[Congressional Record Volume 143, Number 148 (Wednesday, October 29, 1997)]
[House]
[Pages H9713-H9724]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




              ACCOMPLISHMENT OF THE HEALTH CENTER PROGRAMS

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 7, 1997, the gentleman from Illinois [Mr. Davis] is recognized 
for 60 minutes as the designee of the minority leader.


                             General Leave

  Mr. DAVIS of Illinois. Mr. Speaker, I ask unanimous consent that all 
Members may have 5 legislative days within which to revise and extend 
their remarks on the subject of my special order.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Illinois?
  There was no objection.
  Mr. DAVIS of Illinois. Mr. Speaker, about 30 years ago, there emerged 
on the American scene, as a result of the civil rights movement, 
demonstrations, marches, protests, action on the part of the United 
States Congress, initiation of the war on poverty, there emerged a new 
set of health service delivery mechanisms, something that we today know 
as community health centers. They started out with the name 
neighborhood health centers as part of the OEO antipoverty program.
  Every community that OEO would go into, making an assessment to look 
at the issue of poverty, there would always emerge the issue of a lack 
of

[[Page H9714]]

health care resources, the issue of there not being services available 
to the people who lived in inner cities and rural communities. As a 
result of that, these pioneering centers came on the scene.
  Today I rise to underscore that they are indeed a vital component of 
our health care system and one that focuses on providing the access to 
primary and preventive health care services that coverage alone cannot 
assure. As we all know too well from our experience over the years with 
Medicaid, the possession of an insurance card will not necessarily 
guarantee Americans access to health care. Nowhere is this more true 
than in our inner city and rural, medically underserved communities.
  I had the good fortune of taking a job at the Martin Luther King, Jr. 
Neighborhood Health Center in the City of Chicago as its director of 
training, which sharpened my interest in health care, and ultimately 
continued to work in that area and had the good fortune to see the 
emergence and development of this group of inner-city, rural migrant 
health programs throughout the country, got involved and eventually 
became, after the group had developed, a national association which 
even to this day still exists, is very vibrant, viable and a valuable 
part of the American health care delivery system.
  Every place that we went we found that underserved communities 
desperately need the health care system to deliver three things:
  One, the presence of a medical home that offers high quality care 
regardless of a person's health or social status or his or her ability 
to pay for services and that is accessible in terms of location of 
hours of service for those who do not have private transportation or 
cannot take time off from the workday.
  Second, adequate numbers of highly trained, culturally competent 
health professionals to staff these facilities; and, thirdly, the 
assurance that their medical home will not be driven out of business 
due to excessive financial risk or inadequate reimbursement simply 
because they care for those who are the sickest and hardest to reach.
  I strongly believe that our health system should be built and should 
build on what works. Among the programs that have worked best for the 
underserved are the community migrant and homeless health center 
programs. Over the past 30 years, these centers have established an 
unparalleled, uniquely successful record of providing quality, cost-
effective primary and preventive care to the hardest-to-reach 
populations across the Nation, recruiting and retaining health 
professionals where they are most needed and empowering communities to 
develop long-range solutions to their health needs.
  Health reform should invest in such success by preserving and 
building upon these programs in preparation for the implementation of 
reform so that universal coverage will truly guarantee access to 
quality care for everyone.
  One of the things that I liked best about the community health center 
movement is that they have spurred the development of so many 
individuals. I am certain without a doubt that I would not be standing 
here today as a Member of the United States Congress had I not gotten 
involved with the community health center movement in my community that 
not only brought services, but also provided opportunities for 
individuals to be trained, for individuals who had never been in the 
health business to develop careers.
  I remember some of the great training programs that the association 
developed where individuals could go off to the University of Michigan 
and acquire a master's degree in public health on the weekends while 
working in their local centers.

                              {time}  2200

  Or they could go out to the University of California for six-week 
periods at a time and acquire Master's degrees in health administration 
while retaining the job that they had back in their local communities.
  So I am so pleased that one of the real people who have seen these 
developments is also here to join with me this evening, in the person 
of the esteemed Representative from the State of South Carolina [Mr. 
Clyburn]. We will be delighted to have him join and share with us.
  Mr. CLYBURN. Mr. Speaker, I am pleased to be here this evening with 
my good friend, the gentleman from Illinois [Mr. Davis] and to thank 
him for all of his historical work in the field of community health 
centers.
  I want to say to him tonight that one of the most pleasant things for 
me to find out was, as I was working my congressional district a few 
months ago, to find out from so many of my constituents that he is 
considered a real hero among the people in this field. I am honored 
that he has asked me to join with him tonight in this special order.
  Community health centers have long been the sole means of medical 
attention for millions of Americans. For that reason alone, we should 
be very careful to afford them the resources needed to continue their 
services. Community health centers offer a wide range of services, 
including dental care, health education, community outreach, 
transportation, and various support programs. In many communities, 
health centers work in collaboration with other organizations such as 
the local schools, Head Start programs, and homeless shelters, just to 
name a few.
  As events of the past few days have proven, many of us are driven by 
numbers, so let me share some numbers with you concerning community 
health centers of the last year alone. Nine hundred forty community 
health centers served almost 10 million people nationwide. In my home 
State of South Carolina, there are 17 community health centers which 
are private, not-for-profit businesses owned and run by the local 
communities.
  In 1996 they provided primary and preventive health care services at 
more than 60 locations. These health clinics served more than 152,000 
patients, many of whom would not have otherwise received medical care. 
More than 50,000 children, 85,000 adults, and 15,000 elderly South 
Carolinians depended on the health professionals in their community 
health centers for their medical care and made over a half million 
visits to them.
  In the Sixth Congressional District, which I am proud to represent, 
there were over 68,000 people in community health centers last year. 
Many of these people are children, some pregnant women, many uninsured, 
many minorities, many from rural areas, many from low-income 
households, and many Medicaid recipients.
  In my district, the Franklin C. Fetter Family Health Center in 
Charleston County had over 100,000 visits last year, the highest in the 
State. Another center in my district, the Family Health Center, 
Incorporated, in Orangeburg, served over 34,000 individual patients, 
another record high in the State.
  Now, I share these numbers with my colleagues to illustrate the value 
my constituents place on these local health centers. Nationwide, over 
50,000 people are employed in community health centers. In South 
Carolina, that translates into more than 900 jobs and over $53 million 
being pumped into the State's economy. There is tremendous return on 
our investment in health centers. Every $100 million invested brings an 
additional $200 million in other resources into our communities. I 
think that my colleagues will agree with me that that is an investment 
worth making.
  Mr. Speaker, community health centers play a vital role in our 
Nation, our States and, more importantly, in our local communities. I 
am pleased to join tonight with my good friend the gentleman from 
Illinois [Mr. Davis] to ask that this Congress continue to work toward 
the adequate funding of these unique and vital community institutions.
  I thank the gentleman for allowing me the time.
  Mr. DAVIS of Illinois. Thank you so much. I really appreciate your 
being here.
  You mentioned Franklin C. Fetter. I remember when that center 
started, and I remember that it had a director who was there for a long 
period of time, just an outstanding gentleman. I am thinking of people 
that I knew then in South Carolina, like Georgia Goode and Tom 
Barnwell, I mean, people who were so committed and so dedicated and 
gave so much of themselves to make sure that these centers got started 
and that they continue.
  Who was the gentleman I am trying to think of?

[[Page H9715]]

  Mr. CLYBURN. Mr. Speaker, if the gentleman will yield, he may recall 
that that movement in South Carolina started with an effort in Beaufort 
County, the Beaufort-Jasper Comprehensive Health Care Center. That 
occupied significant amounts of our time trying to pull all of that 
together, and it finally got put together. Tom Barnwell, as you know, 
for many, many years directed that effort. It came about because 
Senator Hollings took it upon himself to go and visit rural Beaufort 
County and drew the Nation's attention to the health care problems in 
rural South Carolina.
  When that attention was focused, a lot of people were a bit upset, 
thinking that this was a negative for Beaufort. But when the Congress 
saw, it responded, and what looked like a negative turned out to be a 
tremendous positive not just for Beaufort County, but then it moved 
from there to Franklin Fetter.
  I think my colleague may be talking about Dr. Leroy Anderson.
  Mr. DAVIS. Dr. Leroy Anderson.
  Mr. CLYBURN. He directed that for a long period of time, and of 
course the Franklin Fetter Center started out working with migrants. It 
was my opportunity to serve for a number of years as the director of 
the South Carolina Commission for Farm Workers, and of course part of 
our work was on James Island and Johns Island and Yonges and Edisto 
Islands, trying to work with migrants who came into the area following 
the stream up from Florida, as well as seasonal farm workers. We found 
tremendous health needs among this rural part of Charleston county.
  Of course, Franklin Fetter was born there, and from there it has 
moved to Charleston's east side to focus on the urban aspects of these 
problems. The center is still there, enjoying a tremendous work and, of 
course, working with us now, we are about to establish a similar center 
in north Charleston. Thanks to the mayor and the council of north 
Charleston there, they have come forward to provide the building for us 
to put the center in.
  When we see these kind of efforts, it is not just about health care, 
it is about getting communities to work together, getting people to 
focus on needs that go beyond health, health being the method by which 
we get them organized. I think that your work with my friends in South 
Carolina, and of course I better mention, because also in my district, 
in fact, I spent last Saturday afternoon with the people in Eastover, 
where we have a similar center. Mr. Brown, who directs that, they were 
very pleased with the recent grant they got to help with their work.
  So I want to thank my colleague because, as I move throughout the 
district, I am amazed at the number of people. I am glad he lives in 
Illinois. Do not move to South Carolina, because I find it a little bit 
difficult, people think so much of you there for the work that you have 
done in this field.
  I think that health care is so fundamental to everything that we do, 
so I want to just thank my colleague for all that he has done. 
  Mr. DAVIS of Illinois. Mr. Speaker, reclaiming my time, the gentleman 
from South Carolina [Mr. Clyburn] is just so on target, and again, I 
want to compliment him. I also want to compliment him because we 
recently just finished an outstanding legislative weekend of the 
Congressional Black Caucus, and he was the chairperson of that 
activity. Every place that I go back in my district in Chicago and out 
in the suburban areas and throughout the country, there are people who 
tell me what an outstanding weekend they thought it was, and I always 
say to them, ``Well, one the reasons is the fact that we had an 
outstanding chairman.'' So I commend him for that.
  Mr. CLYBURN. Thank you.
  Mr. DAVIS of Illinois. My colleague jogged my memory, he started 
talking about Dr. Anderson and I remembered other people, like Dr. 
Stephen Joseph; Jack Geiger; Count Gibson; Jerry Ashford out of Boston, 
who became the first director of the association; Dr. Sam Rodgers from 
Kansas City, where they eventually named a center there for him; Dr. 
Charles Swett out of Chicago; Clifton Cole out of Los Angeles, who 
became the first president of our association; Dr. Batcheler from 
Detroit; a woman named Earline Lindsey out of Chicago; another lady, 
Delores Lindsey out of Cincinnati; and Pepper Jacques out of Detroit; 
and Eloise Westbrook from out in San Francisco; and Harvey Holzberg out 
of New York; and Tom van Koffenen, who now directs the association, who 
came on and has been there I guess now 25 years or so, continuing to 
advocate, continuing to develop, to plan, to orchestrate and to provide 
technical assistance and help these centers to grow.
  Because even though we have experienced a tremendous amount of 
success, there are still 43 million medically underserved people in 
this country, and these are people who do not have adequate access to 
health care services and often have poor health status. It is critical 
that health reform include special measures to meet their needs if our 
goal of cost containment is to be realized.
  The underserved are exactly the ones who end up on emergency room 
doorsteps. Studies have shown, for example, that up to 80 percent of 
emergency room visits in underserved visits are non-urgent care. If the 
underserved do not have their preventive and primary health care needs 
met in health reform, then our goal of cost containment will be 
unattainable.
  Health centers have shown that we give top quality care and 
constrained cost for our communities. For example, inpatient hospital 
admission rates for health center patients have been up to 67 percent 
lower than for those served by other providers, including hospital 
outpatient departments or private physicians. I do not know if you can 
get much better than that.
  The length of stay for hospital patients served by health centers has 
been found to be only one-third as long as that for patients who are 
seen by outpatient departments and half as long as that of outpatients 
served by private physicians. Studies have also shown that regular use 
of a health center has produced a 33-percent savings to Medicaid on 
both per case and per person yearly basis. This is for total costs for 
all services.

