|
|
|
|
|
|
|
Issues & Research » Health » Community Health Centers
|
|
|
|
  Community Health Centers
Updated February 2010
Health centers are community-based organizations that provide populations who have limited access to health care with basic primary and preventive care. These include low income populations, the uninsured, those with limited English proficiency, migrant and seasonal farmworkers, individuals and families experiencing homelessness, and those living in public housing.
Resources on Community Health Centers
Community Health Center Spotlight
This feature highlights specific community health centers, relating stories about their role in promoting the health of their communities and discussing the unique public policy settings they operate within. Click here for past spotlights.
Frequently Asked Questions
This section addresses key questions about community health centers, from what they are and who they serve to what studies say about the role of health centers for health and the economy.
State Profiles
This feature examines select state actions that show innovation in the state role supporting community health centers.
Recent NCSL Publications
This is an archive of NCSL publications related to community health centers.
Health Center Population Snapshot
This table provides demographic data illustrating the population served by community health centers.
Health Centers Resources
This page contains a great number of NCSL and other resources on community health centers.
Community Health Center Spotlight
The Illinois General Assembly appropriated $50 million for the construction and renovation of health centers as part of a statewide capital bill designed to stimulate the economy. “With the passage of the capital funding, Illinois health centers will not only be expanding the number of sites and services available to new patients, but will also have the benefit of creating both construction jobs and health professional positions in underserved communities throughout the state. Community health centers have a responsibility to meet the increased needs of their communities … the Community Health Center Construction Program gets them one step closer to meeting those needs,” says Jill Hayden, the director of state government affairs at the Illinois Primary Care Association. For more information on the Community Health Center Construction Program, click here.
|
Frequently Asked Questions
What are community health centers and who do they serve?
Health centers are community-based organizations that offer essential primary and preventive care services to populations with limited access to health care. Services available can range from basic doctor's visits, immunizations, health screenings, laboratory and radiology, pharmacy, dental, and mental health services. Typically services are provided on a sliding-scale based on an individual's ability to pay. Health centers frequently extend beyond the center's walls to better reach underserved populations.
Community health centers care for 16 million people at more than 6,000 locations across the nation. Of those served at health centers, 71 percent are below 100 percent of the federal povery guidelines and 92 percent are below 200 percent. Forty percent are uninsured while 35 percent are enrolled in Medicaid or SCHIP. Sixty percent are Hispanic, African-American or Native American and 35 percent are under the age of 20.
Funding for health centers comes from a variety of public and private sources. According to the National Association of Community Health Centers, health centers receive half of their funds from state and local sources, such as Medicaid, state and local funds, and to a small extent, the children's health insurance program. The remainder comes from federal grants, private insurance, Medicare and patients themselves.
While the term community health center is often used to describe a wide variety of providers, it officially covers three categories. Federally Qualified Health Centers are authorized public or private non-profit organizations that receive federal grants in order to serve migrant workers, homeless populations, residents of public housing and other underserved communities. Federally Qualified Health Center look-alikes meet the Centers for Medicare and Medicaid Services (CMS) definition of a health center, but do not receive grant funding through Health Center Program (Section 330 of the Public Health Service Act). Many of these are newly established and in the process of qualifying for grant funding. Finally, some facilities operated by tribal organizations also qualify as health centers.
What do studies say about the effect of health centers in underserved communities?
According to the National Association of Community Health Centers, health centers provide care for 41 percent less than equivilent care provided elsewhere and save the health care system between $9.9 billion and $17.6 billion each year. Much of these savings come through reduced uncompensated care and less cost to Medicaid and SCHIP programs. Health centers also provide an boost in economically deprived neighborhoods, providing 143,000 jobs and generating $12.6 billion in economic activity. They predict that given increased funding, health centers could serve an additional 14 million people by 2015, saving the health care system $22.6 billion to $40.4 billion annually and generating an economic impact of $40.7 billion and providing the equivilent of 460,000 full-time jobs.
In addition to the economic impact of health centers, health outcomes of those served by health centers are often improved relative to similar populations not served by a health center. For example, communities with health centers have 10 percent lower infant-mortality rate than similar communities not served by health centers, according to the National Association of Community Health Centers.
