A major expansion at a community health center in south Minneapolis will boost care for vulnerable residents in an era when they need it most.
The Community-University Health Care Center serves low-income residents, immigrants and refugees, regardless of their ability to pay. Last year, it saw more than 12,000 patients. Collectively, the center’s patients speak more than 50 different languages, and the majority rely on public health insurance.
The center, founded in 1966, has been working out of an outdated building that staff say they have long outgrown. Ground was broken for a new facility earlier this month next to the clinic’s current site. The new building will be twice the size of the current one, with expanded patient exam rooms, dental clinic capacity and an on-site pharmacy.
Construction is expected to be completed by July 2027. The current building will remain open during construction and will later be demolished. $45 million has been allocated toward the expansion, which includes funding from the University of Minnesota and the University of Minnesota Foundation.
Sahan Journal spoke with Dr. Roli Dwivedi, the center’s CEO, about the work the clinic does, how the expansion will improve outcomes for patients, and the challenges health care providers are facing as cuts to Medicaid collide with rising health care costs.
This interview has been edited for length and clarity.
You’ve been in leadership roles with the Community-University Health Care Center for more than a decade. How have you seen the clinic’s work change in that time?
Things have changed tremendously in terms of, well, the whole pandemic thing happened, and Minnesota has gone through so much, not only the pandemic, but also the [2020] murder of George Floyd, and then, most recently, the Operation Metro Surge federal immigration crackdown. So a lot of things that have happened have impacted not just the health, but the overall well-being of communities.
And health care in general has changed. Chronic diseases have gotten worse because people have been so afraid to seek care. A lot has changed, like how patients or community members have shifted in their way of seeking care, especially from the FQHC [Federally Qualified Health Center] perspective, because the majority of the FQHCs in Minnesota were not doing telehealth.
So it involved learning from the clinic perspective how to launch telehealth. And then from the patient perspective, there was a lot to learn about telehealth, like, what is this? And then there has been a big evolution in data availability. Data has been driving a lot of care. Social and cultural determinants of health, and the political determinants of health, they all have shifted in the last decade, so that has shaped people’s health, and, most recently, there’s AI. The total cost of care has increased so much that I didn’t want to miss that piece; it has just increased so, so much.
What makes the center’s model of care unique?
We serve a very diverse patient population. In 2025, we served patients in 53 languages, and the year before, in 57 languages. The majority of our people who work at the center represent the cultures that we serve. We also have on-site interpretation. So for example, Somali and Spanish, Vietnamese, Hmong, Laotian, Dari and Pashto.
We strongly believe in the integration of care for the whole person — holistic care. So we are known as a one-stop shop for a patient, and that’s really intentional, to address all the barriers that the patients or their families or communities might be experiencing. We have medical and then comprehensive mental health services and dental care on site. So it’s not just the physical health, but the emotional, social and spiritual health that we address for our patients.
We are also on the educational side — part of the University of Minnesota. Last year, we had 177 [medical residents and students], along with 145 full-time employees. So you can see the richness of the people who work there and the people who come to learn and will become future health care professionals.
How does the clinic support low-income residents, refugees and immigrants?
We serve everyone who shows up at our door. For patients who cannot afford care, we provide a sliding fee based on their family situation and income. We don’t say no to anyone. We see everyone — that is our mission. And then, starting from the front desk, to the people who check in patients, to the people who room them and the people who provide care, we try to be very culturally responsive, serving patients in their own language and addressing other barriers that they might be experiencing. We strongly believe in cultural humility and then also trauma-based care.
We have a big suboxone program for people who are struggling with opioid use, but we try to build programming that is more humanistic and patient-centered and to be present in their life to support them in whatever they need. It could be a medicine, it could be just housing, it might be they don’t have food, or they need extra education in learning about their disease, or even providing the care that respects their cultural understanding, their knowledge and attitudes and beliefs around their own health.
During Operation Metro Surge, there were a lot of impacts on health care for immigrants in Minnesota. A lot of people were forgoing care over fears of being swept up by federal officers. How did you support those patients and meet their needs during that time?
