Funding the ties that bind
- By GHIT Staff
- Feb 13, 2006
To link safety-net health clinics, start small, go slowly and stay close to community stakeholders
When Hurricane Katrina swept into the Gulf Coast last summer, it destroyed New Orleans’ public health care infrastructure. Whatever health care safety net that had existed for the city’s poor and uninsured residents, including nine community clinics funded by the federal Health Resources and Services Administration (HRSA), was wiped out with clients’ health records.
A network of similar community health centers, many of which were also funded by HRSA grants, quickly arrived on the scene. HRSA Administrator Elizabeth Duke said HRSA-funded health centers located near the hardest-hit areas treated 42,000 evacuees from New Orleans within two weeks after Katrina hit.
The centers faced funding uncertainties and the challenge of working with patients who were often low income, uninsured or homeless. The community clinic movement’s response to Katrina is the result of a bottom-up approach to community building. That strategy preaches incremental progress — building on small successes, staying flexible and meeting regularly with stakeholders.
“You don’t want to let the perfect to be the enemy of the good,” said Erin Grace, senior vice president of health informatics at the Primary Care Coalition (PCC), a Montgomery County, Md., nonprofit health care funding and development organization that works to link the region’s safety-net clinics together. “It’s an incremental process — you ask for input from everybody. You try to get their engagement. But ultimately, you take the ones that are willing to come and hope the rest will ultimately follow.”
As a self-proclaimed facilitator, PCC funnels donations and grants from private foundations, local governments and federal agencies to eight county community health organizations. It also receives HRSA Community Access Program grants, and Montgomery County has agreed to fund PCC through a program called Montgomery Cares. The county contributed about $4 million to Montgomery Cares in 2005 after starting the program with $250,000 in 2000. Plans call for increasing the program’s funding to $15 million to $20 million in five years to help the county achieve its goal of becoming the healthiest in the country.
But the goal is fraught with problems. Many of the region’s clinics are bare-bones operations that rely on volunteer doctors and nurses to cover an uninsured population of 80,000 to 100,000 residents.