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Community health centers have vital role to play in health care for the needy

Federal stimulus dollars continue to provide additional financial underpinning for St. Louis' system of health care for the needy. Grace Hill Neighborhood Health Centers is a recent beneficiary of stimulus money, and it has used those funds to replace and upgrade two of its facilities.

Last month, the organization opened Grace Hill Health Center South in the Alexian Plaza Building, 3930 South Broadway. The center was formerly located at 3400 South Jefferson. Earlier in the summer, the group opened Grace Hill Water Tower Center at 4414 North Florissant Ave., a state-of-the-art facility across the street from another of its now-closed sites.

The two facilities show the important role of neighborhood health centers in the Obama administration's plans to remake the country's health care for the poor. 

"Community health centers are both the front line and the safety net, proactively educating patients, doing outreach and, as the safety net, helping people who fall through the cracks," says Rima Cohen, counselor to the Health and Human Services Secretary, Kathleen Sebelius. Cohen visited St. Louis recently to underscore the role of community health centers in providing accessible care to medically underserved people in St. Louis and elsewhere.

Grace Hill has expanded rapidly over the years. It now operates about a half dozen health centers throughout St. Louis. Alan Freeman, president and CEO of Grace Hill Neighborhood Health Centers Inc., says the recent expansions mean more access to care for the medically underserved. The expansion was financed in part by $2.4 million in federal stimulus money, with about half the money going to renovation of the South Side clinic, he says.

Freeman said that the old South Side facility was overwhelmed by an increased patient load during the past three years. The building was too small to accommodate the demand for services. The new facility will offer improved and expanded primary care services, he says.

Robert Fruend, head of the St. Louis Regional Health Commission, says expansion of Grace Hill's system was part of a larger trend to make health care for the needy more efficient and cost effective through mergers and better coordination and integration of services. At one time, Saint Louis ConnectCare, the largest community health center in the city, ran the city's four primary-care health clinics.

In 2005, ConnectCare transferred ownership of two of those clinics to Grace Hill and the other two to Myrtle Hilliard Davis Comprehensive Health Care. Fruend cites strategic reasons for the transfers, which allowed the city clinics to tap into resources limited to federally qualified health centers or FQHCs, as they are commonly known. Both Grace Hill and Myrtle Hilliard are federally qualified.

Eligible centers "receive certain federal and state funds to provide uncompensated care to low-income, uninsured patients," Fruend notes. "Discounts are offered on a sliding fee scale and given to eligible patients based on their household income. Patients receive care regardless of their ability to pay. The community health centers specialize in the provision of primary and preventive care."

The upshot is a more streamlined system of caring for the needy in contrast to the old system of city-run clinics that could not tap into some federal funding.

Grace Hill and other FQHCs in Missouri got nearly $29 million under the federal stimulus program. While the amount was relatively large, it's small change compared to the $11 billion pot of community health center money that the federal government will begin distributing over five years, starting in 2011. The money is part of the new health reform law and includes $1.5 billion for community health center construction projects. All grants will be awarded directly to the centers rather than to states. Federal health officials say work is still being done to decide how the grants will be awarded.

Funding for health reporting is provided in part by the Missouri Foundation for Health, a philanthropic organization whose vision is to improve the health of the people in the communities it serves.

This article first appeared in the St. Louis Beacon.

Robert Joiner has carved a niche in providing informed reporting about a range of medical issues. He won a Dennis A. Hunt Journalism Award for the Beacon’s "Worlds Apart" series on health-care disparities. His journalism experience includes working at the St. Louis American and the St. Louis Post-Dispatch, where he was a beat reporter, wire editor, editorial writer, columnist, and member of the Washington bureau.