Access Plan Seeks Broad Expansion of Community Health Centers

The nation's community health centers, or CHCs, have launched a campaign aimed at providing billions of dollars' worth of resources to the centers to help them serve as many as 30 million patients by 2015.

The National Association of Community Health Centers, or NACHC, unveiled the Access for All America plan during a Capitol Hill press conference on March 12. The initiative seeks to boost funding levels for CHCs by billions of dollars during the next seven years, while giving the facilities easier access to billions more in needed infrastructure capital.

The NACHC plan calls for an increase in federal funding levels for CHCs from about $2 billion in 2008 to $5 billion by 2015. In addition, the plan would streamline access to capital and provide CHCs with $10.5 billion during the next several years to make infrastructure expansion possible.

"Despite the laudable benefits of health center expansion, significant investments in infrastructure are needed," said Dan Hawkins, senior vice president of policy and programs for NACHC. "Unfortunately, current programs for capital financing provide a patchwork of options to finance expansion. Getting that help is often difficult, costly and time-consuming. To meet these significant needs, a new paradigm of capital financing is needed today."

The initiative's launch coincides along with the release of an NACHC report, "Access Capital: New Opportunities for Meeting America’s Primary Care Infrastructure Needs," (32-page PDF; About PDFs) which details the goals and objectives of the Access for All America plan. The report was developed in conjunction with Capital Link and Community Health Ventures, which assist CHCs with financing initiatives for facilities and equipment.

"Every candidate for president -- be they Republican or Democratic -- has agreed that we could provide better health care and lower our health costs if every person had a regular source of primary care," said Hawkins. "Community health centers serve as living proof that providing high-quality, continuous care for people in communities without adequate health care not only saves lives and narrows health disparities gaps, it generates significant savings to the health care system."

Community health centers deliver care to more than 17 million patients at about 6,300 sites throughout the country. In this capacity, the centers serve as patient-centered medical homes for a patient population that is disproportionately low-income and predominately uninsured or publicly insured. Most patients seeking care from the centers are members of a racial or ethnic minority group.

The goal of the Access for All America plan is to "reduce the ranks of America's (medically) disenfranchised" by strengthening and expanding existing health centers and creating new ones to provide coverage for up to 30 million patients during the next seven years, Hawkins explained.

"Upon reaching 30 million patients, the number of medically disenfranchised individuals dramatically declines -- from 19 percent to 13 percent of all U.S. residents," the report said. "This translates into improved access to needed preventive services by individuals left out of the health care system." Without an adequate infrastructure, however, the Access for All America initiative cannot reach its goals, said Anita Monoian, CEO and president of the Yakima Neighborhood Health Services in Yakima, Wash., which is located in the middle part of the state.

Most CHCs operate in buildings that are more than 20 years old, and some provide services from buildings that are as much as 110 years old, said the Access Capital report. Ninety-four percent of the surveyed health centers said they must rebuild or renovate their facilities to expand during the next five years, requiring $10.5 billion for necessary improvements during the next several years.

To facilitate access to capital, the Access for All America Plan calls on the federal government to create

According to the report, these three actions will enable the majority of CHCs to finance their capital projects immediately, resulting in a rapid expansion of health centers throughout the country. This, in turn, will generate enormous benefits for local economies, many of which are located in poor, dilapidated communities.

"Once health centers reach 30 million patients by 2015, the savings they generate for the entire health care system will reach between $22.6 and $40.4 billion that year alone," the report said. "This expansion will also produce an additional $40.7 billion in overall economic activity, predominantly benefiting the very communities that need this stimulus most."

Gary Wiltz, M.D., CEO and medical director of the Teche Action Clinic in Franklin, La., said the Access for All America plan is not a "panacea for solving the whole health care problem." But, he added, "we know from our experience that we are a large part of the solution."

"We have been at this for more than 40 years now," Wiltz said of the nation's CHCs. "We have a proven track record of providing high-quality, comprehensive, primary preventive care."