What policies have states enacted related to health centers?
There is a great deal of variation in the level and type of state involvement and funding for community health centers.
State Funding For Community Health Centers - 2008
Source: National Association of Community Health Centers and NCSL, 2008.
Notes: Maryland, Nevada, Rhode Island and Oregon based on previous year's data. Missouri funding level excludes one-time $65 million health IT/capital improvement appropriation.
Below are select state profiles highlighting a variety of interventions:
|
State Primary Care Association
Contact Information
|
State Profile
|
|
Colorado
Colorado Community Health Network
600 Grant St., Ste. 800
Denver, CO 80203
Phone: 303-861-5165
Fax: 303-861-5315
|
In 2004, Colorado voters approved Amendment 35, increasing tobacco product taxes, and dedicating the revenue to health-related spending. 2005 House Bills 1261 and 1262 established how this increased revenue should be spent, creating the Primary Care Fund as 19 percent of the allocation. The Primary Care Fund was created to fund primary care provided by Federally Qualified Health Centers and other providers for whom a majority of patients were uninsured or medically indigent (including Medicaid and Child Health Plan + recipients). The effect of this provision was seen immediately, with state funding of community health centers increasing from $6.6 million in Fiscal Year (FY) 2005 to $41.3 million in FY 2006 and $62.4 million in FY 2007, according to the National Association of Community Health Centers (NACHC). This moved Colorado from an average supporter of community health centers to a leader in health center funding.
Since then, other legislation has passed concerning health centers in Colorado. 2006 House Bill 1396 created a grant program for school-based health centers, including those operated in cooperation with community health centers. 2007 House Bill 1022, 2007 Senate Bill 146 and 2008 House Bill 1391 create pilot programs involving community mental health centers focused on service to rural areas, veterans, and victims of child abuse respectively. 2008 Senate Bill 220 requires health centers to report the number of physicians employed or contracted with each year.
According to the Colorado Community Health Network, Colorado has 15 health centers with over 120 sites located in 35 counties. Colorado's community health centers serve approximately 400,000 patients annually. Additionally, community health centers in Colorado generated $374 million in economic activity. They directly provide the equivalent of 2,900 full-time jobs and create an equal number in associated business activity.
Most prominent among the Colorado health centers is Denver Health, founded in 1966, the second oldest in the country, which operates 22 sites within the City and County of Denver, including 12 school-based health centers. Serving 150,000 patients each year, a quarter of the city's residents, Denver Health is the largest community health center in the nation. |
|
Louisiana
Louisiana Primary Care Association
P.O. Box 966
Baton Rouge, LA 70821-0966
Phone: 225-927-7662
Fax: 225-927-7688
E-mail: lpca@lpca.net
Panel on Community Health Centers and Their Role During and After Katrina (Video) |
In 2003, Louisiana showed a commitment to community health centers in passing House Bill 1584, the Community-based Primary Health Care Initiative, providing grants to health centers for various capital and operational improvements. 2004 Senate Bill 690 recognized that Louisiana was lagging behind neighboring states and launched long-term planning to expand and establish health centers and rural health clinics.
However, health centers rose in particular importance in the wake of Hurricane Katrina in 2005, many having suffered damage in the storm, but also playing a vital role in serving the community in the aftermath. As a response to this, 2007 House Bill 765 appropriated $41.5 million in capital funding for community health centers and $9 million for rural health clinics. In 2008, Louisiana provided $6.3 million in state funding for its 22 health centers, which serve over 100,000 patients at 39 sites. |
|
Massachusetts
Massachusetts League of Community Health Centers
40 Court St., 10th Floor
Boston, MA 02108
Phone: 617-426-2225
Fax: 617-426-0097
E-mail: massleague@massleague.org
|
In 2006, Massachusetts passed an ambitious state health reform package, 2005 House Bill 4479, in order to move towards eliminating uninsured and underinsured individuals within the state. As recognition of the role of health centers in the health care system, a representative of the Massachusetts League of Community Health Centers was included in a number of advisory councils created as a part of the reform. One significant aspect of the reform included a fair share employer contribution, an assessment on companies that do not meet employee coverage levels, based upon the burden of uncompensated care in the state. As a provider of uncompensated care, this provision supported funding. In fact, state funding for health centers in Massachusetts has increased from $20 million in FY 2005 to $80 million in FY 2008, the highest in the nation.
