News & Government

Connecticut’s Community Health Centers:
We Care For Your Community’s Health — 2003 Position Paper

Overview
More than half a million visits are made to Connecticut community health centers each year by people from over 140 towns and cities in our state. Community health centers are easily accessible and affordable safety providers that offer comprehensive, family-oriented, culturally competent medical, dental and social services to the people who need them. Every day community health centers throughout Connecticut act as first responders to prevent and address medical and social issues before they reach an acute or chronic level.

The state’s community health centers are federally mandated and were established in the 1960s to meet the needs of those with little, or no ability to pay for health care. The founders saw quality, personalized medical care as a right of all people and established a policy that no patient would be turned away. Since their inception, health centers have evolved in number, size, and scope of services, and are leaders in the delivery of quality care to Connecticut’s communities. Currently, community health centers operate from more than 50 different sites throughout the state and are one of Connecticut’s largest health care systems.

State funding is critical to ensuring that Connecticut’s community health centers remain viable and accessible to all those who need them. With the numbers of uninsured people rising, more Connecticut residents than ever before will be turning to community health centers to meet their family’s medical, dental and social service needs.

This report summarizes data on Connecticut’s community health centers and illustrates the crucial role they play in the well-being of the entire state. It demonstrates the broad range of services the following health centers provide and how Connecticut benefits from these services.

Bridgeport Community Health Center Charter Oak Health Center Community Health Services East Hartford Community Healthcare Fair Haven Community Health Center Generations Family Health Center Hill Health Center Norwalk Community Health Center Southwest Community Health Center StayWell Health Center Vernon Area Community Health Center

What We Do
Community health centers are the front-line of primary health care, from full-service clinics to school-based services to programs for migrant workers and the homeless. Teams of interdisciplinary health care professionals, including primary care physicians, nurse practitioners, certified nurse-midwives, physician assistants, dentists, dental hygienists and mental health professionals, all work together in community health care centers to ensure that patients receive attentive and quality care.

Community health centers help patients gain access to programs that make their lives easier. Health center staff match patients with programs such as the HUSKY Plan, Medicaid and WIC and work with them through the application process. Medical and personal issues are sensitive in nature and for many, it is difficult to trust a medical professional. It is the one-on-one, personal interactions and relationships patients build with professionals and staff that distinguish community health centers from other facilities where staff are rotated frequently. The scope of services community health centers provide also goes well beyond traditional medical services. Comprehensive support services include:

Primary care Prenatal care Dental services Mental health counseling Immunizations Nutrition counseling HIV education/ prevention AIDS family social services Case management School-based clinics Family planning Homeless support services Substance abuse counseling Pharmacological screening 12-step programs

Domestic violence prevention Senior abuse screening Migrant healthcare Cancer, health screenings Diabetes management Childbirth classes Neonatal home visits Breast-feeding classes Asthma treatment Early education supports Substance abuse referrals Flu clinics Nutritional assessment

The convenience and accessibility of community health care centers that are located in or near the neighborhoods where many of their patients reside make them a preferred and often necessary option.
 

Who Needs Us?
"My patients are hard-working people who often hold not one but as many as three jobs to pay their bills, clothe their children, and put food on the table. Most of them earn just enough to be ineligible for Medicaid ... They’re forced to decide between paying rent and getting the health care they need.” - Margaret Pereyda, health center physician.
 

The People
Community health centers offer one-stop shopping for patients’ health care services, whether the need is medical, dental or psychosocial. Last year, one in every 22 Connecticut residents, a total of 161,408 people, received their health services at community health centers. Almost a third of those patients, 54,000 people, were uninsured. Many were from working families whose jobs either did not offer health coverage, or, if they did, the employee’s share of the premiums was unaffordable.

Health center patients encompass all races, ages and walks of life. Nearly one-third of the health center patients are women, age 25-44. Another third of the patients are children. The number of patients seen by community health centers has been steadily increasing; in 2002 Connecticut’s health centers served 18,800 more people than in 2001. Working families are increasingly at risk of becoming uninsured; in the future, more Connecticut residents will be turning to community health centers for their care.
 

The Hospitals
Community health centers prevent a domino effect of higher-cost health services by maintaining a patient’s health so they don’t reach the acute point of hospitalization. Increased use of community health centers has proven to reduce utilization of emergency room care and admissions at Connecticut hospitals.

