The Wesleyan Argus: Professor Charles Barber on the Public Health Revolution in 1970s Middletown
12/01/2022Originally posted December 1, 2022 on The Wesleyan Argus
By Carolyn Neugarten
On a chilly October night in 1973, Mark Masselli, a Middletown resident, planted his sleeping bag squarely in front of 435 Main St.’s Carrie Plumbing and Heating Co. A restful sleep was not on the agenda—Masselli was waiting for the building’s tenant in an attempt to build the area’s first free public health center right where the building stood. It would take nearly 20 years for Masselli’s idea to become a reality, but with the help of determined Wesleyan students and local residents, the Community Health Center (CHC), now one of the largest free public health centers in the nation, was born in Middletown.
In his recently published book, “Peace & Health: How a group of small-town activists and college students set out to change healthcare,” Associate Professor of the Practice in Letters Charles Barber recounts the extraordinary story of how Masselli created the CHC. Barber documents how Masselli’s quest to change health care in his immediate community grew into a nationwide phenomenon, from Middletown’s Main Street to the White House.
“Mark was a very, very ambitious guy,” Barber said. “If you thought something couldn’t be done, he would be the first to try.”
1970 was a particularly thrilling year to be a Wesleyan student as the University entered a new progressive era. The arrival of the first female students and the record enrollment of students from minority groups came after years of student protest. The formal introduction of the Center for the Arts and an expanded Theater Department followed soon after. The most well-remembered highlight, however, would be the University’s free, open-air Grateful Dead concert. Congregations of long-haired and denim-clad students gathered on Foss Hill for a day of music and peaceful protest. Rumor has it that the band agreed to the concert when promised compensation in “orange sunshine” manufactured by a Wesleyan chemistry professor.
Simultaneously, the New Haven Black Panther trials and the murder of Bobby Seale, the group’s co-founder, led to widespread unrest within the state of Connecticut. The escalation of the Vietnam War and the aftermath of the civil rights movement drove Wesleyan students to join Yale’s May Day Protest in New Haven, right after a series of firebombs went off on Wesleyan’s campus. These events inspired local change.
At the time, Connecticut had a reputation as a state resistant to change and was known as the “Land of Steady Habits.” As a man with no experience or credentials in public health—barring the brief time he had spent with Touch, Inc., a drop-in center run by Wesleyan students—Masselli embarked on his mission to create a more equitable healthcare system in his neighborhood, in spite of the challenges that lay ahead.
Luckily, Masselli wasn’t entirely on his own. A force of local leaders and Wesleyan students assembled to help create and maintain the organization. This included a local pharmacist, a Black community leader from Middletown, a young nurse, a Wesleyan graduate who later became the governor of Colorado, a jazz musician, and an entire slew of other Wesleyan students, all of whom were dedicated to reducing inequity in Middletown.
“Mark banded all of these people together,” Barber said. “It was a conglomeration of outsiders, and a cross-section of both Wesleyan and Middletown that made this happen. What I learned from writing this book is that this story is the classic story of a small group of people that changed the world—think locally, act locally.”
In its early days, the CHC’s operational duties proved difficult to manage. The organization struggled to obtain a dental chair and a dentist, find doctors who were willing to volunteer, and solve other logistical issues. In addition, the Connecticut Department of Health initially refused to issue a license to the CHC because its hallway was said to be one inch too narrow. However, as years passed, the CHC overcame numerous obstacles to become the organization that it is today.
The signing of Section 4161 of the United States’ 1989 Omnibus Budget Reconciliation Act was crucial to the organization’s success. The act incorporated a special designation for “federally qualified health centers” (FQHCs) to be fully reimbursed by Medicare and Medicaid. With this in mind, the CHC worked tirelessly to be named a FQHC and was, therefore, able to expand into New London, Meriden, and other Connecticut areas. Further expansions occurred during the Bush administration, which proved advantageous for the CHC.
“The hero of the movement at a national level is George H. W. Bush,” Barber explained. “He signed legislation under his administration that made the reimbursement structure triple what it was, so that federally qualified health centers could really get paid, not just get by. Malpractice insurance and prescription drug prices were also hugely discounted.”
Such reforms occurred rapidly throughout the 1990s and into the 2000s. Meanwhile, back at the University, the controversial placement of the Zelnick Pavilion, right in the line of traditional brownstones that graces College Row, left many Wesleyan students frustrated. Masselli, however, took one look and instantly fell in love. It became the inspiration for the new CHC building. He quickly contacted an architect, and, with thirty million dollars from the state, construction for Middletown’s North End CHC location began.
These expansions led to more programs, such as school-based healthcare services at Macdonough Elementary School in northern Middletown. The program enabled licensed staff and school nurses to provide essential services to elementary school students during the school day. In fact, close to 200 schools continue to rely on the CHC’s services, from kindergarten to twelfth grade.
After the CHC’s immense success, Masselli received an honorary doctorate of Humane Letters from Wesleyan to applaud his significant contribution to Wesleyan and the larger Middletown area.
Wesleyan students continue to serve as volunteers and researchers at the Community Health Center’s Middletown branches, and the University remains a large part of the organization’s history. The Community Health Center currently serves 150,000 patients in 243 locations and one million patients over TeleHealth, working especially to provide healthcare to underserved areas across the nation.
Recently, during the beginning phases of the COVID-19 pandemic, the CHC established test centers at 18 locations across Connecticut. When vaccines were released, the CHC opened large vaccination sites, including one at Wesleyan, and another that was the first and largest site in Connecticut: a 10-lane drive-through clinic at the Pratt and Whitney Runway in East Hartford.
“Peace & Health” was a book that was somewhat difficult to write, according to Barber, who initially had very little knowledge of what a FQHC was. The process began with a Wesleyan course Barber co-taught with Masselli, “The Art and Science of Social Engagement.” The course used the CHC as an example of a civic engagement program.
The writing process required a large amount of archival work, including gathering newspaper articles, obtaining permission for photos, and extensively researching the history of the CHC.
“I thought this story would be a fairly straightforward thing to write, but it was much more of a [big] project than I expected,” Barber said. “When I initially took this on, I didn’t know what I was getting into. I knew they were an extraordinary organization, but I didn’t know quite the scale. The Community Health Center serves 150,000 individual people in Connecticut, and one million nationally through TeleHealth. I didn’t know that when I said yes.”
The story of the CHC’s creation, made possible with the support of the Wesleyan and Middletown communities, provides a larger look into Middletown’s history and its capacity for change. The belief that healthcare is a right and not a privilege was the motivating factor for the creation of CHC, and its expansion ensures that no one is cast aside.