                              {time}  2215

  Health centers are among the few Federal programs that empower 
communities to craft long-range solutions to their health problems. By 
law, of course, health centers must be governed by a board of 
directors, a majority of whom must be patients of the facility. Only 
through the health center programs are consumers in the driver's seat 
of their primary care delivery site. And only through health centers 
are underserved communities assured that their primary care provider 
will respond to their specific needs. It is for these reasons and 
others that health centers have attracted such broad bipartisan 
support.
  Virtually all major health reform proposals introduced in the 
Congress over the past few years have included funding and other 
provisions for community health centers. That means that a majority of 
the Members of this House, whether they be Democrats or Republicans or 
Independents, have stated that they think health centers are the best 
hope for addressing the needs of the underserved populations. When it 
comes to access to care, health centers are something we can all 
support.
  Most of these legislative proposals have called for efforts to 
respond to the needs of underserved Americans in 3 very important ways. 
First, they have called for an expansion of the community health center 
program, including flexible authority to make grants to other community 
based providers and to establish community owned and operated networks 
and plans consistent of safety net providers.
  Secondly, they have included provisions encouraging managed care 
plans to include health centers in their provider networks and to make 
sure that these providers are not put at undue risk. This will preserve 
the existing safety net primary care infrastructure in underserved 
areas and assure their full participation in the new health system.
  Thirdly, they have encouraged the inclusion of health centers in 
health professions education and training. This will ensure that 
primary health care professionals are trained and practice in 
underserved areas where they are most needed. This is a critical point 
in the history of the health center movement. It demonstrates that to 
get health care to the people who cannot afford it, the Federal 
Government

[[Page H9716]]

must chip in a critical share. It comes in the form of health center 
operating grants. The best action we can take for those health 
professionals who want to give something back to their communities is 
to ensure a broad base of federally assisted community based providers 
in underserved areas. This will give these professionals a place to 
train and practice with the quality care environment and all the 
supports they will need.
  The health centers in my home State are all jewels. As a matter of 
fact, they are indeed worth their weight in gold. They are cost 
effective, responsive to community needs, and the patients just love 
them. I cannot think of much more that we could ask of a group of 
providers. And so I would certainly want to urge this Congress and all 
of my colleagues to continue to provide the support that has been 
provided over the years and let us continue with one of the most 
effective programs that we have ever seen for the provision of quality 
comprehensive health care to large numbers of poor people in this 
country.
  I really thank the gentleman from South Carolina [Mr. Clyburn] for 
sharing. It is also an indication of caring. If the gentleman has got 
some other comments, please go right ahead.
  Mr. CLYBURN. I thank the gentleman so much. I am just pleased to be a 
part of this because, as we have discussed in passing, this is 
something I very much have been involved in over the years. I was just 
so pleased to find that the gentleman had such a rich and hands-on 
involvement. To have someone like the gentleman as an advocate in this 
area is something that makes me feel much more comfortable with our 
efforts. I just want to thank the gentleman for letting me be here 
tonight to join with him and to call upon our colleagues to continue 
this great work.
  Mr. DAVIS of Illinois. I thank the gentleman. I will just make a 
little special recognition to a few of the community health centers 
that operate in my district. I always say that I have the most 
fascinating district in the United States of America. These people have 
simply gone above and beyond being just good providers of primary care.
  For example, under the tireless leadership of Berniece Mills-Thomas, 
executive director of the Near North Health Service Corporation which 
provides primary care to women, infants, school age children and their 
parents, we have seen that infant mortality has gone down significantly 
in the area that they service around Cabrini Housing Development. 
Actually they have reduced infant mortality over the years from 26.6 
per 1,000 live births to now 12.8 per 1,000 live births. That is an 
outstanding indicator of the impact, of the effectiveness.
  The Winfield Moody, I can remember traveling around the country with 
Mrs. Moody as they were getting that community's health center started. 
And we have the Erie Family Center under the strong leadership of 
Rupert Evans, who is the executive director. This center has done an 
outstanding job of providing care to the communities in and around it, 
Humboldt Park, West Town. Plus the Erie integrated care program is the 
only bilingual primary care provider serving HIV and HIV/AIDS infected 
patients in the city of Chicago. They have a great pediatric program.
  We also have a number of other centers, such as the Daniel Hale 
Williams Center, the Mercy Diagnostic, the Sinai Family Centers, which 
just received a substantial grant of $8 million not very long ago to 
continue its great work, the Alivio Medical Center, Circle Family 
Center, the Mill Square Health Center, Komed, New City, the Cook County 
Network. All of these are centers that provide not only the best of 
care but also opportunities for people to work, for people to have 
jobs, for people to plan, for people to serve on the boards of 
directors, to make decisions, to decide what their neighborhoods and 
communities will be.
  And so in its 30th year, I just thought that this would be an 
excellent time to stop and pause and pay tribute to this great group of 
centers that are operating and remember some of the individuals who 
made it happen, people out of New York like Paul Mejias and Janice 
Robinson, Curtis Owens from Philadelphia, Dan Cantrell from Chicago, 
Dave Simmons from Boston, Aaron Shirley from Jackson, Mississippi, 
Melba McAfee from Jackson, Mississippi, and other people from all over 
the country. I just hope that some historian who has been involved in 
the efforts is writing a history so that 100 years from now when we 
look back and look at where health care has come and look at our health 
care delivery systems, we will recognize the tremendous role that the 
community health center movement has played.
  Mr. Speaker, I would like to include some additional documents here 
that I would like to insert:
  ``The American Health Care Revolution and the Critical Role of Health 
Centers.''
  ``Health Centers Are Unique in Structure and Mission.''
  ``Why Health Centers Work for the Nation.''
  ``Community, Migrant & Homeless Health Centers.''
  ``And from the Bureau of Primary Health Care, its depiction of what 
the health center movement has meant to primary care services in the 
country.''
  ``The material referred to is as follows:

  The American Health Care Revolution and the Critical Role of Health 
                                Centers

       A revolution in the American health care system is well 
     underway and by all accounts will dramatically transform that 
     system over the next few years. More than two-thirds of 
     privately-insured individuals, or 120 million people, are 
     already enrolled in some form of managed care, with 
     continuing substantial annual increases in managed care 
     enrollment.\1\ This revolution has been driven by employers' 
     and insurers' demands that costs be held down or even 
     reduced, and that providers share financial risk. Managed 
     care plans have willingly complied with those demands, 
     bargaining for significant reductions in provider charges or 
     rates. Though doubts continue to persist as to the long-term 
     ability of managed care systems in holding down health care 
     costs, data from 1994 and 1995 show medical cost inflation 
     rates in the single digits for the first time in over a 
     decade. Clearly, the era of open-ended, fee-for-service 
     medicine is over.
---------------------------------------------------------------------------
     Footnotes at end of article.
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       While public insurance programs have moved more slowly, 
     they too--especially Medicaid--are now outpacing the private 
     sector in their rates of managed care enrollment. In 1990, a 
     little over 2 million Medicaid beneficiaries were enrolled in 
     managed care plans; that number jumped to an estimated 11 
     million by the end of 1995 \2\. Most of that growth has been 
     accomplished through the use of Medicaid waivers, which the 
     current Administration has granted to more than a dozen 
     states under Section 1115 of the Social Security Act, 
     allowing those states to bypass Medicaid law requirements in 
     establishing state managed care initiatives and other 
     reforms. The recently-enacted Balanced Budget Act of 1997 
     contains far-reaching provisions that give states substantial 
     flexibility to re-structure their Medicaid programs in order 
     to enroll most of their Medicaid populations in managed care 
     plans.\3\
       Under the right circumstances, the American health care 
     revolution can significantly improve both the availability 
     and quality of health care for most Americans while 
     containing costs by reducing the provision of unnecessary or 
     inappropriate care. However, the success of both private 
     market and public financing reforms could be significantly 
     undermined if adequate attention is not given to two other 
     key factors:
       The recent acceleration in the use of Medicaid managed care 
     raises questions as to whether the managed care industry has 
     the capacity and infrastructure to absorb millions of 
     patients who differ dramatically in socioeconomic and health 
     status, education and health care needs from their 
     traditional enrollees, and experience numerous barriers to 
     access to health care services--making them among the most 
     difficult-to-reach and needy patients in the health care 
     system.\4\ Medicaid beneficiaries and other low income 
     Americans have higher rates of illness and disability than 
     other Americans, and thus accumulate significantly higher 
     costs of medical care.\5\ By contrast, most managed care 
     organizations have, until recently, principally focused their 
     enrollment and infrastructure in reasonably affluent, 
     healthy, well-educated suburban patient bases. Therefore, in 
     implementing Medicaid managed care programs, states are 
     moving millions of individuals into health care delivery 
     systems which have had little experience in providing care to 
     them. Without an adequate infrastructure, this difficult-to-
     reach and needy population may be denied access to basic 
     health care.
       At the same time, more than 43 million Americans have no 
     health insurance and that number is rising by more than 
     100,000 each month.\6\ A recent report found that the 
     uninsured are almost twice as likely to lack a regular source 
     of care, have fewer ambulatory visits, and have a higher rate 
     of medical emergencies, than those who have insurance. They 
     frequently depend on hospitals and emergency rooms for even 
     basic care often due to severe shortages of appropriate 
     primary health services in their communities \7\.

[[Page H9717]]

     As more privately-insured Americans join managed care plans, 
     and as plans increasingly demand maximum cost-efficiency from 
     their providers, providers will be less able to provide care 
     to individuals who are uninsured or whose insurer pays less 
     than the cost of care that is provided (as is true of both 
     Medicare and Medicaid today).
       Clearly, the long-term success of the American health care 
     revolution will depend upon steps to assure the availability, 
     and encourage the use, of cost-effective preventive and 
     primary health care for uninsured low income working 
     families; and the key to the longer-term survival of managed 
     care organizations will be the adequacy of their Medicare and 
     Medicaid enrollees' access to lower-cost primary and 
     preventive care, as well as their expertise in managing 
     enrollee costs. To be successful in these efforts, the new 
     American health care system and its managed care plans will 
     need the resources and know-how of providers that have a 
     history of cost-effective, quality service to Medicaid 
     beneficiaries and other low income populations--providers 
     such as America's Health Centers.


                          why health centers?

