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Unprecedented Growth: Health Center
Expansion 2002-2007
In 2001, President Bush launched the Health
Center Growth initiative and set a goal to
significantly impact 1,200 communities across
the Nation by supporting new or expanded
health center sites. This initiative received support
from Congress. A few years later in 2007, High
Poverty grants were awarded to further ensure
health centers expanded to locations where there had previously been none. Since the launch of
the initiative in 2002, the goal to significantly
increase access has not only been reached
but surpassed. With broad support, Federal
investments in the Health Center Program have
nearly doubled, growing from a little more than
$1 billion in 2000 to nearly $2 billion today.
Table 7. Federal Funding for the Health Center Program, 2002-2007
Fiscal Year |
2002 |
2003 |
2004 |
2005 |
2006 |
2007 |
Appropriations (in billions) |
$1.34 |
$1.51 |
$1.62 |
$1.74 |
$1.79 |
$1.99 |
Number of Grantees |
848 |
895 |
914 |
954 |
1,006 |
1,076 |
Figure 4. Goal Met: 1236 New and Expanded Access Points
[D]
Source: U.S. Department of Health and Human Services, Health Resources and Services Administration. Rockville, Maryland: HRSA Electronic Handbooks (EHB) Grants Data, 2002-2007.
Opening More Doors to a Health Care Home
- In 2007 the number of patients served passed
the 16 million mark for the first time.
- Between 2001 and 2007, the number
of patients treated at health centers has
increased by nearly 5.8 million, representing
a 56 percent increase in just 6 years.
- Looking back even further—over 10 years
(1997-2007)—the number of patients
served has nearly doubled (increased
by 95 percent) while the number of
health center grantees grew by almost
60 percent over the same period.
- As a key source of local employment and
economic growth in many underserved
and low-income communities, health
centers have seen their staff grow to over
103,000 full time equivalents, leveraging
over $9 billion in needed health services.
- Health centers are also serving an increasing
number of special populations, including
people experiencing homelessness and
migrant and seasonal farmworkers.
- The number of homeless patients served
during this time period (2001-2007) rose by
over 428,000, a 75 percent increase.
- And the number of migrant and seasonal
farmworkers during this time (2001-2007)
increased by over 140,000, a 20 percent
increase.
Table 8. Percent of Patients Uninsured and Below Poverty, 2007*
|
Percentage of Patients ___________________ |
____________________
|
|
Uninsured Patients |
Individuals with Incomes Below 200% of the Federal Poverty Level |
All Health Centers
|
39 |
92 |
Health Care for the Homeless Program
| 69 |
98 |
Migrant Health Centers
|
54 |
98 |
Public Housing Primary Care Health Centers
| 39 |
97 |
* Based on preliminary estimates
Source: U.S. Department of Health and Human Services, Health
Resources and Services Administration, Bureau of Primary
Health Care. Uniform Data System. Rockville, Maryland: U.S.
Department of Health and Human Services, 2007.
Expanding Health Center Services
During this tremendous period of growth, health
centers have provided more mental health and
substance abuse treatment than ever before. In
2007, more than 613,000 patients received mental
health and/or substance abuse services at health
centers, representing more than triple the number
of patients seen over 2001 and a 31 percent
increase in substance abuse visits over 2001.
For oral health, in 2007, over 2.8 million patients
received dental services at health centers, nearly
double the number of dental patients seen in 2001.
Health centers provided over 6.7 million dental visits,
more than doubling such visits over 2001.
Health Center Growth Opportunities
Opening More Doors to a Health Care Home:
New Access Points
New Access Points support the establishment of
new service delivery sites for medically underserved
populations. Through these grants, organizations
offer access to comprehensive primary and preventive
health care (including mental health, substance
abuse, and oral health care services) and social
services to populations currently with limited or
no access to such services. Federally funded health
centers may offer services to the general community;
migrant and seasonal farmworkers and their
families; homeless people, including children and
families; and public housing residents. All services
must be provided to all persons without regard to
an individual's ability to pay. Each application for
support to establish a new access point must identify
a population in need of primary health care services
and propose a specific plan to increase access to care
and reduce disparities identified in the population or
community to be served.
