Health Centers funded by the federal government are known as
Federally Qualified Health Centers, or FQHCs.The earliest
federally-funded Centers in Indiana were Citizens
Health Center in Indianapolis, developed as part of the War on
Poverty, and Indiana Health Centers, Inc., which initially served
and migrant farm worker population. HealthNet
in Indianapolis soon followed.
As a corporation, Indiana Health Centers, Inc. grew to include not only
migrant farm worker sites, but also Community Health Center (CHC) sites in multiple
communities. In the early '90s, two sites in Evansville received federal
funding - Washington Avenue Community Health Center and ECHO Health
Center, a CHC for the homeless. They merged to form a new ECHO, which
continues to serve both homeless and community members at three sites.
State support for the development of CHCs in Indiana began in
Indiana General Assembly appropriated $2 million over the
(two-year period) for the development of non-profit
health care centers in medically underserved parts of the state.
This legislation was the culmination of several years of conversations
Indiana Primary Health Care Association (IPHCA) and its members
about the need to improve access to primary health care services
During 1995, staff from IPHCA and the Indiana State Department of
(ISDH) worked closely together to establish criteria for Health
the end of the first year of state funding, Joni Albright, ISDH
reported to the General Assembly State Budget Committee that six
implementation awards and three planning awards had been made
to community groups during the
year. At that time, recommendations were made for
four additional implementation grants, as well as two
for two planning grantees from the first year. A contract with
IPHCA for technical assistance to all grantees was part of the package.
federal FQHC program was used as a model for Indiana State-Funded Community
Health Centers, and threshold requirements for applicants included (but
were not limited) to:
- Non-profit entity in an area with a shortage designation, or the ability
to demonstrate need;
- Board of Directors with minimum 30% users of the Health Center
- Open to all regardless of ability to pay, and sliding fee scale adopted
- Health Center open during extended hours;
- Comprehensively serving all ages and genders; and
- Having at least one full-time provider 32 hours per week, and a physician
with hospital admitting privileges.
In 1997, funding allocated by the General Assembly for the
biennium grew to $10 million, with $1 million reserved for capital
expenditures. Nine additional communities received implementation / operating
funds, and eight communities received planning grants. Four Health Centers
received capital awards. With Indiana's participation in the tobacco settlement
fund, the Indiana Legislators were able to move the Health Center program
from the state's general fund to the tobacco settlement program. In 2000, an additional
$10 million was made available to Health
Centers for capital expenditures, and 10 Health Centers received between $89,250 and $1 million in capital dollars.
In 2006, 42 organizations benefited from the tobacco settlement
funds. In addition, more Community Health Centers have been able
to meet federal program expectations and compete for federal
Seven additional corporations have received federal funding.
In 2007, funding for Health Centers doubled, from $15 million a year to
$30 million a year, with the stipulation that a portion of the money could
be utilized for capital expenditures.
In 2009, the funding for Community Health Centers increased, from
$15 million per year to $17.5 million the first year and $20 million
the second year of the biennium.
In 2010, President Obama signed the Patient Protection and
Affordable Care Act and the Healthcare and Education Reconciliation Act
of 2010. Both bills dramatically reformed health care in the United
States by allowing individuals to obtain affordable health care coverage
over the course of the next several years.
In looking back over this history, it is clear that state funding in Indiana has acted as a powerful incubator program
for Health Center growth.