       For more than 30 years, Health Centers have served as 
     ``managed care'' providers for publicly-insured and uninsured 
     families. Nationwide, 2700 local health center service sites 
     currently deliver preventive and primary health care to more 
     than 10 million people--including 3.8 million Medicaid 
     recipients, 1 million Medicare beneficiaries, and 4.2 million 
     people who have no health insurance--in urban and rural 
     underserved communities across the country. The underlying 
     goal of the health center programs has been to help 
     communities and their people to take responsibility for their 
     health; toward that end, the programs have facilitated the 
     flow of public and private resources, enabling the 
     communities themselves to establish and operate health 
     centers and to develop innovative programs to meet their 
     health needs.
       Health Centers have historically operated with very limited 
     budgets and have developed considerable expertise in managing 
     patients with significant health needs in low cost settings, 
     providing access to primary and preventive health services. 
     With literally thousands of communities across the country 
     suffering from acute shortages of cost-effective preventive 
     and primary health care service providers, with the numbers 
     of uninsured Americans rising each month, and with cost 
     controls making it increasingly impossible for other 
     providers to continue offering care to those without 
     coverage, health center programs are today, more than ever, 
     critical to the success of the new American health care 
     system. This is especially true because health centers:
       Are, by law, located exclusively in rural and inner city 
     communities that have been designated as ``medically 
     underserved,'' because they have far too few ``front-line'' 
     providers and poor health status indicators. I these 
     communities, health centers are frequently the only available 
     and accessible primary care provider.
       Care for those whom other providers do not serve because of 
     their high costs and complex health needs.
       Offer high quality preventive and primary health care under 
     one roof, in a ``one-stop caring'' system.
       Have had a major impact on the health of their communities 
     and provide care in a highly cost-effective fashion.


            health centers are a private sector alternative

       Although health centers have a broad, prevention-focused 
     perspective on many health problems, they are much like 
     private medical practices, staffed by physicians, nurses, and 
     other health professionals. They differ from private medical 
     practices, however, by their broader range of services, such 
     as social service and health education, and by their 
     management structure. Health centers are owned and operated 
     by communities through volunteer governing boards composed of 
     leaders and residents of the communities they serve. They 
     function as non-profit businesses with professional managers; 
     purchase goods and services; provide employment; and make an 
     economic impact within their community.
       Because they exist to serve their communities, health 
     centers are committed to seeking out and combining resources 
     from a variety of sources to ensure that access to primary 
     health care services is made available to all community 
     residents, regardless of their financial or insurance status. 
     Patients who can afford to pay are expected to pay. Medicare 
     and Medicaid patients are always welcome. And insurance 
     companies are billed on behalf of patients with coverage. The 
     centers' Board and staff also work to obtain support from 
     other sources, such as local governments and foundations, to 
     ensure that care is available for all patients based on 
     ability to pay.
       In order to maximize limited resources, these private, non-
     profit community practices have developed community linkages 
     with local health departments, hospitals, nursing homes, 
     pharmacists and others to ensure that services are 
     coordinated and to eliminate duplication of effort. Although 
     some services may not be available on-site, the health center 
     does coordinate care and referrals to other providers in a 
     way that assures true ``one stop caring'' for its patients.


           health centers are found where they're needed most

       By law, all Health Centers must be located in and serve 
     medically underserved areas and/or populations--and their 
     2,700 sites are split evenly between rural and urban 
     communities. The residents of these communities suffer from 
     the most profound shortage of accessible primary health care 
     services and, not surprisingly, exhibit some of the most 
     severe health problems and the poorest health status of all 
     American communities.
       More than 43 million people, living in these inner-city and 
     rural communities, remain seriously medically underserved 
     because of special needs or circumstances \8\:
       They are overwhelmingly members of low income families, and 
     are disproportionately young.
       Many are uninsured, but 60 percent of them already have 
     some form of insurance (including Medicare and Medicaid).
       Many live and work in areas with too few providers of care, 
     while others face serious non-financial barriers to care 
     (such as language or physical disabilities), or have complex 
     health and social problems.
       In simplest terms, the medically underserved are people who 
     can't get care when they need it, and when it is most 
     appropriate--to prevent the onset of a health problem or 
     illness, or to diagnose and treat a condition in its earliest 
     stages--because of who they are, where they live, or because 
     of their health status. Two recent reports found that, even 
     when insured, these Americans continue to face significant 
     barriers to care, especially to primary and preventive health 
     services, and as a result have measurably poorer health 
     outcomes and overall health status.\9\


            health centers serve the most vulnerable of all

       Health center patients are almost universally among the 
     most vulnerable of all underserved people in America today--
     persons who even if insured, nonetheless remain isolated from 
     traditional forms of medical care because of where they live, 
     who they are, and their frequently far greater levels of 
     complex health care needs:
       Fifty percent reside in isolated rural areas; the other 
     half live in economically depressed inner city communities.
       Virtually all patients have family incomes below 200 
     percent of the federal poverty level ($28,700 annually for a 
     family of four in 1994).
       Nearly one in two is completely uninsured, either publicly 
     or privately, and more than one-third depend on Medicaid.
       44 percent of all patients are children under 18, and 
     thirty percent are women of childbearing age (nearly one in 
     ten is pregnant). Health centers delivered over 400,000 
     babies last year--10 percent of all births and 1 in 5 low 
     income births \10\.
       Because of factors such as poverty or homelessness, and 
     other social-environmental threats that permeate low income/
     underserved communities, health center patients are at higher 
     risk for serious and costly conditions (such as asthma, 
     tuberculosis, or high-risk pregnancies) than the general 
     population, and require unique health services not typically 
     offered by traditional providers, including most managed care 
     entities.


                health centers are clinically effective

       Health centers provide more than just care for illness or 
     episodic conditions. They offer a ``health care home'' for 
     all residents of an underserved area. Like any good family 
     doctor's office, they provide ongoing care and health 
     management for families and individuals through all life 
     stages. Care is provided in the office whenever possible; 
     physicians are on the medical staffs of their local 
     hospitals; and referrals to other providers are made whenever 
     needed.
       Health center practices are staffed by a team of board 
     certified or board eligible physicians, physician's 
     assistants, nurses, dentists, social workers and other health 
     professionals. In rural areas, physicians are typically 
     family practitioners, while larger urban centers are usually 
     staffed with interdisciplinary teams of internists, 
     pediatricians, and obstetricians. Almost 98% of the more than 
     5,000 health center physicians are board-certified or 
     eligible \11\, and all are required to have hospital 
     admitting privileges.
       The hallmarks of effective primary health care are the 
     entry point it provides into the entire system of care, its 
     comprehensiveness, continuity, and responsiveness to the 
     needs of the patients served. Because primary care must be 
     patient-centered to be effective, it is not the same for 
     everyone--one size cannot fit all. Local centers have 
     developed special intervention programs for significant 
     health care needs in their community, including strong 
     obstetrical practices to fill a gap in their community or a 
     special focus on patients with diabetes, or hypertension or 
     AIDS. Many centers have developed special outreach programs 
     to help overcome the cultural and language barriers faced by 
     people who speak little or no English in obtaining primary 
     health care access \12\.
       Centers also emphasize services designed to enhance the 
     effectiveness of the medical care provided, such as community 
     outreach, health/nutrition education, and case management. 
     Some 98 percent of health centers offer health education 
     services; over 90 percent offer case management services; 
     more than three-quarters offer preventive dental services and 
     in-house laboratory services. All health centers employ 
     outreach and patient relations workers from the communities 
     they serve \13\.
       Health centers are required by the U.S. Public Health 
     Service (PHS) to update their

[[Page H9718]]

     quality assurance program and health care plan in response to 
     annual community need assessments, and are required to report 
     to PHS outcome measures, including immunization rates, low 
     birth weight reduction, hospital admission and length of stay 
     \14\.
       Available literature provides extensive documentation of 
     the quality and effectiveness of care offered by health 
     centers, using factors such as patient health outcomes, 
     satisfaction and health status of the community. These 
     studies provide strong evidence that where there is a health 
     center, the level of health of the community is dramatically 
     improved. For instance:
       Infant mortality: Communities served by health centers have 
     been shown to have infant mortality rates from ten to forty 
     percent lower than communities not served by health centers. 
     The provision of health center services also has been linked 
     to improvements in the use of prenatal care and reductions in 
     the incidence of low birthweight \15\.
       Incidence of disease/hospitalization: Health centers have 
     been shown to reduce rheumatic fever and untreated middle ear 
     infections in children and have significantly increased the 
     proportion of children who are immunized against preventable 
     disease \16\.
       Use of preventive care: Health centers have increased the 
     use of preventive health services such as Pap smears and 
     physical exams \17\.
       Effectiveness of care: Health center patients have been 
     shown to have lower hospital admission rates, shorter lengths 
     of stay and make less inappropriate use of emergency room 
     services \18\.
       Two recent (1994 and 1995) system-wide studies of thousands 
     of Medicaid patient medical records in Maryland found that 
     health centers scored highest among all providers for the 
     proportion of their pediatric patients who had received 
     preventive services, including immunizations; and that health 
     centers consistently scored at or near the highest in 21 
     separate measures of quality assessment, even though their 
     costs of care were among the lowest of the various provider 
     types reviewed \19\.
       Health center patients are also overwhelmingly satisfied 
     with their care and treatment. According to a 1993-1994 
     nationwide study of health center patients conducted by the 
     Picker/Commonwealth Fund: 96% of health center patients were 
     very satisfied or satisfied with the quality of their 
     care; 97% would recommend the health center to friends and 
     family; 95% receive regular health care services, even 
     when they are not sick (preventive and primary care 
     services); 87% have never had a concern or complaint.


           Health Center Cost-Effectiveness Is Second to None

       Health centers are subject to ongoing Federal scrutiny of 
     their cost-effectiveness and quality of care. Cost screens 
     applied to health centers by the U.S. Public Health Service 
     and the Health Care Financing Administration, such as 
     administrative costs and costs per patient visit, are 
     virtually unparalleled in the health care industry. The 
     result is that health centers provide quality, comprehensive 
     primary care to some of the hardest-to-reach patients in the 
     health system at a price second to none. Several recent 
     studies have found that Medicaid patients who regularly use 
     health centers cost significantly less than those who use 
     private primary care providers, such as HMO's, hospital 
     outpatient units or private physicians. For instance:
       In Washington state in 1992, health center patients were 
     found to be 36% less expensive for all services than patients 
     of other primary care providers and used 31% fewer emergency 
     room services \20\;
       In California in 1993, health center patients were 33% less 
     expensive overall (controlling for maternity services), and 
     had 27% less total hospital costs \21\;
       In Maryland in 1993, health center patients had lowest 
     total payments; lowest ambulatory visit cost; lowest 
     incidence of inpatient days and lowest inpatient day cost; 
     health center patients were one-third as likely as hospital 
     outpatient unit patients to be admitted on an inpatient basis 
     and were half as likely to have unstable chronic medical 
     diagnoses as patients of other providers \22\;
       In New York in 1994, health center patients were 22-30% 
     less expensive overall, and had 41% lower total inpatient 
     costs; diabetics and asthmatics who were regular health 
     center uses had 62% and 44% lower inpatient costs, 
     respectively \23\.
       These findings are consistent with those from dozens of 
     previous studies on the cost-effectiveness and quality of 
     care provided through the health center model, and in 
     particular addressing the health centers' demonstrated and 
     historic savings to state Medicaid programs. Taken together, 
     these studies have found that:
       Use of health centers led to lower utilization of more 
     costly emergency rooms, ranging from 13 percent to 38 percent 
     in the case of pediatric emergency room use. \24\
       Health centers have reduced inpatient admission rates for 
     their patients by anywhere from 22 percent to 67 percent, 
     reduced the number of patients admitted per year and the 
     length of stay among those who were admitted. \25\
       Health centers have achieved such tremendous success 
     because, like managed care organizations, they are a first 
     point of entry for their patients into the health care 
     delivery system, and they manage their patients' care to keep 
     them healthy and out of costly emergency rooms, hospitals, 
     and specialists' offices. They are also experienced in the 
     management of health care costs, since they must run their 
     programs within a limited annual budget.
       Health centers are well tested and highly successful models 
     of community-based health care. They are partnerships of 
     people, governments, and communities working together to meet 
     local health care needs in an culturally competent, effective 
     and efficient way. Health centers develop primary care 
     infrastructure in areas of the nation that need it most with 
     limited Federal assistance. Federal grants to health centers 
     average less than $100 annually per patient. This represents 
     a small investment for what centers accomplish in 
     strengthening community health and fostering prevention and 
     health education.


