[Congressional Record Volume 150, Number 130 (Monday, October 11, 2004)]
[Extensions of Remarks]
[Pages E1873-E1874]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




         HONORING THE CONTRIBUTION OF COMMUNITY HEALTH CENTERS

                                 ______
                                 

                         HON. RAUL M. GRIJALVA

                               of arizona

                    in the house of representatives

                       Thursday, October 7, 2004

  Mr. GRIJALVA. Mr. Speaker, community health centers (CHCs) are at the 
forefront of the noble endeavor to provide quality health care to our 
nation's most underserved communities. Nearly 900 CHCs throughout the 
country treat more than 12 million patients who are typically low-
income, uninsured, and disproportionately affected by chronic diseases 
such as diabetes. Ninety percent of patients live at or below 200% of 
the federal poverty level, and nearly half (5 million) lack health 
insurance. CHC patients are predominantly women, who require 
gynecologic and obstetric care, as well as pediatric care for their 
children. CHC patients are also ethnically and linguistically diverse--
with nearly one-third whose native tongue is not English.
  Not only are many CHCs the sole source of health care in the 
underserved communities where they operate, but they are also the sole 
providers of other crucial services such as dental care, mental health 
counseling, substance abuse treatment, and assistance to domestic 
violence victims. In my state, Arizona, CHCs service about 350,000 
people in 85 neighborhoods--from densely populated urban centers to 
far-flung rural towns and tribal communities deep in desert locales, 
miles away from the nearest community. Last year, nearly 1.5 million 
visits were made to Arizona's CHCs.
  Clearly, health centers save our health care system an untold amount 
of money by treating patients who, due to lack of access and finances, 
would otherwise end up in the emergency room needing intensive and 
expensive treatment. Yet, CHCs struggle to generate adequate revenues 
to maintain their operations. They do not pocket any of the savings 
they bring to the system, which are instead transferred by hospitals 
and private physicians. And while the latter can absorb losses from 
treating uninsured patients due to their high percentage of privately 
insured patients, CHCs receive the majority of their reimbursement from 
Medicaid, which accounts for 36% of all their revenues. Federal grants 
make up the second largest source of funding, at 22%. By contrast, only 
six percent of CHC revenues come from reimbursements of private 
insurers.
  This year, the House allotted $1.84 billion to the federal CHC direct 
grant program in the FY 2005 Labor, HHS and Education appropriations 
bill. Although this is a welcome increase from the federal government's 
funding of $1.57 billion for FY 2004, I am disappointed that the Health 
Community Access Program was eliminated. Without Medicaid, however,

[[Page E1874]]

CHCs would collapse. Many are already suffering from inadequate or 
irregular Medicaid funding, as states slash their budget expenditures 
and seek cost-saving Medicaid waivers that, for instance, allow them to 
cap the number of enrollees. To empower CHCs to function at their full 
potential, we must ensure that the Medicaid program is secure and well-
funded. The federal government has a moral obligation to support the 
life-saving work of community health centers.

                          ____________________