Federally Qualified Health Center Look-Alikes
In 1990, Congress authorized the FQHC Look-Alike Program as a result of limited Federal funding to support the increased
demand for health centers to serve the millions of uninsured and underinsured populations throughout the country.
Organizations that are approved for FQHC Look-Alike designation do not receive grant funding under section 330 of the Public
Health Service Act; however, they operate and provide services similar to grant funded programs. FQHC Look-Alikes are
required to meet the statutory, regulatory, and policy requirements of section 330 and demonstrate a commitment to providing
primary health care services to medically underserved populations regardless of their ability to pay.
FQHC Look-Alikes receive the following Federal benefits in lieu of section 330 grant funding: (1) enhanced Medicare and
Medicaid reimbursement; (2) eligibility to participate in the 340(b) Federal Drug Pricing Program; (3) automatic Health
Professional Shortage Area designation; and (4) eligibility to receive National Health Service Corp personnel. These benefits
support FQHC Look-Alikes in improving access to culturally-competent, high quality primary health care services for the
medically underserved in their community.
The FQHC Look-Alike Program has been an effective additional resource in meeting the increased demand for primary health
care delivery systems. What started with 28 organization designated as FQHC Look-Alikes in 1991 has grown to 122 Look-
Alikes operating in 2007. As a key primary care resource, FQHC Look-Alikes have also successfully competed for section
330 grants due to their increased experience in meeting section 330 program requirements. From 2002 to 2007 there were
286 applications for New Access Point funding from FQHC Look-Alikes; 36 percent were successful in obtaining New Access
Point awards during the 5-year period. HRSA anticipates that the number of FQHC Look-Alikes will vary each year based on
demand for service and availability of Federal funds.
Figure 5. Number of FQHC Look-Alikes, 2002-2007
[D]
Strengthening Existing Health Care Homes:
Expanded Medical Capacity
Supporting the expansion of medical capacity
at existing health center sites allows grantees to
significantly increase the number of people with
access to comprehensive primary and preventive
health care services. Strategies may include but
are not limited to expanding existing primary care
medical services, adding new medical providers,
expanding hours of operations, or providing
additional medical services through contractual
relationships (e.g., obstetric/gynecological services).
Applicants for expanded medical capacity funds
must ensure that the proposal will increase access
to comprehensive primary and preventive health
care and improve the health status of underserved
and vulnerable populations. Further, applicants
must address the major health care needs of the
target population and ensure the availability and
accessibility of essential primary and preventive
health services to all individuals in the service area.
Expanding Existing Health Care Homes:
Service Expansion
Mental health/substance abuse, oral health and
comprehensive pharmacy services are critical to
improving the health status of communities and
patients served by health centers and eliminating
disparities in access to health care. Applicants
for service expansion funding are expected to
describe the target population and its need for
mental health/substance abuse services, oral
health, and comprehensive pharmacy services and
present a service delivery plan that demonstrates
responsiveness to the identified needs of the target
population.
Table 9. Trends in Health Center Program Funding by Type, 2002-2007
|
Number of Grants |
|
|
|
|
|
|
2002 |
2003 |
2004 |
2005 |
2006 |
2007* |
2002-2007 |
New Access Points
|
171 |
100 |
63 |
94 |
86 |
202 |
716 |
Expanded Medical Capacity
| 131 |
88 |
66 |
64 |
36 |
135 |
520 |
Total New and Expanded Funding
|
302 |
188 |
129 |
158 |
122 |
337 |
1236 |
*Includes High Poverty New Access Point awards.
Source: U.S. Department of Health and Human Services, Health Resources and Services Administration. Rockville, Maryland: HRSA
Electronic Handbooks (EHB) Grants Data, 2002-2007.
next page > Moving Forward
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Health Center Growth Initiative
- Purpose: Increase health care access for low-income
people
- Goal: 1,200 new or expanded health centers
- Status: Goal reached with over 1,200 new and expanded
health center access points funded and nearly 6 million
additional patients served
High Poverty County
- Purpose: High Poverty County grants put
health center sites in more low-income counties
than ever before stretching America’s health
care safety net to places it’s never been
- Goal: Significantly impact 200 high poverty counties
through the support of new access points or planning grants
- Status: 80 new health center sites and 25 planning grants
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