| The Office of Management and Budget has ranked HRSA's Health
Center Program as one of the 10 most effective Federal programs.
In FY 2002, President Bush proposed a multi-year initiative
for the Federal Consolidated Health Center Program authorized
under section 330 of the Public Health Service (PHS) Act.
The President's Initiative seeks to substantially
expand and strengthen the safety net for those
most in need by extending the availability of primary health
care services to new and existing patients served by community
health centers.
The President's Initiative has allowed California to secure
additional federal resources in an effort to serve vulnerable
populations within our state. In California , there are
currently 102 health center grantees operating over 600
delivery sites and serving over 1.6 million patients statewide.
In 2003, 65% of those patients had incomes below 200% of the federal poverty
level. California 's health center patients are extremely
diverse - 61% Latino, 21.3% Caucasian, 5.4% Asian/Pacific
Islander, 6.6% African American, and 0.4% Native American.
CPCA provides a wide range of technical support to assist
applicants to become 330-funded health centers. Furthermore,
CPCA serves as an advocate to ensure continued appropriation
for the President's Initiative. Additional information and
updates regarding health centers, the President's Health
Center Initiative, Congressional appropriations and application
technical assistance is available at the links below.
The
health center movement began with the creation of the migrant
health center program followed by the neighborhood health
center demonstration projects initiated in 1965 as part
of President Johnson's War on Poverty. It was recognized
that by addressing untreated health problems of the poor,
the economic burden of these communities could be reduced.
Background
and History of Health Centers
Health
centers were envisioned as comprehensive health services
programs oriented towards the needs of the vulnerable and
underserved. They made great strides in eliminating barriers
to health care for the poor and underserved, ensuring continuity
and quality of care, promoting the use of preventive services,
and increasing community participation. Health centers also
served as an economic engine for their economically disadvantaged
communities by generating jobs in the local economy. Health
centers were unique in providing access to a wide range
of medical and non-medical services and their mission to
serve all regardless of ability to pay.
Today, there are over 1,000 health centers that operate over
3,600 sites throughout the country. Despite major growth
and numerous challenges over the past 40 years, the mission
has remained the same - the provision of high-quality primary
and preventive health care services to people in rural and
urban medically underserved areas. To view the statutory
authorization language for the President's Initiative, please
select the link below:
Section 330 of the Public Health Service Act defines a health
center as a non-profit organization that provides primary
and preventive health care services for uninsured and underserved
populations in collaboration with other community providers.
The Bureau of Primary Health Care (BPHC) is charged with
developing and administering all section 330 funding opportunities.
Description
of the Federally Qualified Health Center (FQHC) Program
"I
strongly support these community health centers because . .
. they are compassionate, they are cost effective, and America
needs more of them. . ."
~ President George W. Bush ~
A federally qualified health center (FQHC) is a type of
provider defined by the Medicare and Medicaid statutes and
includes all organizations receiving grants under section
330 of the Public Health Service Act, certain tribal organizations,
and FQHC Look-Alikes.
An FQHC Look-Alike is an organization that meets all of
the eligibility requirements for Section 330 grant but does
not receive grant funding. In its place, the organization
is designated as an FQHC Look-Alike and receives financial
and organizational support not extended to non-FQHC health
centers.
There are many benefits of being an FQHC. For FQHCs that
are PHS section 330 grant recipients, the biggest benefit
is the grant funding. For new starts, funding up to $650,000
can be requested under the New Access Point (NAP) Program
Information Notice. Other benefits include:
Unfortunately, not all of these benefits are extended to
FQHC Look-Alikes. However, FQHC Look Alikes are eligible
to receive many of the same benefits, which include:
-
Enhanced Medicare and Medicaid reimbursement
-
Eligibility to purchase prescription and non-prescription
medications for outpatients at reduced cost through the
340B Drug Pricing Program
Look-Alikes, by definition, are not recipients of PHS 330
grant funding. However, because they already meet the program
requirements for this grant funding, FQHC Look-Alikes are
mature applicants for PHS 330 funding.
For those organizations interested in submitting an FQHC
Look Alike or New Access Point application, please visit
the Application Guidelines
section of our webpage. It
is important that organizations review the program expectations
and eligibility requirements developed by the BPHC prior
to preparing a section 330 New Access Point or FQHC Look
Alike application.