As health centers provide services primarily to uninsured and low-income individuals, they play a heightened outreach role in educating patients about the reform's individual mandate and helping to enroll them in public plans or new options offered through the Commonwealth Connector. This outreach effort has been supported by $2.7 million in grants from the state to health centers and other community organizations. Health centers also provide a medical home for many of these newly insured individuals. Massachusetts has 52 health centers, including the nation's oldest, with more than 180 sites that serve more than 700,000 patients annually. |
Recent NCSL Publications
Health Center Population Snapshot
|
Income Level
|
-
70.7% Below 100% FPL
-
14.6% 101-150% FPL
-
6.6% 151-200% FPL
-
8.1% More than 200% FPL
|
|
Insurance Status
|
-
39.8% Uninsured
-
35.1% Medicaid/SCHIP
-
15.1% Private
-
7.5% Medicare
-
2.3% Other Public
|
|
Race and Ethnicity
|
|
|
Age Group
|
-
35.6% Ages 0-19
-
56.4% Ages 20-64
-
7.1% Ages 65+
|
Health Center Spotlight Archive
|
Date/Topic
|
Spotlight Text
|
|
Feb. 2009
Stimulus Provisions Support Health Centers
|
The American Recovery and Reinvestment Act (ARRA) contains $1.5 billion in funding for health center infrastructure and $500 million for health center operational costs, to be dispersed by the Health Resources and Services Administration (HRSA). The Act's significant funding for Medicaid and Health IT, distributed by CMS, is also expected to have a benefit for health centers.
HRSA is one of the first federal agencies to begin awarding ARRA funds. President Obama announced the release of $155 million to fund 126 health center New Access Points (NAPs). For more information about the Community Health Center grants by state, click here. For more information regarding the program, click here.
|
|
Community Health Centers
Updated February 2010
Health centers are community-based organizations that provide populations who have limited access to health care with basic primary and preventive care. These include low income populations, the uninsured, those with limited English proficiency, migrant and seasonal farmworkers, individuals and families experiencing homelessness, and those living in public housing.
Resources on Community Health Centers
Community Health Center Spotlight
This feature highlights specific community health centers, relating stories about their role in promoting the health of their communities and discussing the unique public policy settings they operate within. Click here for past spotlights.
Frequently Asked Questions
This section addresses key questions about community health centers, from what they are and who they serve to what studies say about the role of health centers for health and the economy.
State Profiles
This feature examines select state actions that show innovation in the state role supporting community health centers.
Recent NCSL Publications
This is an archive of NCSL publications related to community health centers.
Health Center Population Snapshot
This table provides demographic data illustrating the population served by community health centers.
Health Centers Resources
This page contains a great number of NCSL and other resources on community health centers.
Community Health Center Spotlight
The Illinois General Assembly appropriated $50 million for the construction and renovation of health centers as part of a statewide capital bill designed to stimulate the economy. “With the passage of the capital funding, Illinois health centers will not only be expanding the number of sites and services available to new patients, but will also have the benefit of creating both construction jobs and health professional positions in underserved communities throughout the state. Community health centers have a responsibility to meet the increased needs of their communities … the Community Health Center Construction Program gets them one step closer to meeting those needs,” says Jill Hayden, the director of state government affairs at the Illinois Primary Care Association. For more information on the Community Health Center Construction Program, click here.
|
Frequently Asked Questions
What are community health centers and who do they serve?
Health centers are community-based organizations that offer essential primary and preventive care services to populations with limited access to health care. Services available can range from basic doctor's visits, immunizations, health screenings, laboratory and radiology, pharmacy, dental, and mental health services. Typically services are provided on a sliding-scale based on an individual's ability to pay. Health centers frequently extend beyond the center's walls to better reach underserved populations.
