President Obama’s 2011 HHS budget builds on the American Recovery and Reinvestment Act (AARA) investment in federally qualified health centers (FQHCs), providing an additional $290 million for further expansions.  With this increase, the administration estimates that health centers will be able to serve more than 20 million individuals in FY 2011.

Combined with other AARA provisions, this is good news for some of our nation’s “safety net” providers, including FQHCs, as well as public and nonprofit hospitals that treat many low income patients.  But there’s also a growing hole in the safety net as free medical clinics struggle to survive the current economic recession.

In a recently released research brief on safety net providers by the Robert Wood Johnson Foundation’s Center for Studying Health System Change^[1], the authors note, “while many FQHCs have benefitted from both the recent ARRA funding and federal expansion grants over the past 10 years, many free clinics without FQHC status were facing more serious financial strains than safety net hospitals and FQHCs.”  The report goes on to quote one FQHC executive as saying, “FQHCs got money, and free clinics are worried about keeping their doors open…There’s a big have and have-nots disparity.”

FQHCs include community health centers, public housing centers and some outpatient programs.  These providers receive federal payments for qualified services and are eligible for stimulus funds and federal expansion grants.  In contrast, free clinics do not receive federal payments and they are not eligible for funding available to FQHCs.  Instead, they depend primarily on private philanthropy and a team of volunteer physicians to provide care to the uninsured.

Having served recently on the board of a free medical clinic, I can attest to their value in local communities.  In addition to serving as a major provider of primary care services for the uninsured, our free clinic had an expansive network of volunteer specialty physicians who provided free services not available through the FQHC located just blocks away from the clinic.  In fact, the FQHC would refer their patients to the free clinic in order that they might receive needed specialty services.

Certainly, I’m not suggesting that free clinics receive federal funding for medical services provided by volunteer physicians.  But the attendant administrative and resource costs of providing primary and specialty care services can be significant and funding from existing sources is languishing.  It is time to recognize the unique role of all safety net providers of care, including free clinics, and develop new measures for federal support.  Each has a valuable role to play in our health care safety net for the uninsured.

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^[1] “The Economic Recession: Early Impacts on Health Care Safety Net Providers,” January  2010.

This entry was posted on Monday, February 8th, 2010 at 8:13 am and is filed under Consumer Health Care, Guest Posts, Policy. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.