Last year, the 3.3 million people who live in Connecticut made an average of 1.3 million hospital emergency room visits. A 1994 Stamford University study reported that 10% of all emergency room visits are for non-urgent conditions that could be treated in a primary care setting, such as a health center or physician’s office. Researchers estimated that between $5 billion and $7 billion would have been saved nationally if the needed care had been provided in a more appropriate setting – this equates to a potential $650 in savings per unnecessary ER visit. The following estimates show that a combination of increased health center use and reduced utilization in emergency room care at Connecticut hospitals could save $86.2 million annually:

1.3 million Connecticut ER visits x 10% = 132,574 unnecessary ER visits 132,574 x $650 = $86.2 million in unnecessary care costs that would be saved.

The State of Connecticut
Community health centers in Connecticut save the state $30.5 million annually in state Medicaid expenditures. According to the Kaiser Commission on Medicaid and the Uninsured, the Connecticut Medicaid program spends $1,603 per beneficiary for children under age 20, $2,175 per beneficiary for adults age 20-64 and $21,398 per elderly beneficiary. The average total Medicaid spending for each health center Medicaid patient was $3,133. Several studies have found that health centers save the Medicaid program more than 30% in annual spending per beneficiary due to reduced specialty care referrals and fewer hospital admissions. According to the federal Uniform Data System, Connecticut community health centers served 67,088 Medicaid patients in 2002:

$3,133 x 30% = $940 in annual savings per health center Medicaid patient $940 x 67,088 patients = $63.1 million in total annual Medicaid Savings 63.1 million x 50% = $30.5 million in Medicaid savings in 2002 for the state

The 1,250 people employed by Connecticut community health centers are also a plus for Connecticut’s employment and spending outlook.

Three Important Facts Connecticut Taxpayers Should Know About the
Cost-effectiveness of Community Health Centers
Fact 1:
Centers save the state $30.5 million annually in state Medicaid expenditures alone.
Fact 2:
The federal government saves $5.89 in Medicaid expenditures for every $1 it invests in Connecticut’s community health centers through the federal primary care grant programs.
Fact 3:
Increased use of health centers and reduced utilization in emergency room care at Connecticut hospitals could save $86.2 million annually.
 

How You Can Help!

“The number of Americans without health insurance rises and falls for a variety of reasons, but the state of the economy is undoubtedly the most significant factor.”
– Robert Wood Johnson Foundation report “Covering the Uninsured”

Community health centers are nonprofit public agencies that serve more than half a million people in Connecticut. The state funding we receive is a critical piece of financial support for us; more than ever we need it to maintain a health care safety net for the people of Connecticut. Here is why:

Over the last several years state funding of community health centers has been reduced to the point that we are now below our 1997 state funding level. Any funding level change at this point will disable the system and the system’s ability to cope with a new influx of uninsured patients. The changes in HUSKY and SAGA planned for April and June of this year will add more than 50,000 uninsured patients to our health center patient rolls. Historically, 70% of our uninsured patient costs are ultimately recorded as bad debt. Even when community health centers receive payment for services from uninsured patients, sliding fee scale reimbursements per visit are about $85 less than the reimbursements from Medicaid and insurance. So community health centers are already running in a deficit position. We have maximized our operating efficiencies to the point where the capacity to serve our patients will be greatly diminished by cuts to staff, services and hours of operation.

We ask the state to continue its financial support of community health centers at $5.2 million. If community health centers are not available for uninsured patients, they will have no option but to seek emergency room services or hospital admission. This would put the entire health care community in a downward spiral financially and erase the $86.2 million benefit Connecticut taxpayers realize through the state’s $5.2 million funding of community health centers. If $2.6 million is cut, as proposed by Governor Rowland, hospital emergency rooms, Connecticut taxpayers and other health facilities will be burdened with $8.2 million in additional costs.
 

Connecticut Primary Care Association Contact Information:
Evelyn A. Barnum, J.D.
Executive Director
90 Brainard Road
Hartford, CT 06114
860.727.0004
E-mail: [email protected]
www.ctpca.org

The Connecticut Primary Care Association (CPCA) was established in 1989 as the voice of Connecticut’s nonprofit community health centers. Our mission is to promote and further the delivery of comprehensive, accessible, family-oriented community-based health care. Our primary focus is education of the public, health policy makers, and health care providers. CPCA provides on-going information on community health center clinical performance and programs to Connecticut’s decision-makers and elected officials.