God will bestow upon you and yours the blessings of a long successful life is my sincere wish. Your city government is desirous of aiding in the health and education of your child. We want you to continue to live in Boston, and take advantage of our modern nurseries, schools, playgrounds, and beautiful parks. There is no better place to bring up your family than right here in Boston."

Hunt ultimately got religion, the Curley kind, through a childhood and early adult life of rigorous education, sports, work, creative endeavors, and public service. He attended of Dorchester elementary schools, including St. Ann's, and graduated from Boston Technical High School, Boston State College with a bachelor's degree in science, and Boston University with a master's in urban affairs. In all ways, Hunt was a driven man like his father, who worked three jobs. In addition to his Post Office responsibilities, the senior Hunt was a commercial artist, and a window dresser extraordinaire, who traveled by train—often with his son—to New York and Philadelphia to arrange store windows in fancy department stores throughout the northeast. At Christmas time, the senior Hunt dressed the Post Office windows throughout Boston in holiday cheer.

"Dad was a quiet, funny man, yet intense in ways," Hunt recalls, noting his father was treasurer of Local 51-100 of the Postal Clerks Union. "Like my mother, he also was deeply religious and service-orientated, and was an unsung hero who worked 80 to 100 hours a week. My dad always told me that ‘proof of dedication in life is in the work you do,' "

Not one to suffer fools gladly, the senior Hunt posted a family anthem on the refrigerator. It read: "Beware of zealots because they eventually become humorless!"

The son has always kept his wits about him and his work ethic in tow, coordinating three paper routes (morning and afternoon Boston Globe and the Herald) and purchasing a new Pontiac with cash his senior year of high school. He remembers the exact price: $3,751.28. The hardworking Hunt always found time for sports. As a pitcher and first baseman, he played with the Shawmut Knights in the Senior Park League. "I was a junk ball pitcher," he recalls. "Kinda sneaky, like a Wakefield knuckler." His off-speed delivery has been helpful in business and in political pitches throughout the city, but none of his successes, he is quick to note, would be possible without the enduring support of his wife of 40 years, Jean (Costigan).

The two met in their early teens at a Mission High School dance; she was captain of the cheerleading squad. A retired nurse who worked long hours at Carney Hospital and Mass General for years, she graduated from Northeastern where she received a master's degree in nursing. She later took another master's, in public health, from Boston University. They have raised four boys: James III, an attorney who is chief of environment and energy management for the city of Boston; Matthew, who died after a long illness; Peter, a banker who just returned from a two-year tenure in Dublin with State Street Europe; and Daniel, a Boston College graduate who works as chief of staff to State Rep. Daniel E. Bosley, a Democrat from the first Berkshire District. He is attending law school at Suffolk University.

When the boys were young, Hunt's mother, a sensitive and thoughtful woman, and her twin sister Gladys were helpful caregivers while her son and his wife were working fulltime. Grace and Gladys were avid Red Sox fans and bingo players, and they infused the family with a sense of loyalty and fun. "We had a sense of Irishness growing up," young Jim recalls. "The Hunt house was always full of people coming and going, mostly aunts and family friends from the north and south of Ireland. We always felt we had to prove we were Irish because we had such an English sounding name. So we made sure we attached ourselves to cousins with the names of Byrne, Gallagher, and Finnegan."

To this single child, his extended family has been at the core of Hunt's existence, and the relationship carries over to his work at the Massachusetts League of Community Health Centers where he has presided since 1978 after working for ten years at Boston City Hall. Initially, he had planned to be a civil engineer, but didn't have the stomach for surveying equipment. So he turned to his passion—public service and health care.

Hunt's lengthy resume is filled with accomplishments. As an effective state and national leader on community-based health care issues, he has helped to promote the worth of the centers in improving access to quality health care and reducing costs. In addition, he also directed Massachusetts's health centers through the roiling waters of reform; stabilized center financing; expanded center services to the homeless, seasonal farm workers, persons with disabilities and the elderly; developed the center workforce; and extended best practices across the network.

More recently, with funding from Bank of America, the Commonwealth of Massachusetts, Partners HealthCare, Neighborhood Health Plan, and the Blue Cross Blue Shield of Massachusetts Foundation, Hunt assisted in the establishment of a loan repayment program for primary care providers who commit to practicing at community health centers. The League three months ago received a 2009 Summit Award from the American Society of Association Executives (ASAE) and the Center for Association Leadership in recognition of the program's success in securing placement of 99 primary care providers at 42 Massachusetts health centers in less than two years.

In tribute to his leadership, Hunt has been appointed to several state commissions, including the Governor's Health Care Task Force and Responsible Fatherhood Commission. He was also appointed to the board of directors of the Blue Cross and Blue Shield of Massachusetts Foundation in 2001. In 1996, he received the prestigious Johnson and Johnson Community Health Care Award for an innovative outreach project for Greater Boston's underserved women and children.

Not that he has any extra time on his hands, but Hunt also is an adjunct professor at the Sawyer School of Management at Suffolk University. In 2002, his resume notes, he was honored with an honorary doctorate in humane letters from the New England College of Optometry, and in 2005, he was chosen as the first Geiger/Gibson Distinguished Visitor in Community Health Policy at the George Washington University's School of Public Health and Health Services. The award is given to an individual who has exhibited extraordinary and sustained leadership in community health policy.

Hunt, however, is quick to credit those around him. "I draw my energy and passion from the work of others," he says.

Rounding the corner on midlife, there's no slowing down or retirement on the horizon for Hunt, who could have earned ten fold in the private sector. "I have no plans to go anywhere," he professes. "I bumped into my accountant the other day, and asked how I was doing. ‘Better,' the accountant said, ‘but you'll have to work until your 93!' "

As he has all his life, Hunt accepts reality as motivation. "All the more reason," he says with a smile, "to push the cause of quality community health care. There is no greater mission for me."

Greg O'Brien is editor and president of Stony Brook Group in Brewster, a political/communication strategy company. The author/editor of several books, he has contributed to various regional and national publications.