Community health centers care for 16 million people at more than 6,000 locations across the nation. Of those served at health centers, 71 percent are below 100 percent of the federal povery guidelines and 92 percent are below 200 percent. Forty percent are uninsured while 35 percent are enrolled in Medicaid or SCHIP. Sixty percent are Hispanic, African-American or Native American and 35 percent are under the age of 20.
Funding for health centers comes from a variety of public and private sources. According to the National Association of Community Health Centers, health centers receive half of their funds from state and local sources, such as Medicaid, state and local funds, and to a small extent, the children's health insurance program. The remainder comes from federal grants, private insurance, Medicare and patients themselves.
While the term community health center is often used to describe a wide variety of providers, it officially covers three categories. Federally Qualified Health Centers are authorized public or private non-profit organizations that receive federal grants in order to serve migrant workers, homeless populations, residents of public housing and other underserved communities. Federally Qualified Health Center look-alikes meet the Centers for Medicare and Medicaid Services (CMS) definition of a health center, but do not receive grant funding through Health Center Program (Section 330 of the Public Health Service Act). Many of these are newly established and in the process of qualifying for grant funding. Finally, some facilities operated by tribal organizations also qualify as health centers.
What do studies say about the effect of health centers in underserved communities?
According to the National Association of Community Health Centers, health centers provide care for 41 percent less than equivilent care provided elsewhere and save the health care system between $9.9 billion and $17.6 billion each year. Much of these savings come through reduced uncompensated care and less cost to Medicaid and SCHIP programs. Health centers also provide an boost in economically deprived neighborhoods, providing 143,000 jobs and generating $12.6 billion in economic activity. They predict that given increased funding, health centers could serve an additional 14 million people by 2015, saving the health care system $22.6 billion to $40.4 billion annually and generating an economic impact of $40.7 billion and providing the equivilent of 460,000 full-time jobs.
In addition to the economic impact of health centers, health outcomes of those served by health centers are often improved relative to similar populations not served by a health center. For example, communities with health centers have 10 percent lower infant-mortality rate than similar communities not served by health centers, according to the National Association of Community Health Centers.
What policies have states enacted related to health centers?
There is a great deal of variation in the level and type of state involvement and funding for community health centers.
State Funding For Community Health Centers - 2008
Source: National Association of Community Health Centers and NCSL, 2008.
Notes: Maryland, Nevada, Rhode Island and Oregon based on previous year's data. Missouri funding level excludes one-time $65 million health IT/capital improvement appropriation.
Below are select state profiles highlighting a variety of interventions:
|
State Primary Care Association
Contact Information
|
State Profile
|
|
Colorado
Colorado Community Health Network
600 Grant St., Ste. 800
Denver, CO 80203
Phone: 303-861-5165
Fax: 303-861-5315
|
In 2004, Colorado voters approved Amendment 35, increasing tobacco product taxes, and dedicating the revenue to health-related spending. 2005 House Bills 1261 and 1262 established how this increased revenue should be spent, creating the Primary Care Fund as 19 percent of the allocation. The Primary Care Fund was created to fund primary care provided by Federally Qualified Health Centers and other providers for whom a majority of patients were uninsured or medically indigent (including Medicaid and Child Health Plan + recipients). The effect of this provision was seen immediately, with state funding of community health centers increasing from $6.6 million in Fiscal Year (FY) 2005 to $41.3 million in FY 2006 and $62.4 million in FY 2007, according to the National Association of Community Health Centers (NACHC). This moved Colorado from an average supporter of community health centers to a leader in health center funding.
Since then, other legislation has passed concerning health centers in Colorado. 2006 House Bill 1396 created a grant program for school-based health centers, including those operated in cooperation with community health centers. 2007 House Bill 1022, 2007 Senate Bill 146 and 2008 House Bill 1391 create pilot programs involving community mental health centers focused on service to rural areas, veterans, and victims of child abuse respectively. 2008 Senate Bill 220 requires health centers to report the number of physicians employed or contracted with each year.
According to the Colorado Community Health Network, Colorado has 15 health centers with over 120 sites located in 35 counties. Colorado's community health centers serve approximately 400,000 patients annually. Additionally, community health centers in Colorado generated $374 million in economic activity. They directly provide the equivalent of 2,900 full-time jobs and create an equal number in associated business activity.