       The Health of Each Health Center is Always Leadership And 
                             Accountability

       Health centers are professional health care organizations 
     providing a comprehensive range of high quality services for 
     their community. But their most distinctive feature is that 
     the health centers are developed and run by their 
     communities, and are dedicated to the needs of their people. 
     Health center governing boards are composed of local 
     community leaders and residents who care about the primary 
     health care access needs of their community and are committed 
     to working together to make a difference. Federally funded 
     centers are required to have patients as a majority of their 
     governing board members.
       The empowerment and involvement of local citizens in 
     planning and governance has been the essential characteristic 
     that has made in possible for health centers to make a real 
     difference in underserved communities, in terms of both the 
     sense of ownership they help foster and the tangible benefits 
     they yield. In recent years, the role of community governance 
     has achieved increased recognition and respect, especially 
     because it promotes direct involvement by local residents in 
     developing the services they use. Because of their commitment 
     to their local communities, health centers have become an 
     effective solution for primary health care access in 
     thousands of communities across the nation, affirming their 
     vital role in America's future health care system.


The Health Center Experience: Limited Investment Generates Outstanding 
                                Success

       Health center achievements over the past 30 years show how 
     much is known about how to make a difference in the health of 
     the poor and how far even a modest investment will go.
       Every Federal dollar invested in health centers leverages 
     another two dollars in other revenues--in addition to the 
     Medicare and Medicaid savings they produce. Health centers 
     understand and respond to their communities' most urgent 
     health care needs. Health centers care for those whom other 
     providers cannot or will not serve. Health centers offer high 
     quality medical care. Health centers have had a major impact 
     on the health of their communities and provide care in a 
     highly cost-effective fashion. There is no better health care 
     bargain anywhere--public or private.
       Perhaps the greatest testament to the unique ability of 
     health centers to design services that are accessible to 
     their patients is that, ironically, health centers report 
     that for every 10 patients currently served there are another 
     3 on local centers' waiting lists who are seeking care there 
     \26\. And those on health center waiting lists do not even 
     begin to take into account the far larger number of persons 
     who need the services of health centers but who do not have a 
     center within reach--particularly in the nearly 1,000 
     underserved U.S. counties that today have no health center 
     \27\.


                   Health Centers Can Do So Much More

       As policy makers consider options for improving the reach 
     and effectiveness of America's health care system, they would 
     do well to seriously consider including steps to:
       Expand the network of health centers to ultimately reach 
     all medically underserved people and communities. With 
     current funding, health centers are able to reach just 9 
     million of the 43 million medically underserved Americans who 
     would benefit from their services. This effort could be 
     accomplished incrementally over several years, with each 
     additional $100 million in funding for health centers 
     extending services to an additional 1 million people in some 
     400 communities.
       Assist health centers to fully participate in managed care, 
     by allowing them to form or join Provider Sponsored Networks 
     as fully integrated partners, and by ensuring that any 
     Medicaid or Medicare reforms include supplemental payments to 
     health centers--in addition to other reimbursements from 
     Medicare or Medicaid, or from managed care plans--for the 
     purpose of making sure that health centers receive sufficient 
     funds to adequately care for their Medicaid patients. Without 
     sufficient resources to meet the needs of their patients, 
     centers and clinics would be forced to substantially reduce 
     their services and patient loads (mostly uninsured patients), 
     and many could go out of business.
       Involve health centers in the training of the enhanced 
     primary care workforce required for the future, by making 
     teaching health centers eligible for direct payment of their 
     health professions teaching costs. The Council on Graduate 
     Medical Education (COGME), as well as the Institute of 
     Medicine, and the Physician Payment Review

[[Page H9719]]

     Commission, have recommended revision of current GME policies 
     to support expanded primary care and ambulatory training 
     programs; and health centers represent the ideal site for 
     training in comprehensive preventive and primary ambulatory 
     health care, because they have an established history of 
     functioning as interdisciplinary care environments, providing 
     quality, comprehensive primary and preventive care.
       Health centers provide comprehensive, continuous care to 
     their patients regardless of insurance status or ability to 
     pay. It is this ability to offer continuous care that makes 
     the health centers unique and particularly valuable. Health 
     centers form a critical base on which to build managed care 
     systems for low-income and medically underserved populations. 
     Already, health centers are managed care providers for over 
     1.5 million Medicaid patients, and that number is expected to 
     more than double over the next year or two.
       The road to long-term managed care plan viability and 
     effectiveness can be made smoother by the inclusion of health 
     centers in managed care networks. As experienced and 
     effective health care providers to the medically underserved, 
     health centers can provide the primary care infrastructure 
     network which managed care systems need to provide cost 
     efficient quality health care. Health centers have much to 
     offer managed care systems and stand ready to collaborate 
     with them.


                                 notes

     \1\ ``Market Strategies and the Growth of Managed Care'', 
     Paper Presented by Howard Bailit, D.M.D., Ph.D., Senior Vice 
     President for Health Services Research, Aetna Health Plans, 
     to the Annual Meeting of the Association of Academic Health 
     Centers, September 29, 1994.
     \2\ Testimony of Bruce Vladeck, Administrator, Health Care 
     Administration (HCFA), before the House Committee on 
     Government Reform and Oversight, January, 1996.
     \3\ See Subtitle H of Title IV of P.L. 105-33, the Balanced 
     Budget Act of 1997.
     \4\ Holahan, Liska and Obermaier, Medicaid Expenditures and 
     Beneficiary Trends, 1988-1993; Report to the Kaiser 
     Commission on the Future of Medicaid by The Urban Institute, 
     September 1994.
     \5\ Health Insurance of Minorities in the U.S., Report by the 
     Agency for Health Care Policy and Research, U.S. Department 
     of Health and Human Services, 1992 and Green Book, Overview 
     of Entitlement Programs Under the Jurisdiction of the Ways 
     and Means Committee, U.S. House of Representatives, 1994.
     \6\ Employee Benefits Research Institute, Sources of Health 
     Insurance and Characteristics of the Uninsured, EBRI Special 
     Report and Issue Brief No. 158, February, 1995.
     \7\ Baker, Laurence, and Baker, Linda, ``Excess Costs of 
     Emergency Department Visits for Nonurgent Care,'' Health 
     Affairs, Winter 1994: 162-171.
     \8\ Hawkins, Daniel, and Rosenbaum, Sara, Lives in the 
     Balance: A National, State and County Profile of America's 
     Medically Underserved (National Association of Community 
     Health Centers, 1993).
     \9\ Grumback, Kevin, et al, Primary Care Resources and 
     Preventable Hospitalization in California, CPS Report, 
     California Policy Seminar, May 1995; and Kohrs, Francis P., 
     MD, and Mainous, Arch G., PhD, ``The Relationship of Health 
     Professional Shortage Areas to Health Status, Archives of 
     Family Medicine, Vol. 4, August 1995: 681-685.
     \10\ Data from 1995 health center reports to the Bureau of 
     Primary Health Care, HHS.
     \11\ Data from Bureau of Primary Health Care, 1994.
     \12\ See Community and Migrant Health Centers; Critical 
     Components of Health Reform (National Association of 
     Community Health Centers, 1993).
     \13\ Lewin-ICF, 1991 Survey of Health Centers.
     \14\ See Program Expectations for Community and Migrant 
     Health Centers, Bureau of Primary Health Care, HHS (1994).
     \15\ Grossman, Michael, and Goldman, Fred, ``An Economic 
     Analysis of Community Health Centers,'' National Bureau of 
     Economic Research (1983); see also Schwartz, Rachel, and 
     Poppen, Paul, Measuring the Impact of Community Health 
     Centers on Pregnancy Outcomes, Abt Associates (1982), and 
     M.B. Wingate, et al, ``Obstetric Care in a Family-Health 
     Oriented Neighborhood Health Center, ``Medical Care'' 14, 4 
     (April 1976): 315-325.
     \16\ Mary E. Biscoe et al, ``Follow-up Study of the Impact of 
     Rural Preventive Care Outreach Program on Children's Health 
     and Use of Medical Services'', American Journal of Public 
     Health 70, 2 (February 1980); 151-156; Theodore J. Columbo et 
     al, ``The Effect of Outreach Workers' Educational Efforts on 
     Preschool Children's Use of Preventive Services'', American 
     Journal of Public Health 69, 5 (May 1979): 465-468; and David 
     L. Cowan et al, ``Impact of a Rural Preventive Care Outreach 
     Program on Children's Health,'' American Journal of Public 
     Health 68, 5 (May 1978: 471-476; and Leon Gordis, 
     ``Effectiveness of Comprehensive Care Programs in Preventing 
     Rheumatic Fever'', New England Journal of Medicine 289, 7 
     (August 16, 1973): 331-335.
     \17\ Sheils A. Gorman and Hannah Nelson, ``Meeting the Data 
     Needs of Neighborhood Health Centers,'' (Presented at the 
     102nd meeting of the American Public Health Association, 
     1984); and John C. Hershey and John R. Moore, ``The Use of an 
     Information System for Community Health Services Planning and 
     Management,'' 13 Medical Care (February 1975): 114. See also 
     Joel J. Alpert, et al, ``Effective Use of Comprehensive 
     pediatric Care'', American Journal of Diseases of Children 
     116 (November 1968): 529-533; and Theodore J. Columbo, et al, 
     ``The Effect of Outreach Workers' Education Efforts on Use of 
     Preventive Services by a Poverty Population,'' (Presented at 
     the 104th meeting of the American Public Health Association, 
     1976).
     \18\ De Prez, Ronald, et al, ``The Substitutability of 
     Outpatient Primary Care in Rural Community Health Centers for 
     Inpatient Hospital Care,`` Health Services Research 22,2 
     (June 1987): 207-233; Gretchen V. Fleming and Ronald M. 
     Anderson, ``The Municipal Health Services Program: Improving 
     Access to Primary Care with Increasing Expenditures,'' 
     Medical Care 24,7 (July 1986): 565-579; Howard E. Freeman, K. 
     Jill Kiecolt, and Harris M. Allen, ``Community Health 
     Centers: An Initiative of Enduring Utility'', Milbank 
     Memorial Fund Quarter 60,2 (Spring 1982): 245-267; Marsha R. 
     Gold and Robert G. Rosenburg, ``Use of Emergency Room 
     Services by the Population of a Neighborhood Health Center'', 
     Health Service Report 89,1 (January-February 1974): 65-70; 
     Louis I. Hochheiser, Kenneth Woodward, and Evan Charney, 
     ``Effect on Neighborhood Health Center on the Use of 
     Pediatric Emergency Departments in Rochester, New York'', The 
     New England Journal of Medicine 285,3 (July 15, 1971): 148-
     152; Gordon T. Moore, Rosemary Bonanno, and Roberta 
     Bernstein, ``Effect of a Neighborhood Health Center on 
     Emergency Room Use'', Medical Care 10,3 (May-June 1972): 240-
     247; and Elliot Sussman, et al, ``Can Primary Care 
     Deliver?'', Journal of Ambulatory Care Management 2,3 (August 
     1979): 29-39.
     \19\ Starfield, Barbara, et al, ``Costs vs. Quality in 
     Different Types of Primary Care Settings,'' Journal of the 
     American Medical Association 272,24 (December 28, 1994); 
     1903-1908; and Stuart, Mary e., et al, ``Improving Medicaid 
     Pediatric Care,'' Journal of Public Health Management 
     Practice 1(2) (Spring, 1995): 31-38.
     \20\ Braddock, Dennis, et al, Using Medicaid Fee-For-Service 
     Data to Develop Health Center Policy, Washington Association 
     of Community Health Centers and Group Health Cooperative of 
     Puget Sound (1994).
     \21\ Health Services Utilization and Costs to Medicaid of 
     AFDC Recipients in California Served and Not Served by 
     Community Health Centers, Center for Health Policy Studies/
     SysteMetrics (1993).
     \22\ Steinwachs, Donald M., and Stuart, Mary E., (Johns 
     Hopkins Univ. School of Public Health and Hygiene), 
     ``Patient-Mix Differences Among Ambulatory Providers and 
     Their Effects on Utilization and Payments for Maryland 
     Medicaid Users,'' Medical Care 34,12 (December 1993): 1119-
     1137.
     \23\ Utilization and Costs to Medicaid of AFDC Recipients in 
     New York Served and Not Served by Community Health Centers, 
     Center for Health Policy Studies (1994).
     \24\ Hockheiser, L., Woodward, K., and Charney, E., ``Effect 
     of the Neighborhood Health Center on the use of Pediatric 
     Emergency Departments in Rochester, New York,'' 285 New 
     England Journal of Medicine 148 (July 15, 1971).
     \25\ ``Final Report for Community Health Center Cost 
     Effectiveness Evaluation,'' JRB Associates for U.S. 
     Department of Health and Human Services, Contract No. 100-78-
     0138 (1981). See also Davis, Karen and Schoen, Cathy, Health 
     and the War on Poverty: A Ten-Year Appraisal (Brookings 
     Institution, Washington, D.C., 1977).
     \26\ Lewin-ICF, 1991 Survey of Health Centers.
     \27\ Hawkins, Daniel, and Rosenbaum, Sara, op cit.
                                  ____

