Bill Wagner, CEO of Family Health Centers for the past 22, years is retiring. A celebration of his retirement was at the Portland Museum in early July. We talked to Wagner about how he got started in healthcare, what he learned from these early lessons and most importantly, what he plans to do during retirement. Highlights are below.

Medical News: How did you get started in healthcare in the Louisville area?

Bill Wagner: I was born and raised in Louisville, but like many, went away to college. I initially enrolled in pre-med hoping to become a physician. However, I became deeply involved a student-run volunteer organization working in Eastern Kentucky and inner-city Dayton Ohio. That was a life-changing experience. For the first time, I was exposed to extreme poverty in the hills and hollers of Appalachia, and I saw firsthand the devastating effects of unemployment, inadequate housing, unsafe drinking water and substance use on the health of families living there. Much to my parent’s dismay, I changed my major to social work, hoping to change the systems and conditions that trapped so many families in poverty, hopelessness and poor health.

After graduating with an undergraduate degree, I returned to Louisville and worked in an inpatient psychiatric hospital with seriously mentally ill patients who were being released to the streets, under court orders, without adequate social and emotional supports. The recidivism rate was high; and patients cycled between the hospital, the jail and general hospital. Frustrated with this never-ending cycle, I moved to central Kentucky where I joined an organization providing substance abuse treatment services. Living in small town Kentucky, I became acutely aware of the lack of physicians in many rural communities, and the need for integration between the physical and behavioral health services.

I decided to enroll in graduate school at the UofL Kent School of Social Work, in a program specializing in comprehensive health services, with the goal of opening a rural health clinic, expanding access to care and changing the fragmented systems.  After graduation, I worked with a federally funded health planning agency, providing technical assistance for primary care development. It was there, that my eyes were opened once again. I became aware of the medically underserved neighborhoods right in my own hometown, in the West End of Louisville.

I had the good fortune of being offered a position at the Family Health Centers (formerly Louisville Memorial Primary Care Center) in the former U. S. Marine Hospital building in the West End. This not-for-profit, federally qualified health center, serving the Portland, Russell and Shawnee neighborhoods, was based on the community-based primary care model that had grown out of the 60’s War on Poverty. I embraced the health center movement, advocating for and working to expand community health centers throughout Louisville Metro and across the nation. The Family Health Centers, and the community health center model of care, has been my passion for the past 40 years. Today, Community Health Centers provide access to a comprehensive range of services, without regard to ability to pay, and help address health disparities in medically underserved urban and rural communities across the country.

MN: What did you learn from early healthcare careers?

BW: As a student volunteer, before I started by healthcare career, I became acutely aware of what we all now call the “social determinants of health.” These social factors that influence health status are now widely recognized and embraced by hospital systems and health insurance companies alike. Community health centers were designed to reach out beyond the walls of the health centers, to address issues such as employment, housing, transportation, food insecurity and environmental health factors that influence the overall health of an individual and family.

I have advocated for and overseen the development of many of these programs and services at Family Health Centers, such as permanent supportive housing for the homeless, transportation assistance and prescription food pantries. Collaboration with other health and human services organizations is the key to success. And the key to successful collaborations is the recognition that “organizations don’t collaborate, people do.” You must get out beyond the walls of your institution and listen, get to know the needs and concerns of your partners and find ways to accomplish things together.

Early in my career, I became frustrated by the fragmentation between the physical health, mental health and substance abuse treatment services, and the lack of adequate community-based supports for the most vulnerable in the community. When we had the opportunity to start a healthcare for the homeless program that integrated physical health, behavioral health, dental and other services, in collaboration with other community agencies, we attempted to bridge some of these gaps and better coordinate care. We still have a long way to go to address the needs of the persistently mentally and homeless on the streets of Louisville. This has been one of my greatest disappointments and one of the greatest challenges we still face.

MN: How will the healthcare industry continue to evolve?

BW: There is no stopping the healthcare industry’s relentless march to build more modern facilities, acquire the latest technology and develop new high-cost pharmaceuticals. These trends will undoubtedly continue and will further drive up the cost of care.

At the same time, I see some positive new developments that may take us back to the basics, focus on prevention, help control total costs, and improve community health. There is a growing awareness and concern with the underlying social determinants of health; a recognition of the critical importance of public health because of the COVID pandemic; a renewed focus on health equity resulting from recent racial unrest, and the emergence of primary care medical homes as a foundation for improved health. There are also exciting new developments in optimal aging and end of life care. I am eager to watch as these various trends move forward, in hopes that the industry will evolve into a more just and equitable health system for all.

MN: What is your proudest moment?

BW: Harry Truman said, “It’s amazing what you can accomplish if you do not care who gets the credit.” That has been my guiding principle. I have been fortunate to assemble and lead a team of dedicated and caring professionals over the years, and we have accomplished many things together. We have opened new health centers and built new facilities, expanding to eight locations serving more than 45,000 patients annually. Together, we have integrated dental, behavioral health, substance abuse and many other services with primary medical care. We have launched the largest healthcare for the homeless and refugee health screening programs in Kentucky. We participated in the founding of Passport Health plan, one of the most successful Medicaid managed care plans in Kentucky history. We have worked to ensure that everyone has insurance coverage. We listened to our patients and the community and developed services to meet their changing needs. There are many things to be proud of, but I most proud that we did it together as a team.

MN: What are your plans for after retirement?

BW: I have not really decided what I am retiring to. I want to step away for a while and see what life brings me. I know I want to spend more time with my daughters and grandsons. I hope to travel, ride my bicycle and motorcycle, play golf, hike, swim and relax. I will still be involved on several health-related boards and hope to remain engaged in health advocacy work. I will likely become a full-time volunteer, back to where I started this journey, hoping to make things a little better along the way.