Additionally, to qualify for section 330 New Access Point
grant opportunities, an applicant must serve a defined geographic
area this federally designated as a Medically Underserved
Area (MUA) or Medically Underserved Population (MUP). This
is applicable to Community Health Center (CHC) applicants
only - Migrant Health Center (MHC), HealthCare for the Homeless
(HCH) and Public Housing Primary Care (PHPC) are not required
to meet this criteria to apply. CHC applicants can determine
whether they meet this criteria by visiting the following
website:
MUA/MUP database
Overview
of President Bush's Health Center Initiative
"I'm
proud of the health care system in America... we've got
some problems because too many of our citizens go without
health care. We've got a lot of people who go to emergency
rooms for primary care. That's why I'm for Community Health
Centers- realistic, smart ways to make sure people can get
primary health care who don't have it."
~ President George W. Bush ~
The President's Community Health Center Initiative will
create new and expanded health center access points to impact
1200 communities over 5 years (starting in FY 2002)
Expected Results include:
-
Approximately 630 New Access Points (new health center
sites) will provide primary care services for populations
not currently being served.
-
Approximately 570 Expanded Access Points will support
capacity expansion at existing community health center
sites to also serve new patients and penetrate deeper
into currently underserved areas.
-
20% of the increase in funding will support the expansion
of oral health, mental health, substance abuse, and disease
collaborative at sites currently supported under section
330.
- The
increase will allow community health center grantees to
reach an additional 6 million people over the next 5 years.
-
The initiative will lead to an eventual doubling of the
total number of health center users.
Combined, these strategies will help to move the nation
closer to 100% access to primary care and towards the elimination
of health disparities.
There are a variety of types of organizations that may receive
330 grants, which include: Community Health Centers , Migrant
Health Centers , Health Care for the Homeless Programs,
and Public Housing Primary Care Programs. School-based health
centers are also eligible for funding and are awarded under
the Community Health Center .
Community Health Centers (CHC):
-
The CHC Program provides primary and preventive health
care services in medically underserved areas throughout
the U.S. and its territories.
-
This program provides care to over 1.6 million low-income
Californians.
Migrant Health Centers (MHC):
-
The MHC program supports an array of culturally and linguistically
competent medical and support services to migrant and
seasonal farmworkers (MSFW) and their families.
-
In 2003, this program provided care to over 284,187 of
California 's MSFWs and dependents, approximately 20 percent
of this community.
Health Care for the Homeless (HCH):
-
The HCH program is the only Federal program with the sole
responsibility of addressing the critical primary health
care needs of homeless individuals.
-
In 2003, this program provided services to approximately
140,823 homeless individuals in California .
Public Housing Primary Care (PHPC):
-
The PHPC program provides Federal support to primary health
care organizations that deliver health services as well
as social services linkages to individuals and families
who live in public housing and other federally subsidized
units.
Schools Based Health Centers (SBHC):
-
The SBHC program provides Federal support for the development
of new, comprehensive, full-time, school-based primary
care programs that serve high risk children.
-
In 2003, this program provided primary care services to
approximately 16,394 low-income, school age children in
California .
Health Disparities Disease Collaboratives:
-
The California Primary Care Association is one of five
lead agencies nationwide for the Health Disparities Collaborative.
CPCA's Pacific West Cluster includes Alaska , Arizona
, California , Guam , Hawaii , Idaho , Palau , and Washington
-
Collaboratives develop quality improvement models that
focus on chronic conditions and other related topics,
such as asthma, cancer, cardiovascular disease, depression,
diabetes, and diabetes prevention.
- This HRSA Program has been described as "arguably
the largest, most important health care quality improvement
initiative in the country".
CPCA has compiled information on the effectiveness of the
Health Disparities Disease Collaboratives being utilized
by community health centers in California . To review the
effectivness of the program, please select:
"It's
exactly what the health care system needs right now -- a
demonstration that it is possible both to improve care dramatically
and even reduce health care costs."
-Tracy Orleans, Ph.D., Senior Scientist, Robert Woods Johnson
Foundation, Advances Online, RWHF Newsletter (Oct 2002)
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