       America's Health Centers are comprised of Community, 
     Migrant and Homeless Health Centers and other federally-
     qualified community-based providers. In a thirty-year 
     history, they have shown the value and strength of a health 
     system rooted in community partnership and built on the 
     delivery of accessible, quality primary care to Americans in 
     need. Today, this growing nationwide network delivers primary 
     and preventive care to more than 10 million medically 
     underserved people--spanning urban and rural communities in 
     all fifty states, the District of Columbia, Puerto Rico, Guam 
     and the Virgin Islands.


           health centers are unique in structure and mission

       Health centers are public-private partnerships. They are 
     nonprofit, private corporations, which are locally-owned and 
     operated by the communities they serve.
       Health Centers serve in medically underserved communities--
     America's inner cities, migrant farmworker communities, and 
     isolated rural areas. They are defined areas with few or no 
     physicians--suffering high levels of poverty, infant 
     mortality, elderly, and poor health.
       Health centers are governed by consumer boards--composed of 
     51 percent patients who represent the community served. This 
     is a powerful link to the community. Consumer governance 
     gives patients and local citizens a voice in the workings of 
     their center--and ensures that care is patient-centered and 
     responsive to diverse cultures and needs within the 
     community.
       Health center revenues are multi-sourced. Federal grants on 
     average represent 36 percent of a health center budget. 
     Reimbursement from Medicaid and Medicare constitutes 38 
     percent. The remainder is leveraged from state and local 
     governments, insurance, and patient fees.
       Health centers provide care to all who seek their service. 
     Patients are charged on a sliding fee scale to ensure that 
     income or lack of insurance is not a barrier to care. Federal 
     grants received by centers subsidize the cost of care 
     provided to the uninsured--and the cost of services not 
     covered by Medicare or Medicaid or private insurance.


                 why health centers work for the nation

       Health centers fill critical gaps in health care. Health 
     centers serve low-income working families, the uninsured as 
     well as high-risk populations such as the homeless, the frail 
     elderly, migrant farmworkers, and poor women and children. 
     They are people who confront barriers to care and whose unmet 
     health needs represent a huge and growing cost to the nation.
       Health Center Patient Profile: Virtually all health center 
     patients have family incomes below 200 percent of the federal 
     poverty level. More than two in five are completely 
     uninsured. More than one-third depend on Medicaid. 70 percent 
     of health center patients are children and poor women of 
     childbearing age. 60 percent of health center patients are 
     members of racial and ethnic minorities at high risk. Nearly 
     half a million of our patient population are migrant 
     farmworkers and their families.
       Health Centers are built by community initiative. A limited 
     federal grant program provides seed money. The purpose: to 
     empower communities themselves to find partners and resources 
     to develop centers--to hire doctors and needed health 
     professionals--and to build their own points of entry into 
     the nation's health care delivery system.
       Health centers focus on wellness and prevention--the keys 
     to cost savings in health care. Through innovative programs 
     in outreach, education, and prevention centers reach out and 
     energize communities to meet critical health needs and 
     promote greater personal responsibility for good health.

[[Page H9720]]

       Health centers produce savings. Their skills and experience 
     are unsurpassed as providers of quality, cost-effective 
     health care to high-risk and vulnerable populations.


                    health centers make a difference

       Cost effectiveness: Health centers provide cost-effective 
     high quality care--second to none. Total health care costs 
     for center patients are on average 40 percent lower than for 
     other providers serving the same populations. Centers also 
     achieve significant savings by reducing the need for hospital 
     admissions and costly emergency care.
       Improving Access: Health centers bring needed health 
     services and facilities to areas of greatest need--often not 
     served by traditional providers. They train, recruit, and 
     retain highly-skilled health professional in acute shortage 
     areas.
       Quality Managed care: Health centers provide comprehensive 
     primary and preventive care. Ninety-eight percent of health 
     center physicians are board certified/eligible. Centers are 
     linked to hospitals, health departments, nursing homes, and 
     other providers as well as social service agencies to ensure 
     that patients have access not only to primary care but a 
     continuum of coordinated care, including special treatment 
     and support services.
       Accountability: Health centers meet high uniform standards 
     of accountability and performance. Health centers demonstrate 
     the effective utilization of public and private investment as 
     reflected in positive health outcomes; a 40 percent reduction 
     in infant mortality; improved immunization and prenatal care 
     rates; and increased use of preventive health services.


                           OTHER KEY FACTORS

       Health Centers empower Communities. They provide jobs and 
     generate new investment into devastated and poor communities. 
     Health centers employ over 50,000 community residents. They 
     are the nation's leading trainer and health career path for 
     minority health professionals. Their total operating budget 
     of $2.8 billion leverages over $14 billion in economic 
     development in needy urban and rural areas--Which translates 
     into jobs, facilities and contracts.
       Health Centers are vital safety net providers for millions 
     of poor Americans. They are frontline providers of care 
     helping communities attack costly and compelling health 
     problems such as AIDS, substance abuse, teenage pregnancy, 
     and crime. But, they are more than just providers. They are 
     catalysts--empowering communities with the resources, jobs/
     education--and leadership--that can improve health and bring 
     new promise to America's disadvantaged.
                                  ____

       Community, Migrant and Homeless Health Centers and other 
     community-based providers comprise America's Health Centers. 
     In a thirty year history, they have shown the value and 
     strength of a health system rooted in community partnership--
     and built on the delivery of accessible, quality primary care 
     to Americans in need. Today, this growing nationwide network 
     delivers primary and preventive care to more than 9 million 
     medically underserved people--spanning urban and rural 
     communities in all fifty states, the District of Columbia, 
     Puerto Rico, Guam and the Virgin Islands.


                 WHY HEALTH CENTERS WORK FOR THE NATION

       Health centers fill critical gaps in health care delivery. 
     Health centers serve low-income working families, the 
     uninsured as well as high-risk populations such as the 
     homeless, the frail elderly, the disabled, migrant 
     farmworkers, and poor women and children and others. They are 
     people who confront barriers to health care--and whose unmet 
     health needs represent a huge and growing cost to the nation.
       Health centers are built by community initiative. A limited 
     federal grant program provides seed money. The purpose: to 
     empower communities themselves to find partners and resources 
     to develop centers--to hire doctors and needed health 
     professionals--and to build their own points of entry into 
     the nation's health care delivery system.
       Health centers focus on wellness and prevention--the keys 
     to cost savings in health care. Through innovative programs 
     in outreach, education and prevention--centers reach out and 
     energize communities and their people to meet critical health 
     needs and promote greater personal responsibility for good 
     health.
       Health centers produce savings--in Medicare and Medicaid--
     and preventive care. Their skills and experience are 
     unsurpassed as providers of quality, cost-effective health 
     care to vulnerable populations. A track record of 
     accomplishment demonstrates that prevention and primary care 
     works: It keeps people healthy--It saves tax dollars--It 
     builds stronger communities.
       Community Partnership is the dynamic that drives the 
     success of America's Health Centers. Health centers are 
     partnerships of people, governments, businesses, communities 
     working together to expand access and to improve health.


        HOW HEALTH CENTERS ARE UNIQUE--IN STRUCTURE AND MISSION

       Health centers are public/private partnerships. They are 
     nonprofit, private corporations, which are locally owned and 
     operated by the people and communities they serve.
       Health centers are governed by consumer boards--composed of 
     51 percent patients--who represent the community served. This 
     is a powerful link to the community. It not only gives 
     patients and local citizens a voice in the workings of their 
     center--but ensures that care is patient centered and 
     responsive to diverse cultures and needs within the 
     community.
       Health centers revenues are multi-sourced. Federal grants 
     on average represent 36 percent of a health centers budget. 
     Reimbursements from Medicaid and Medicare constitute 38 
     percent. There remainder is leveraged from state and local 
     governments, private contributions, insurance and patient 
     fees.
       Health centers serve in medically underserved communities--
     America's inner cities--migrant farmworker communities--and 
     isolated rural areas. They are defined areas with few or no 
     physicians--suffering high levels of poverty, infant 
     mortality, elderly and poor health.
       Health centers provide care to all people who seek their 
     services. Patients are charged on a sliding fee scale to 
     ensure that income or lack of insurance is not a barrier to 
     care. All patients pay something toward the cost of their 
     care. Medicare and Medicaid as well as private insurance are 
     billed for those with coverage. Federal grants received by 
     centers subsidize the cost of care provided to the 
     uninsured--and the cost of services not covered by public or 
     private insurance.
       Health center care is patient centered and community 
     directed. Centers provide additional services of outreach--
     transportation and translation--education, and case 
     management--to maximize effectiveness in producing long-term, 
     positive health outcomes for high-risk populations. Health 
     centers also deal with costly community health problems such 
     as teenage pregnancy, infant mortality, homelessness, 
     substance abuse, AIDS and others.
       Today, a cost-conscious nation is looking to the success of 
     the U.S. health center model, which has produced the markers 
     to an effective alternative in accessible, affordable 
     community based care. This model has shown that it takes more 
     than governments to solve the problems in health care; that 
     people and community partners must be involved to protect 
     health--to realize cost savings--and to make health care 
     delivery work for more Americans.