It was hard. We are still recovering. We did everything that we could to support our patients. Our clinic suffered a lot in terms of that, people stopped coming. The way that we took some action was making sure that our care coordinators, our case managers, our social workers, our community health workers were doing outreach and asking what people needed. It could be medication delivery or food delivery.
We also worked internally to switch appointments to telemedicine, and some people were OK with that, but the fear was so great that some people were afraid to even pick up the phone. So we said, we’ll call you and try to provide a safe environment. We also did home ob-gyn visits where a nursing staff went to a pregnant person’s home and set them up for a video appointment or phone appointment through the provider who would be sitting in the clinic. We also provided food to people in their houses.
Why is the expansion needed, and how will it improve outcomes for patients?
The clinic has been in need of a new building for a long time. In the almost 17 years I have been there, there’s been talk about that. There have been days where we did not have a place for people to sit, but also, our patients have been asking for a better place. I strongly believe in health equity; our patients deserve the same type of care that I get. So having a better space is going to be more patient- and community-centric; it will be a healing space for them. We talked to a lot of our patients, asking things like what type of services they wanted.
A lot of our patients have physical trauma, so physical therapy and imaging, and then the pharmacy were among the greatest needs. We prescribe medicine, and sometimes it happens that the patient does not have time to pick it up. So the new pharmacy will help. We’re also expanding our dental care; we have nine chairs right now, but we will be expanding by one chair.
Can you talk a bit about the importance of the dental services that the center offers?
Dental care access is an issue statewide, and several entities are creating a work plan to improve that. Other clinics might not see a patient for the dental appointment if they have Medicaid, but we will. We also know there is a shortage of dentists, dental hygienists and dental assistants, but being a teaching site, we also get dental students and residents. So we are not only increasing access to dentistry for patients, but also we are feeding into the future health care profession.
Many of the clinic’s patients are on public health care coverage. How do you think cuts to programs like Medicaid might impact the center and patients?
I am very worried, really, really worried, about the H.R.1 implications and what it will do to patients. [H.R.1 is legislation passed by Congress last year that includes significant cuts to Medicaid and other social services.] There’s a projection that in Minnesota alone, there will be a 25% drop in Medicaid. Even though H.R.1 is not here, people are prepping for that. But with Operation Metro Surge and the post-COVID Medicaid redetermination, we have already started seeing the impact. I am very worried about this, because the majority of our patients, that is our model. So if the model is disrupted, people will lose access, and they will get sicker, and that will increase the total cost of care. So the already burdened system will also get burdened further.
Last year, undocumented adults became ineligible for MinnesotaCare. Have you seen an impact from that change as well?
That is what we are seeing right now; we have seen a huge drop in just recent months. So it’s sad.
We have financial advocates for patients. So if you don’t have insurance, that person will help you figure out if you qualify for the insurance. If you don’t qualify, you go to the sliding scale. If you do qualify, they help you apply. Our patient financial advocates are so busy, but the application processing at the other end is so slow. So that’s another barrier.
Can you talk a little bit more about why it’s important that the center provides social services in addition to medical care?
Every clinic serves a different type of patient population. The majority of our patients are below 100% poverty level and have severe, persistent mental illness. More than 50% of our patients don’t speak English and cannot read English. A lot of them do not have housing and don’t have access to food. So it is very important to have those social services in place. We know that for social drivers of health, if you don’t address them, no one’s health is going to get better. Addressing those social and cultural barriers are very, very important. We put the patient in the center. We want them to be empowered and supported so that they can drive their own health,
Is there anything else that’s coming up for you as you’re getting ready for this expansion? How are you feeling?
I am cautiously optimistic. Sometimes when the sky is falling, you still try to find the opportunity. There’s a lot of strength in community health. So I’m really, really hopeful, and our patients are our major strength. I think we will pass through this stage, and I’m so hopeful for the new clinic and expansion. Health care is a human right. I’m also very, very hopeful for our future health care professionals and also for our staff, which provides a lot of trauma care. We have been in a crowded space for a very long time. The new space is going to help with their own self-care, wellness and healing as they are doing this healing work.
