LITTLE ROCK — Arkansas’ network of federally funded community health clinics served more than 155,000 patients last year, but advocates who just returned from a week of lobbying in Washington say many more go without care.
“In Arkansas, we’ve got over 555,000 people whose health-care needs aren’t being met,” said Sip Mouden, chief executive officer of Community Health Centers of Arkansas Inc.
Mouden was among three health advocates chosen by the National Association of Community Health Centers to tell their states’ stories during a Capitol Hill briefing March 20 in which congressional aides heard its pitch for more grant funding for the clinics, which primarily serve the low-income and uninsured.
On March 22, the advocates met with members of the congressional delegation, save for one. U.S. Rep. Steve Womack, R-Ark., was on the House floor voting at the time, so Mouden said her group met with one of his legislative assistants.
The Arkansas association’s trip coincided with the national group’s release of its report, Health Wanted: The State of Unmet Need for Primary Health Care in America, as well as with its Policies and Issues Forum, which ended March 25.
The community health centers, also known as “federally qualified health centers,” are often confused with free health clinics. They serve patients on an income based, sliding-scale fee, and meet certain other criteria to qualify for federal grant funding such as offering comprehensive primary health-care services.
Grants for the centers come from the Health Resources and Services Administration, the federal government’s primary agency for helping communities defined as being “medically under served.” Each of the clinics also must be governed by a community board composed of 51 percent or more of health-center patients who represent each clinic’s service population.
“I’m all for free clinics,” Mouden said last Monday. “In fact, I think they are an important part of our health care delivery system.”
But in her experience, when patients take ownership of their treatment plan and take some financial responsibility for it, they have better health outcomes, she said.
“When a patient has some financial ownership - if you’ve got ‘skin in the game’ you’re going to hang in there, you’re going to be responsible for yourself,” she said.
Nearly 70 percent of Arkansas’ 154,575 patients served by community health centers in 2011 were uninsured or poor enough to qualify for Medicaid. Another 18.7 percent of patients who sought care at the clinics had private health insurance and 11.4 percent were on Medicare.
The term federally qualified health centers often is used to describe “parent” clinics that can apply for the Health Resources and Services Administration grants, either for their own clinics or other satellite clinics, health advocates have said.
NO CLINICS FOR SOME
When Mouden joined the Little Rock-based Arkansas association in 2001, there were nine federally qualified health centers with 45 clinic locations in the state. Now there are 12 federally qualified health centers with 75 clinic locations in 44 Arkansas counties, she said.
But that means 31 Arkansas counties still don’t have such a clinic, she said. And according to the administration’s website, the vast majority of Arkansas counties are federally designated as “medically under served,” which means there are too few primary care providers, a high infant mortality rate, high poverty or a high elderly population.
Nationally, “at least 25 percent of U.S. counties in greatest need do not have a health center,” the parent association wrote in its Health Wanted report.
Kathy Grisham, executive director of the Springdale based Community Clinic, said her staff wrote a grant proposal in late 2010 that went unfunded.
“Sometimes they will award, but not fund,” said Grisham, who was among those who joined Mouden on the recent Washington trip. “It may be that they just can’t keep up.”
HELP FROM CONGRESS
According to the Health Wanted report, the Patient Protection and Affordable Care Act provided a dedicated funding stream for community health centers in 2010, but Congress cut the federal health budget allocation for the centers by $600 million in fiscal year 2011 and less than 10 percent of 1,900 grant applications in the country were funded.
For fiscal 2012, Congress provided $200 million in additional funding that could award some of 1,800-plus pending applications, but the national group predicts many will remain unfunded.
A spokesman for Womack, J.R. Davis, said he understands the importance of community health centers in the health care system.
“As with all federal grants, he wants to make sure that the agency is distributing all funds made available, and he’s hopeful that [in general] agencies are acting as good stewards of taxpayer money and vetting all applications thoroughly,” Davis said.
“The congressman is just as concerned about it as everyone else,” he said. “He knows this process sometimes takes longer than he, his colleagues and grant applicants hope it will take.”
Two members of the delegation who’ve recently been honored by the health associations for their support in the past, Sen. John Boozman, R-Ark., and Rep. Tim Griffin, R-Ark., weren’t specific last Monday on how they help the clinics.
Boozman spokesman Sara Lasure said the senator “has taken the lead on urging the Appropriations Committee to continue supporting community health centers because of their proven track records of health outcomes at lower costs.”
The senator is one of 40 to sign on to the letter to the Senate Appropriations Committee, which asks for continued support for health centers because of their success in strengthening primary care capacity, improving people’s health and lowering health care costs, Lasure said.
During the Capitol Hill briefing, Mouden joined Maryland’s Allen J. Bennett, president and CEO of Park West Health Systems Inc. of Baltimore, and Nancy A. Sink, CEO of Family Health Care of Northwest Ohio Inc. in Van Wert, in telling how the health centers help their states.
Arkansas, Pages 7 on 04/02/2012