                  How Health Centers Make A Difference

       Cost Effectiveness. Health centers provide cost-effective, 
     high-quality health care--second to none. Total health care 
     costs for center patients are on average 30 percent lower 
     than for other providers serving the same populations. 
     Centers also achieve significant savings by reducing the need 
     for hospital admissions and costly emergency care.
       Improving Access. Health centers bring needed health care 
     services and facilities to areas of greatest need--often, not 
     served by traditional providers. They train, recruit, and 
     retain highly skilled health professionals in acute shortage 
     areas.
       Quality Managed Care. Health centers provide comprehensive 
     primary and preventive health care. Ninety-eight percent of 
     health center physicians are board certified/eligible. 
     Centers are linked to hospitals, health departments, nursing 
     homes and other providers as well as social service agencies 
     to ensure that patients have access not only to primary care, 
     but a continuum of coordinated care, including specialized 
     treatment and support services. Numerous independent studies 
     document that health centers improve the health of their 
     communities--reducing preventable deaths, costly disability, 
     and communicable disease.
       Accountability. Health centers meet high, uniform standards 
     of accountability in terms of cost effectiveness and quality 
     care under the Public Health Service Act. Centers are subject 
     to periodic reviews and federal audits, and are required to 
     submit comprehensive health plans detailing health services 
     in their geographic area, demonstrating need and demand, and 
     showing the impact of their intervention. Health centers 
     demonstrate effective use of resources and public and private 
     funds.
       Empowerment. Health centers empower communities to take 
     charge and meet health needs. They engage citizen 
     participation and involvement--facilitate the flow of public 
     and private investment into communities--and generate jobs 
     and new community development.
       Opportunity. Health centers contribute to the well being 
     and strength of communities. By providing cost-effective 
     prenatal care--health centers reduce the high costs 
     associated with adverse pregnancy outcomes. By keeping 
     children healthy--centers enable them to stay in school and 
     train for the future as responsible members of the community. 
     By keeping workers healthy--health centers reduce absenteeism 
     and help workers remain productive and contributing citizens.
       Investment. Health centers yield a substantial return on 
     public and private investment. They are more than providers. 
     Health centers are community assets that improve health--
     provide jobs--strengthen schools--stabilize neighborhoods--
     and enhance community pride.
                                  ____


     Community, Migrant and Homeless Health Centers--United States

 (Presented by: Thomas J. Van Coverden, president and chief executive 
    officer, National Association of Community Health Centers, Inc.)


                 Historical Background and Development

       Community and Migrant Health Center programs were 
     established by the federal

[[Page H9721]]

     government in the decade of the sixties. Conceived as part of 
     a war on poverty, the programs were a major social experiment 
     joining the resources of the federal government and local 
     communities to expand quality and accessible health care to 
     Americans in need.
       Health centers were the product of two powerful forces. 
     Social unrest was erupting in riots for lack of jobs, 
     opportunities, and health care in inner cities. Reform-minded 
     physicians and nurses were calling for a better way to 
     deliver health care by reaching out into communities in need 
     and attacking the problems underlying poverty.
       This step in U.S. health care was historically significant. 
     For the first time, resources were committed by the federal 
     government to assist local communities in development of a 
     community-based primary care infrastructure to serve 
     medically underserved populations. Experimentation with a new 
     model of health care marked recognition of large gaps in 
     America's health delivery system. It confronted the reality 
     that even with expansion of public health insurance to cover 
     broad segments of the poor and elderly, millions of Americans 
     and their families would still lack access to doctors and 
     basic health services because of poverty, cultural, and 
     geographic barriers. Moreover, it conceded that a national 
     war on poverty to help all Americans to education and job 
     opportunities and a better standard of living would never be 
     won without a frontal assault on the problems of inadequate 
     health care.
       Federal grants to public and nonprofit entities for the 
     development and operation of neighborhood health centers 
     (later called community health centers) were made available 
     in 1965 under the Office of Economic Opportunity (OEO). The 
     first two neighborhood health centers opened in rural 
     Mississippi and in a public housing project in Boston, 
     Massachusetts. While services were directed to the poor and 
     near poor, centers also provided care to individuals who 
     could pay all or part of the cost of their health care. 
     During the early years, grants were awarded to established 
     medical entities such as hospitals, health departments, and 
     medical schools. Later this orientation was to change to 
     nonprofit community groups, which reinforced independent, 
     local control over health centers; community management; and 
     a focus on tailoring health services to specific community 
     needs.
       A similar program of grants for the development of migrant 
     health centers was authorized by the U.S. Congress with 
     enactment of the Migrant Health Act in 1962. Centers were to 
     provide medical and essential support services such as 
     translation, outreach, and social service linkages to the 
     nation's migrant and seasonal farmworkers and their families.
       Steadily and with growing local and congressional support, 
     both the migrant and neighborhood health center programs took 
     root. By the mid-1970's and phaseout of the OEO, about 100 
     neighborhood health centers were in operation, mainly in 
     poverty-stricken inner cities and isolated rural areas.


                  phases of health center development

       1965-1975: a period of demonstration projects, with 
     authority broadly defined, but calling for targeted focus on 
     the needs of the poor, accessible health care services plus 
     outreach and full integration and coordination with community 
     resources, and community participation.
       1975-1980: a period of growth with enactment of permanent 
     legislation laying the foundation for community health 
     centers with establishment of standards of clinical practice 
     and administrative efficiencies related to fee schedules, 
     billings and collections, patient care, administrative cost 
     limitations, productivity, and hospital linkages as well as 
     consumer board involvement.
       1981-1990: a period of retrenchment and consolidation for 
     health centers fending off reduced funding and conversion of 
     health center grants to state block grants until 1986.
       1990-Present: a period of expansion and public recognition 
     with changes in federal reimbursement policy for health 
     centers requiring full cost-reimbursement for services 
     rendered to Medicaid and Medicare patients, and federal 
     malpractice coverage for centers and their clinical staffs.
       Health centers have evolved through the years into a 
     dynamic and expanding network of locally-owned, nonprofit 
     community-based health providers. Their mission is a provide 
     comprehensive primary and preventive care to America's poor 
     and underserved. America's health center network, today, is 
     comprised of federally-assisted community and migrant, and 
     homeless health centers as well as other community-based 
     health centers, which are qualified under the Medicare and 
     Medicaid laws.
       Nationwide 2200 health center service sites deliver primary 
     and preventive health care to almost 8.8 million people in 
     urban and rural underserved communities. More than 7.5 
     million people obtain care from health centers that receive 
     funding from the four principal health center grant programs 
     administered by the U.S. Public Health Service: Community 
     Health Centers; Migrant Health; Health Care for the Homeless; 
     and Health Service for Residents of Public Housing. Another 
     1.3 million persons receive care from other federally 
     qualified centers that do not receive federal grant funds. 
     Health centers are located in all fifty states including the 
     District of Columbia and the American territories of Guam, 
     Puerto Rico, and the Virgin Islands.
       In Fiscal Year 1995, Congress appropriated $757 million for 
     the support of America's health center programs. It is a 
     modest sum in public investment given that health centers 
     have been given the challenging task of providing care for 
     some of America's poorest, sickest, and hard-to-reach 
     populations. The typical budget of an urban health center is 
     $3.7 million; a typical rural health center budget is $1.6 
     million. The average health center operates with a main 
     facility and three to four satellite delivery sites, which 
     are all located in the center's service area. The collective 
     budget of the nation's health centers, inclusive of grants, 
     Medicare and Medicaid reimbursements, and other revenues 
     approximate $2 billion annually, which is less than one-
     fourth of one percent of total U.S. health care expenditures.
       In structure, health centers are public/private 
     partnerships. They nonprofit corporations, locally owned and 
     operated by the people and communities they serve. Their 
     revenue base is multisourced. Federal grants, on average, 
     represent 36 percent of a health center's budget. 
     Reimbursements from Medicaid, the public insurance program 
     which pays for the care of many low-income and poor, on 
     average, accounts for 33 percent of a health center's budget. 
     Medicare, which insures the nation's elderly, is 
     approximately 5 percent of a health center's budget. State 
     and local government contributions as well as foundation and 
     private donations average about 11 percent of a health center 
     budget. Eight percent of a health center budget is derived 
     from private insurance and about 7 percent is from patient 
     fees.


                        service characteristics

       The health center mission is to promote high quality, 
     comprehensive health care that is accessible, culturally and 
     linguistically competent, and community directed for all 
     medically underserved populations.
       Health centers are required to provide a broad range of 
     primary and preventive health services including physician, 
     physician assistant and nurse clinician services; diagnostic 
     laboratory and radiology services; perinatal services, 
     immunizations, preventive dental care, disease screening and 
     control, case management, emergency medical services, and 
     family planning services, and hospital referrals.
       The focus of health centers is prevention and health care 
     access. Centers emphasize services that are designed to 
     enhance access and the effectiveness of medical care through 
     outreach, transportation services, heath/nutrition education 
     and case management. Some 98 percent of health centers offer 
     health education services; over 90 percent offer case 
     management service; more than three-quarters offer preventive 
     dental services and in-home laboratory services. All health 
     centers employ outreach and patient relations workers from 
     the communities they serve. Health centers recognize that the 
     risk factors and pervasive needs of patients from low-income 
     underserved communities require health services not typically 
     offered by traditional providers.
       Health centers promote community directed responsive, 
     patient-centered care. Special intervention programs are 
     frequently developed by local health centers to address 
     significant community health needs such as teenage pregnancy/
     infant mortality, AIDS, substance abuse, hypertension, 
     diabetes. Centers also organize the provision of services to 
     ensure that medical care is available at convenient times, 
     and in locations that take into account the special needs of 
     the populations they serve. Many centers offer evening and 
     weekend hours for working families; provide care at multiple 
     sites; use mobile clinics to reach rural and homeless 
     patients, and employ multi-lingual staffs or translators to 
     overcome barriers faced by people who speak little or no 
     English. Bilingual physicians are available at 63% of health 
     centers. All health centers have a 24 hour system for after-
     hours calls and emergencies.
       Health Centers are appropriately linked to hospitals, 
     health departments, nursing homes, and other providers and 
     social service agencies for emergency and specialty referrals 
     as well as counseling and other assistance as may be needed 
     by patients. The goal is to ensure that patients have access 
     not only to primary care, but a continuum of coordinated 
     care, including specialized treatment and support services.
       Health centers serve in areas of greatest need. By law 
     health centers are mandated to serve urban and rural 
     communities that have been designated as ``medically 
     underserved''--areas suffering acute physician shortages, 
     with high levels of poverty, elderly, infant mortality, and/
     or poor health status. Health centers are equally distributed 
     between urban and rural areas. Half are located in isolated 
     rural areas, the other half in economically-depressed inner 
     cities. In these locations, they are often the only available 
     and accessible primary care providers for the patients they 
     serve.
       America's health centers are able to reach 20 percent of 
     America's 43 million medically underserved. They are 
     America's poor and vulnerable--persons who even if insured, 
     nonetheless remain isolated from traditional forms of medical 
     care because of where they live, who they are, and 
     frequently, their far greater levels of complex health care 
     needs.
       Virtually all patients have family incomes below 200 
     percent of the federal poverty levels ($28,700 annually for a 
     family of four in 1994).
       Nearly one in two is completely uninsured, either publicly 
     or privately, and more than one-third depend on Medicaid.

