Stimulus Funds Help Health Centers Meet Growing Needs

The recently enacted American Recovery and Reinvestment Act of 2009, or ARRA, has provided an immediate infusion of funds into the nation's community health centers, enabling them to expand care and to retain or hire additional staff, according to an analysis (1-page Word file; About Downloading) produced by the National Association of Community Health Centers, or NACHC.

The ARRA provides $2 billion in funding for community health centers, or CHCs. HHS has released about $1.3 billion of that funding, which has allowed CHCs to expand care to more people during the past seven months, according to NACHC estimates. CHCs, which serve approximately 20 million people, also have been able to retain or create nearly 12,000 jobs with the ARRA money, including positions for primary care and family physicians, according to the NACHC.

HHS released the $1.3 billion in three separate stages and for three distinct purposes. The agency allocated $155 million to establish 126 new health centers, thus supporting care for an additional 750,000 people and leading to the creation or retention of 5,500 jobs, according to NACHC. HHS also released $338 million in grants to support care for an additional 2.1 million people and to create or retain 6,400 jobs.

Additionally, in late June, HHS released $851 million in capital improvement program grants to support the construction, repair and renovation of more than 1,500 CHC sites nationwide. More than 650 centers will use the funds to purchase new equipment or health information technology systems, and nearly 400 CHCs will adopt and expand the use of electronic health records, or EHRs, according to a White House press release.

"Stimulus funding for health centers was the right medicine at the right time," said Amy Simmons, communications director at the NACHC. "The investment allowed the health centers to quickly begin responding to increased demand for health care from people across America who are jobless and uninsured or underinsured in today's challenged economy."

To demonstrate the immediate effect of the stimulus investment, the NACHC has launched an economic stimulus Web page that allows visitors to click on a particular state to see how many jobs were created and how much care was expanded at CHCs because of the stimulus money.

"You also can access individual stories and pictures about how this money made a difference to health centers and the communities they serve," said Simmons.

For example, the Margaret J. Weston Community Health Centers in South Carolina used the money to upgrade equipment, make renovations, install an EHR system and hire a new primary care provider, according to the NACHC stimulus map.

Similarly, the ARRA money enabled the Open Door Family Medical Centers Inc., in Westchester County, N.Y., to hire a family nurse practitioner and two more family physicians to meet surging patient demand. The community health center, which operates four primary care sites and four school-based sites, also added 15 examination rooms because of the stimulus money.

"We were never in danger of going anywhere," said FP Daren Wu, M.D., of Greenwich, Conn., chief medical officer at Open Door. "But we were never going to advance and get ahead."

Open Door serves about 750 patients every day, and according to Wu, "We can now meet the demand more reasonably."

"There are so many patients to be seen and not enough family doctors or primary care nurse practitioners to see them," Wu said. "This will help plant some seeds of further growth."

Many community health centers are experiencing increased patient demand because of the economic recession. Most CHCs report increases in the overall number of patients and uninsured patients from June 2008 to June 2009, according to preliminary results of a health center survey by the NACHC. Nearly all CHCs report a need for at least one new site to meet community needs, and half report that recent unemployment has affected 10-30 percent of patients or patients' families.

About 500,000 more patients have accessed the health centers since Jan. 1, and at least 40 percent of those patients are estimated to be uninsured, according to the NACHC.

"Most health centers that we talked with in collecting information for the stimulus Web page report an increased patient demand from the uninsured in a range of 20-30 percent," said Simmons.

CHCs traditionally have served patients who live on incomes below 200 percent of the federally designated poverty threshold. But increasingly as people lose their jobs and their health insurance, health care access is becoming an issue for the middle class, said Simmons.

"That is where health centers have stepped in and played a vital role in providing people with health (care) during this recession," said Simmons.