Growing Community Health Centers to Improve Primary Care

Grantee Name

Multiple Grantees

Funding Area

Primary Care

Publication Date

December 2018

Grant Amount

16 grants totaling $1.6 million

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With the passage of the Affordable Care Act (ACA), NYHealth recognized that successful implementation of federal health reform would require expanded primary care capacity to both care for the influx of newly insured people and ensure a strong safety net for those who remained uninsured.

It was estimated that 1.2 million more New Yorkers statewide would gain coverage as a result of the ACA, whereas up to 1.4 million could remain uninsured—many of whom would rely on community health centers (CHCs) for their primary care needs. Those providers that are federally qualified health centers (FQHCs) are meeting high standards in quality of care and services offered, including primary care and dental, behavioral health, and preventive care services. CHCs were a cornerstone of the ACA’s plan to develop primary care capacity; the law allocated $11 billion over five years to double CHC capacity nationally. But as the new health care law went into effect, many CHCs were already laboring with low margins and limited funding. The growing demand expected under the roll-out of the ACA would add to these struggles if CHCs did not take measures to grow their services, staff, or physical capacity.

To meet this growing need for access to primary care services, NYHealth issued two Requests for Proposals (RFPs), “Promoting and Managing Growth at Primary Care Centers,” to support CHCs in New York State to take practical steps to care for more patients, expand existing sites, establish new sites, and/or increase the range of services provided, including behavioral health, dental, optometry, and pharmacy. Through these RFPs, grants of up to $100,000 were made available to FQHCs, FQHC look-alikes (organizations that meet all of the requirements for, but do not yet receive, federal grant funding), and comprehensive diagnostic and treatment centers in medically underserved regions of the State. Through both RFPs, NYHealth awarded 16 grants totaling $1.6 million to CHCs statewide.

Outcomes and Lessons Learned

Supported 16 projects across the State that would grow the volume or scope of services to serve more patients.
Allowed for funding to go to costs for which there are usually no other sources readily available: real estate consultants, architects, signage and advertising, recruitment, legal and regulatory services, and business planning. CHC leaders themselves identified these as among their biggest needs that were the hardest to fund.
Initiated or grew specific services, like dental care or OB-GYN services, that were previously lacking in their communities.
Hired new physicians, added additional exam rooms, or conducted targeted community outreach to increase the numbers of patients served.
Reached an additional 57,892 patients in 2016 as compared with 2012—a 123% increase in the number of patients served by these CHCs across the State.

Along with the many successes of the initiative, the CHCs also faced obstacles in implementing their projects and learned important lessons over the course of the grant period. During the process, some of the sites found that stakeholder and community buy-in was not what they had expected. For example, a couple of CHCs discovered that, despite having worked in the community for many years, establishing a new site was still difficult. Vast geographical distances between their headquarters and the new site locations made it a challenge to gain community input or led some to deem them as outsiders. Other CHCs faced issues such as under-estimating the costs of projects and changing leadership during project implementation. And after integrating primary and behavioral health care services, one clinic faced a higher-than-expected demand for such services that led to a backlog.

CHCs are part of the safety net’s backbone. These centers provide necessary services to hundreds of thousands of New Yorkers who require primary care. Federal attention to CHCs has emphasized their contributions and ensured renewal of federal grant funding for the centers. Many of these organizations funded by NYHealth have since gone on to further expand their services, as demand continued to grow and their role in the community deepened.

Read the full report.

Co-Funding and Additional Funds Leveraged: N/A

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