[[Page H9722]]

       44 percent of all patients are children under 18, and 30 
     percent are women of childbearing age (nearly one in ten is 
     pregnant).
       Over 60 percent of health center patients are members of 
     racial or ethnic minorities, compared to 26.3 percent for the 
     nation's population as a whole.
       Health Centers improve access to care. Within available 
     resources, health centers must serve all who seek their 
     services. Patients are charged on a sliding fee scale to 
     ensure that income or lack of insurance is not a barrier to 
     care. All patients pay something toward the cost of their 
     care. Medicare and Medicaid as well as private insurance are 
     billed for those with coverage. Federal grants received by 
     health centers subsidize the cost of care furnished to the 
     uninsured, and additional services not covered by public or 
     private insurance.


                    organization and administration

       Health centers recruit, train, and retain health 
     professionals. They bring physicians and health professionals 
     and needed services and health facilities to people not 
     served by traditional providers. Health center practices are 
     staffed by a team of board certified or board eligible 
     physicians, nurses, physician's assistants, nurses 
     practitioners, nurse mid-wives, dentists, social workers and 
     other health professionals. In rural areas, physicians are 
     typically family practitioners, while larger urban centers 
     are usually staffed with multi-disciplinary teams of 
     internists, pediatricians and obstetricians.
       Health centers employ 5000 physicians. Almost 98 percent 
     are board certified or eligible and all are required to have 
     hospital admitting privileges. The number of other health 
     professions serving the nation's health centers is 
     approximately 6200.
       Health center physicians and staff are salaried employees. 
     Salaries are negotiated and paid out of budget by the 
     individual health center entity. In some cases, staff 
     services may be contracted. The National Health Service Corps 
     (NHSC) also provides a source of doctors and other health 
     care professionals who serve in health centers in partial 
     obligation to repay government student loans and/or 
     educational scholarships. Approximately 1900 NHSC primary 
     care providers serve in underserved/shortage areas. Health 
     center employment for Community and Migrant Health Centers 
     alone is more than 35,700 with a total health center payroll 
     of $1.4 billion.
       Health centers are governed by volunteer consumer boards, 
     composed of leaders and residents of the communities they 
     serve. A unique and distinguishing feature of health center 
     boards is that a majority of board members (51 percent) must 
     be patients of the center and who, as a group, represent the 
     community of patients served. The remaining members of the 
     board must be individuals who are actively engaged in the 
     community with local government, finance and banking, legal 
     affairs, business and/or cultural and social endeavors. At 
     present, there are a total of 12,500 health center community 
     board members.
       Health center boards foster community ownership and local 
     participation. Health center boards meet on a regular basis 
     and are responsible for the approval of the health center 
     budget; financial management practices; the establishment of 
     center policies and priorities; personnel policies, including 
     the hiring and firing of the executive director; evaluation 
     of center activities, including program services and patient 
     satisfaction; and health center compliance with applicable 
     federal, state, and local laws and regulations. Health 
     centers are managed by a team led by an executive director or 
     chief executive officer, including a clinical/medical 
     director responsible or clinical programs and a chief 
     financial officer with responsibility for fiscal affairs.
       Health centers meet high national standards of 
     accountability. They are subject to ongoing federal scrutiny 
     of their cost effectiveness and quality of care. Health 
     centers are required to periodically report to the government 
     on services, utilization, quality measures (for perinatal, 
     pediatric, adolescent, adult and geriatric services, low 
     birthweight, and infant mortality, and hospital admissions 
     and length of stay), financial management and status, 
     billings and collections, and patient satisfaction. In 
     addition, they are required to submit comprehensive health 
     plans for their geographic area detailing services, 
     demonstrating need and demand, and showing the impact of 
     their intervention.
       Health centers hold an unparalleled 30 year track record of 
     providing quality and cost-effective care. Studies 
     demonstrate that health care costs for health center patients 
     are on average 30 percent lower than for other providers 
     serving the same populations. Health centers also achieve 
     significant cost savings by reducing the need for hospital 
     admissions and costly emergency care. The federal grant cost 
     for each patient cared for by health centers is less than 
     $100 annually; and the total cost of health center services 
     amounts to less than $300 when compared to other providers 
     serving similar populations.
       Independent studies further document the success of health 
     centers in achieving positive health outcomes. Communities 
     served by health centers have cut infant mortality rates 10-
     40 percent as compared to those that are not served by health 
     centers. In addition, centers have increased the proportion 
     of children who are immunized and have increased the use of 
     preventive health services such as Pap smears and physical 
     exams. Patients also have expressed overwhelming satisfaction 
     with the care they receive in health centers.


                         community partnership

       Health Centers Empower the Community. The empowerment and 
     involvement of local citizens in planning and governance has 
     been the basic characteristic that has made it possible for 
     health centers to make a difference in medically underserved 
     communities in terms of the community ownership they foster 
     and the tangible benefits they yield. The community is 
     directly involved in every aspect of center operations--from 
     setting policy to staffing vital services, from providing 
     information on community needs to determining whether the 
     center is properly responding to those needs.
       Health center governing boards, composed of community 
     leaders and patients/residents, engage citizen participation 
     and responsiveness to local health needs. In turn, health 
     centers are an integral part of their communities--providing 
     meaningful jobs for local residents, a means to attract 
     investment and other business and forms of community/economic 
     development, a base for community advocacy and action, and a 
     source for developing community leaders and giving them 
     recognition and stature in the community.
       Health center board members and staff are vital to building 
     community ties and partnerships. They are actively involved 
     with schools, hospitals, state and local health departments, 
     community groups, businesses, churches and others in 
     developing health/education programs, identifying community 
     health needs, and creating integrated health networks to 
     enhance service capacity. They reach out to the greater 
     community leveraging support, additional resources, and 
     investment in health center programs. Successful 
     collaborative efforts, for example, are currently helping 337 
     health centers access free prescription drugs for low-income 
     patients. Center ties with universities and medical schools 
     are fostering the training of leaders in community-based 
     health care and promoting health centers as recognized 
     environments for the training of needed primary care 
     physicians.
       Health centers are advocates for the patients and the 
     communities they serve. As a nationwide network, they are 
     using their experience, expertise and ideas to help 
     communities and governments leaders find solutions to health 
     care needs. Through education, communication, and 
     interaction, they are telling their remarkable story of 
     success in serving medically underserved populations--making 
     this nation aware that programs in primary care, outreach and 
     prevention work are essential to expanding access and 
     building stronger and healthier communities.


                                summary

       America's health centers are tested models of community 
     based care. They are partnerships of people, governments, and 
     communities working together to meet health needs. In three 
     decades of growth and development, health centers have become 
     an integral part of America's health delivery system serving 
     as a safety net for the nation's poor and medically 
     underserved.
       America's health centers have yielded a substantial return 
     on public and private investment. They have proven that the 
     special needs of high-risk and vulnerable populations can be 
     met with quality, dignity, and cost-effective health care. In 
     their committed work, they have produced compelling evidence 
     showing the dollar value of their programs, the cost savings 
     to communities, and the positive case-by-case outcomes of 
     primary care intervention.
       Yet, health centers confront serious challenge as the 
     health care industry rapidly consolidates to contain costs 
     and the federal government moves to reduce public spending 
     and shift greater responsibility for health care and other 
     social programs to the states and private sector. The reality 
     is that health centers are being thrust into a price-driven, 
     competitive health care market. In a new managed care 
     environment, centers are being forced to compete not only for 
     scarce resources, but for paying/insured patients and market 
     base, which are vital to their financial viability and their 
     continued ability to serve the poor and uninsured.
       While America's health centers are determined to survive, 
     the problem is that they face large and well-financed 
     providers such as HMOs and other conglomerates, who are now 
     tapping the Medicaid market and competing for lucrative and 
     exclusive managed care contracts with States. In some cases, 
     centers are being forced to contract with purchasers and 
     providers for health care whose bottom line is cost and who 
     have little or no interest in paying for a broad range of 
     social and other support services that have traditionally 
     characterized the health center mission, and which have been 
     the hallmark of their success in achieving quality and 
     containing health care costs.
       The looming question is whether, in the process of 
     integrating into a managed care market, health centers will 
     be able to retain their unique identity as health care 
     providers. Will health centers be able to access the capital 
     and sources of investment needed for growth and development; 
     improved organizational frameworks to leverage strength and 
     capacity as providers; management and financial skills and 
     advanced technologies to sustain a competitive position? Will 
     health centers have access to adequate resources to

[[Page H9723]]

     compete for doctors and other health professional staff? Will 
     the federal government continue to support the health center 
     mission to the extent that appropriate funding and safeguards 
     are provided to ensure a level playing field of competition?
       Today, health centers are aggressively moving to be part of 
     the evolving health care system. In states and communities 
     across the country, health centers are taking steps to form 
     networks and full managed care plans with other local 
     providers, to negotiate subcontracts with other managed care 
     plans, and to develop the financial, legal, and business 
     acumen necessary to effectively function in the new 
     environment.
       Health centers hold many strengths. They are low-cost 
     providers in high-risk markets. Their skills and experience 
     are unsurpassed as providers of patient-centered care to 
     vulnerable populations. They are locally owned businesses and 
     community driven in their approach to meeting health care 
     needs. Health center programs in primary care offer 
     accountability, quality, efficiency and cost savings. In 
     addition, they hold tremendous assets in a nationwide solid 
     infrastructure ready for fast-track development to meet 
     growing health needs.
       America's health centers stand prepared to build on their 
     heritage and compete and endure in the future.


                               references

       Access to Community Health Care--A State & National 
     Databook. National Association of Community Health Centers, 
     Inc., Washington, DC, 1995.
       America's Essential Providers: The Foundation of Our 
     Nation's Health System. Gage, Larry S., National Association 
     of Public Hospitals; Willson, Peters D., National Association 
     of Children's Hospitals and Related Institutions; Finerfrock, 
     Bill and Thometz, Alice, National Association of Rural Health 
     Clinics. Jointly published, 1995.
       America's Health Centers. National Association of Community 
     Health Centers, Inc., Washington, DC, 1995.
       America's Health Centers: Value in Health Care. National 
     Association of Community Health Centers, Inc., Washington, 
     DC, 1995.
       Basic Information--Community & Migrant Health Centers. 
     National Association of Community Health Centers, Inc., 
     Washington, DC, 1992.
       Community and Migrant Health Centers: A Key Component of 
     the U.S. Health Care System--Overview and Status Report. 
     National Association of Community Health Centers, Inc., 
     Washington, DC, 1991.
       Community Health Centers: Engines for Economic Growth. 
     National Association of Community Health Centers Inc., 
     Washington, DC, 1994.
       Improving Access to Care for Hard-to-Reach Populations. 
     National Association of Community Health Centers Inc., 
     Washington, DC, 1992.
       Lives In The Balance: The Health Status of America's 
     Medically Underserved Populations. National Association of 
     Community Health Centers Inc., Washington, DC, March 1993.
                                  ____


Bureau of Primary Health Care: 43 Million People Lack Access to Primary 
                              Health Care


                               unmet need

       Forty-three million persons without access to a primary 
     care provider; 41 million persons are uninsured; minority 
     health status disparities.


                    pressures facing the safety net

       Reduced Medicaid revenue from managed care: reimbursement 
     rates down; reduction in Medicaid eligibles.
       Increase in the number of uninsured served; e.g. health 
     center uninsured up 46% from 1990-96 (national up 16%)
       Mergers/Privatization decrease capacity: reduced outpatient 
     provider capacity.