Most prominent among the Colorado health centers is Denver Health, founded in 1966, the second oldest in the country, which operates 22 sites within the City and County of Denver, including 12 school-based health centers. Serving 150,000 patients each year, a quarter of the city's residents, Denver Health is the largest community health center in the nation. |
|
Louisiana
Louisiana Primary Care Association
P.O. Box 966
Baton Rouge, LA 70821-0966
Phone: 225-927-7662
Fax: 225-927-7688
E-mail: lpca@lpca.net
Panel on Community Health Centers and Their Role During and After Katrina (Video) |
In 2003, Louisiana showed a commitment to community health centers in passing House Bill 1584, the Community-based Primary Health Care Initiative, providing grants to health centers for various capital and operational improvements. 2004 Senate Bill 690 recognized that Louisiana was lagging behind neighboring states and launched long-term planning to expand and establish health centers and rural health clinics.
However, health centers rose in particular importance in the wake of Hurricane Katrina in 2005, many having suffered damage in the storm, but also playing a vital role in serving the community in the aftermath. As a response to this, 2007 House Bill 765 appropriated $41.5 million in capital funding for community health centers and $9 million for rural health clinics. In 2008, Louisiana provided $6.3 million in state funding for its 22 health centers, which serve over 100,000 patients at 39 sites. |
|
Massachusetts
Massachusetts League of Community Health Centers
40 Court St., 10th Floor
Boston, MA 02108
Phone: 617-426-2225
Fax: 617-426-0097
E-mail: massleague@massleague.org
|
In 2006, Massachusetts passed an ambitious state health reform package, 2005 House Bill 4479, in order to move towards eliminating uninsured and underinsured individuals within the state. As recognition of the role of health centers in the health care system, a representative of the Massachusetts League of Community Health Centers was included in a number of advisory councils created as a part of the reform. One significant aspect of the reform included a fair share employer contribution, an assessment on companies that do not meet employee coverage levels, based upon the burden of uncompensated care in the state. As a provider of uncompensated care, this provision supported funding. In fact, state funding for health centers in Massachusetts has increased from $20 million in FY 2005 to $80 million in FY 2008, the highest in the nation.
As health centers provide services primarily to uninsured and low-income individuals, they play a heightened outreach role in educating patients about the reform's individual mandate and helping to enroll them in public plans or new options offered through the Commonwealth Connector. This outreach effort has been supported by $2.7 million in grants from the state to health centers and other community organizations. Health centers also provide a medical home for many of these newly insured individuals. Massachusetts has 52 health centers, including the nation's oldest, with more than 180 sites that serve more than 700,000 patients annually. |
Recent NCSL Publications
Health Center Population Snapshot
|
Income Level
|
-
70.7% Below 100% FPL
-
14.6% 101-150% FPL
-
6.6% 151-200% FPL
-
8.1% More than 200% FPL
|
|
Insurance Status
|
-
39.8% Uninsured
-
35.1% Medicaid/SCHIP
-
15.1% Private
-
7.5% Medicare
-
2.3% Other Public
|
|
Race and Ethnicity
|
|
|
Age Group
|
-
35.6% Ages 0-19
-
56.4% Ages 20-64
-
7.1% Ages 65+
|
Health Center Spotlight Archive
|
Date/Topic
|
Spotlight Text
|
|
Feb. 2009
Stimulus Provisions Support Health Centers
|
The American Recovery and Reinvestment Act (ARRA) contains $1.5 billion in funding for health center infrastructure and $500 million for health center operational costs, to be dispersed by the Health Resources and Services Administration (HRSA). The Act's significant funding for Medicaid and Health IT, distributed by CMS, is also expected to have a benefit for health centers.
HRSA is one of the first federal agencies to begin awarding ARRA funds. President Obama announced the release of $155 million to fund 126 health center New Access Points (NAPs). For more information about the Community Health Center grants by state, click here. For more information regarding the program, click here.
|
|
|
|
|
|
|
|
|
|
|
|
|