Funding New CHCs Not Complete Solution, Say FPs

Although the House of Representatives recently passed legislation to renew the program that provides federal support to the nation’s more than 1,000 community health centers -- a number that continues to grow -- federal legislators so far have failed to address many other problems these clinics face.

H.R. 5573, the Health Centers Renewal Act of 2006, (at the THOMAS Web site, type "H.R. 5573" in the search box after selecting "Bill Number") easily passed the House on June 21 and now resides with the Senate Committee on Health, Education, Labor and Pensions. The bill calls for the CHC program to be funded at about $2 billion a year for the next five years. At the same time, however, Congress has made cuts to vital programs that support community health centers, such as Title VII education funding and Medicaid.

“It doesn’t matter how much you spend on building new community health centers if you just have big empty buildings in a few years,” said AAFP President Larry Fields, M.D., of Ashland, Ky.

Both the House and Senate appear to be moving toward a 2007 budget that would again halve funding for Title VII compared with that appropriated for 2005. Such physician training grants play a significant role in bringing family physicians and other primary care physicians into rural and other medically underserved areas where CHCs operate, said Fields.

The focus on funding for new CHCs also overlooks the needs of existing health centers, said Daren Wu, M.D., of Greenwich, Conn., a family physician who runs Open Door Family Medical Centers in upstate New York. The number of uninsured continues to grow, while Medicaid payments continue to shrink, he noted.

Wu said that Open Door had a 50 percent increase in patient visits between 2001 and 2005. During that period, however, the center saw little in the way of new federal money, according to Wu.

At President Bush’s request, Congress has been substantially raising the budget allocation for the CHC program every year. Under the appropriations plan currently being considered, the program would get $181 million more in 2007 than it did in 2006. However, much of that money would be slated to establish new health centers rather than to increase support for existing ones.

There is no question that new health centers are needed in many underserved regions across the country, said Wu. They provide high-quality care, keep patients out of the emergency department and save the system money in the long run, he explained.

Open Door's clinics are being forced to grow to keep up with a record number of patient visits, and the clinics' board of directors has had to start looking for other ways to pay for the needed increased capacity, such as seeking private grants and holding fundraising concerts, said Wu.