                             health centers

       Private, not-for-profit organizations: true safety net 
     providers, obligated to serve all patients without regard to 
     ability to pay; community-based governing boards, and 
     community supported; located in underserved areas; provide 
     comprehensive care services and enabling services; improve 
     health outcomes and decrease Medicaid costs; 685 center 
     grantees; services provided at 3,032 sites (incl. NHSC); over 
     10 million uninsured and vulnerable patients served; 33 
     million encounters in 1996; and 5,500 primary care providers.


                 health center patient characteristics

       42% children; 32% women of child-bearing age; 65% minority; 
     41% uninsured; and 85% poor and near poor.


       chcs as ``economic engines''--the economic benefit of chcs

       CHCs as ``employers'': CHCs are often one of the largest 
     employers within their immediate service area.
       CHCs as ``purchasers'': CHCs are often one of the largest 
     purchasers of goods and services within their service area.
       CHCs represent a significant and vital source of economic 
     inertia for local communities which is consistent with the 
     objectives of emerging economic development initiatives.


               response of health centers to managed care

       Individual contracts with managed care organizations; 
     Formation of health center-owned health plans and MCOs; and 
     Development of integrated service networks to contract with 
     managed care organizations.


   market share--health center-owned managed care plans in 12 states

       Number of States: first in market share: Connecticut; New 
     York; California; Massachusetts; Colorado; and Washington
       Second in market share: Rhode Island.
       Third in market share: Maryland and Oregon.
       Fourth in market share: Ohio; Hawaii; and Missouri.


                    solutions not business as usual

       Increased partnerships; integrated networks/delivery 
     systems; innovative models of care; and document impact.


                             health centers

       Agents of care.
       Agents of change: Integrated delivery system; making system 
     responsive to local needs; and giving communities control.


                      health centers as solutions

       Serve everyone regardless of ability to pay; guaranteed 
     access through enabling services; empower communities; 
     improve health outcomes and lower Medicaid costs; and 
     economic engines and create jobs.

                The ``Community'' in Health Care Centers

       The most frequently mentioned aspect of consumer 
     involvement in the health center programs is the fact that a 
     majority of each center's policy, or governing board must 
     consist of persons who are patients of the center and who, as 
     a group, represent the community of patients served there. We 
     use many terms to describe this characteristic of the health 
     centers: consumer-controlled, consumer-directed, community-
     responsive, and so on. Their majority status on the health 
     center policy boards gives patients control in determining 
     how the centers operate: what services are provided, the 
     locations and hours of operation, the sliding scale fee 
     discount system, the annual budget and program plans. But the 
     real value of this patient-majority governance system lies in 
     the fact that, as a result of it, the community is given a 
     true sense of ``ownership'' over the health centers; and this 
     feeling of ownership makes the centers a course of community 
     empowerment, in which the centers serve as the basis and 
     focal point for a whole host of activities that serve the 
     community and its people. When the community is empowered in 
     this fashion, they will actively involve themselves in being 
     a part of its work (a part of the solution, not the problem). 
     They will care for and nurture ``their'' system of care, and 
     they will fight like hell to keep it going. This experience 
     plays itself out in any number of ways, such as:
       Creating a forum for bringing real and immediate problems 
     to the table for action. This clearly happens as a natural 
     part of the regular policy board meetings; but most health 
     centers also reach out to the whole community as part of 
     their needs assessment process. For Asian Health Services, in 
     Oakland, CA, this has meant community meetings conducted in 6 
     different languages to involve each of the population 
     subgroups they serve: Korean, Japanese, Chinese, Laotian, 
     Cambodian, and Pacific Islander. Their efforts have been 
     rewarded with high community turnout and solid input from the 
     residents.
       Getting feedback on the acceptability and appropriateness 
     of services and the centers' program plans. Here again the 
     policy boards provide a vehicle for evaluating the center's 
     responsiveness to the community's needs. Consumer board 
     members bring the community's needs and concerns and 
     complaints about the health center to the board for 
     consideration. This is perhaps the most important role they 
     can play.
       Providing a training ground for community leaders and 
     spokespersons--including board members and center employees--
     and giving them credibility, recognition, and stature in 
     advancing or advocating community needs or concerns.
       Providing a means and forum for involving community 
     residents, and the community itself, in the political process 
     and system--at the local, state, and national levels. The 
     critical value of this point is that several individuals in 
     the health center movement have--for perhaps the first time 
     in their lives--involved themselves actively in our American 
     political system. This has helped the movement itself, which 
     has survived and benefitted from their advocacy. 
     Through NACHC and the State Primary Care Associations, 
     community residents have found an invaluable mechanism for 
     taking on critical health policy issues, and winning for 
     their communities. As a direct result of their experience, 
     many health center representatives have become quite 
     involved in local, state, and national politics--for 
     example, former board member Danny Davis is now a Member 
     of Congress; community representative Lenny Walker is now 
     a Rhode Island state representative; and former center 
     Director Harvey Sloane has served as Mayor of Louisville 
     and almost became Kentucky's junior U.S. Senator.
       Serving as a conduit of important information to and from 
     the community. Whether this involves information on how to 
     avoid common childhood injuries or potentially serious 
     agricultural accidents, warnings about unsafe water supply 
     sources or the emerging incidence of an infectious disease, 
     or whether the community provides information that the center 
     needs to better serve its needs, the centers can serve as a 
     vital communications link for the entire community. For 
     example, a Brownsville, TX health center brought considerable 
     national attention to a growing local controversy, reported 
     in the New York Times and on ABC's Prime Time

[[Page H9724]]

     Live, involving the center's report of an abnormally high 
     number of births to babies with severe anencephaly and a 
     possible connection to certain airborne toxins being emitted 
     from nearby chemical plants. Here, obviously, the center is 
     serving both as an information source and as an advocate for 
     its community.
       Generating action in response to community needs, even in 
     case where those needs might not appear to be health-related. 
     Whether it is the affordable, low income housing developed by 
     health centers in Boston and Wood River, RI, or the community 
     water supply and sewer systems spawned by centers in Beaufort 
     County, SC, and the lower Rio Grande Valley of Texas, health 
     centers all over the country have played key roles in 
     organizing their communities to address pressing local needs.
       Providing jobs and meaningful employment for community 
     residents. In particular, when respected community people are 
     employed and trained by the health center as outreach or 
     community health workers, or as patient advocates, or in any 
     of the dozens of clinical and administrative positions, it 
     can be the start of a long and rewarding health career. Many 
     health center directors today are community residents who 
     have worked their way up the ladder at the health center over 
     the past 15 or 20 years. Employees with the longest tenure at 
     health centers--often dating back to the center's founding--
     are local community residents. One such person recently 
     stated, ``It's been a wonderful experience, working at a 
     great place like a health center, serving the community and 
     helping my neighbors and friends--and being paid a decent 
     salary to boot!''
       Serving as a source of information and inspiration--
     complete with role models--for the community's youth, 
     encouraging them to pursue a health professions career, and 
     showing them how (and where) they could put that professional 
     training to good use by coming back to serve their old 
     neighborhood or town. Dr. Jack Geiger, one of the founding 
     fathers of the health center movement, recently spoke of what 
     he saw as the real successes of one of the country's first 
     centers, in Mound Bayou, MS. In doing so, he noted that the 
     center had either trained or assisted in helping to train the 
     county's first black sanitarian, several of the physicians 
     now working at the health center, and literally dozens of 
     other professionals working there and at other centers across 
     the country.
       Serving as an ``anchor'' in their communities, helping by 
     their presence to attract or retain other local businesses--
     including other physicians, diagnostic services, pharmacies 
     or other health providers--or to bring in other forms of 
     community or economic development. In a very real sense, many 
     health centers have played pivotal roles in sustaining a 
     sense of ``community'' in neighborhoods or towns that 
     otherwise might well have completely disintegrated, giving 
     its residents a feeling of pride and a ``can-do'' attitude, 
     which in turn has led to significant neighborhood or 
     community revitalization.
       Thus, the critical, distinguishing factor that separates 
     the health center model of community empowerment from other, 
     less successful models, is that the community has been 
     directly involved in virtually every aspect of the center's 
     operations--from setting policy to staffing vital services, 
     from providing information on community needs to determining 
     whether the center is properly responding to those needs, 
     and, in turn, the health centers have become an integral part 
     of their communities--providing meaningful jobs for local 
     residents, a means to attract other businesses and other 
     forms of community/economic development, information and 
     opportunities for pursuing health professions careers, a base 
     for community advocacy and action, and a source for 
     developing community leaders and giving them recognition and 
     stature in the community. The greater the degree of community 
     involvement in the health center, the greater the center's 
     role and strength as a vital part of the community itself.
       Today, we are in the midst of sweeping changes in the way 
     health care is both financed and delivered, all across the 
     country. As the numbers of uninsured have reached levels not 
     seen since before the creation of Medicare and Medicaid, and 
     as health care costs continue to skyrocket, health care has 
     reached the ``hot button'' level as a public policy issue. 
     The growth in HMOs, PPOs, institutional networks, financing 
     bureaucracies, consolidated services, hospital closings and 
     transitions, self-funded insurance plans--all these thing 
     point to major, fundamental shifts in our health care system. 
     By the end of the decade, there will be no more Marcus 
     Welbys, even in group practice form. Every provider--
     physician, dentist, midlevel--will work for ``the man''. For 
     us, the big question is who will ``the man'' be? Will it be 
     the government, an HMO, an institutional network--or the 
     community.
       The health center model is our last, best hope for 
     community-directed, community-responsive health care. Health 
     centers may well be the closest things to Marcus Welby in the 
     21st century--the last real opportunity for the community to 
     have a voice in how its health care system functions and 
     meets their needs. We in the health center movement--yes, we 
     still see it as a movement--have our plan, our Access 2000 
     plan, to bring top quality health care to all 43 million 
     medically underserved Americans by the turn of the century. 
     It's a hefty order, to be sure, but we are committed to that 
     vision, that struggle; and yet, we cannot succeed without an 
     equally committed band of health professionals--and we need 
     to find and train them in record numbers, if we are to have 
     any chance at success. As our health center movement expands 
     and grows, we will continue to need the best and brightest 
     clinicians, to provide care and leadership.
  Mr. TOWNS. Mr. Speaker, I rise to day to urge my colleagues to 
support Community, Migrant and Homeless Health Centers and other 
community-based providers that comprise successful models for health 
care delivery across this Nation.
  Community health centers benefit the residents and the areas where 
they are located in many ways. First, with the partnerships between 
business, government and the people, community residents have a greater 
sense of control over the quality of health care and the means of 
gaining health care. This is particularly shown in the health centers 
that are governed by consumer boards. These boards, where more than 
half of the board members are patients, represent the community served 
and give local residents a voice regarding the programs and center's 
services. With community representation on these boards, responsiveness 
is no longer a concern--who best knows what services communities need 
than the people who reside in the community?
  Second, health centers service communities which are traditionally 
and chronically underserved. Often, the inner cities, migrant 
farmworker communities, and isolated rural areas benefit greatly from 
these health care services. These often forgotten populations also now 
have access to quality managed care; health centers provide 
comprehensive primary and preventive health care. All patients, 
especially women with their particular health care concerns, can look 
forward to up-to-date yearly medical exams. We know that the key to 
health care is taking preventative measures. With community health 
centers, we can do this by low-income seeing patients early and 
regularly.
  Finally, health centers save money. In total, they provide cost-
effective, high-quality health care. The total costs for patients are 
on average 30 percent lower than for other providers serving the same 
populations.
  Mr. Speaker, I urge my colleagues to support community health 
centers. In my district these centers have played a vital role, as I am 
sure they have done in other districts, and we should support them as 
they continue to support our communities.

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