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The burden of providing care for the neediest people often falls on the shoulders of federally qualified health centers (FQHCs).
However, funds for these clinics are drying up just as American families are experiencing considerably greater—and dramatically
growing—need for their services.
As part of former President George W. Bush's Health Centers Initiative, launched in 2002 to increase access to primary care
services, FQHCs are community-based organizations that provide comprehensive primary care and preventive care, including medical,
oral, mental-health and substance-abuse services, to people of all ages—including migrant workers and non-citizens—with payment
based on a sliding scale. They are not-for-profit, and the majority of the boards of directors must be consumers of the services
provided by the facility.
In 2007 alone, health centers provided care to more than 16 million people, including dental services for 2.8 million and
mental-health services for 617,000 more. It was expected that Congress would pass a final Omnibus FY 2009 Appropriations bill
this quarter, and that it would include $100 million to $150 million in new funding for the centers.
According to Deborah Kilstein, director of quality management and operational support for the Association for Community Affiliated
Plans (ACAP), the funding would be used to establish new service sites in underserved communities, expand the offerings in
already existing sites, and strengthen the centers' dental, mental-health and pharmacy services. "While deeply appreciated by all community health centers, the final funding level is well below the $248 million increase
we requested last year, and below the growth rate needed to meet our Access for All America Plan targets," Kilstein says.
The Access for All America Plan is a comprehensive movement to reduce the ranks of America's medically disenfranchised by
preserving, strengthening, and expanding health centers to reach a total of 30 million patients by the year 2015.
John Sniezek, CEO of Akron Community Health Resources (ACHR), an Ohio-based FQHC, believes that health centers will continue
to be a high priority for President Obama, which bodes well for future funding and support. However, he is concerned that
"the demand for our services is rising faster than ever before, as even middle-class workers now find themselves without healthcare
coverage."
Amy Simmons, director of communications for the National Association of Community Health Centers (NACHC), concurs with Sniezek's
assessment. "The biggest challenges are a surge in new patients—especially uninsured—in almost every community, and a drop
in support from state and local governments, and from philanthropic sources as well, all as a result of the recession," she
says.
Meeting that challenge will require collaboration between health centers, health plans and hospitals to reduce inappropriate
emergency room use, and experts agree that such partnerships are a critical step toward creating a more cost-effective and
higher-quality healthcare system.
AN EMERGENCY, INDEED
While overall health insurance numbers took a positive turn in 2007, a closer look at the data underscores the continued need
for a strong network of FQHCs.
• In 2007 (according to the U.S. Census health insurance update), the percentage of U.S. residents without health insurance
was 15.3%, down from 15.8% in 2006, and the number of uninsured was 45.7 million in 2007, down from 47 million the previous
year.
• The percentage of people covered by government health insurance programs increased to 27.8% in 2007, up from 27% in 2006.
The percentage and number of people covered by Medicaid went from 38.3 million (12.9% of the population) in 2006 to 39.6 million
in 2007 (13.2%).
