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History
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In the early 1970s, the health centers program was transferred to the Department of Health, Education, and Welfare (HEW). The HEW has since become the U.S. Department of Health and Human Services (HHS). Within HHS, the Health Resources and Services Administration (HRSA), Bureau of Primary Health Care (BPHC) currently administers the program.[1]
Community health centers are primarily funded by Medicaid payments and federal grants set up by Section 330 of the Public Health Service Act.[2] In 2010, the Community Health Center Fund was created by Congress to aid in the expansion of community health centers. Since the 2013 fiscal year, discretionary funding from Congress has flatlined at approximately $1.5 billion but increased to $1.6 billion in 2018 via the Consolidated Appropriations Act of 2018.[3] Funding has increased for CHCs, allowing them to increase their reach, staffing, and the services they can provide.[2] Between 2010 and 2017, the number of operating sites increased by over 4,000, and shares of centers providing mental health services increased by 22%.[2]
Since the Affordable Care Act's expansion of Medicaid, a challenge facing community health centers—and the health care safety net as a whole—is how to attract newly insured patients, who now have more options in terms of where to seek care, in order to remain financially viable.[4]
The evolution of the terminology used to describe what are now called "community health centers" is crucial to understanding their history and how they are contextualized in the United States social safety net. When they were titled "neighborhood health centers", heavy emphasis was placed on grassroots community involvement and empowerment. Since, the terms have shifted to "community health centers" and "Federally Qualified Health Centers", indicating how these clinics have transformed into government provisions, and are now subject to bureaucratization. While CHCs still retain their historical commitment to responding to community needs, through mechanisms such as requiring at least 51% of governing board members to be patients at the health center, their positioning as a government provision makes CHCs responsible for meeting federal requirements as well.[5]
Immigrants and community health centers
editCommunity health centers in California
editAsian Health Services
editOne example of a community health center that serves immigrants is Asian Health Services (AHS) in Oakland, CA. Asian Health Services aims to provide health, social, and advocacy services for the immigrant and refugee Asian community by entailing many of the strategies previously discussed. Additionally, they provide primary care services, including mental health, case management, nutrition, and dental care in English and 14 languages: Korean, ASL, Lao, Burmese, Mandarin, Cantonese, French, Mien, Karen, Mongolian, Karenni, Tagalog, Khmer, and Vietnamese.[6] Their youth program provides services including health education, cultural awareness, job training, and college readiness to East Bay Asian American youth.[6]
Asian Health Services Youth Program
editIn addition to their main clinic they also have a youth program that attempts to address the stigma about mental and sexual health in Asian culture by recruiting local Asian American youth to get involved with advocacy and create educational resources/workshops surrounding these topics. Many Asian Americans, though a very diverse group, have historically felt discouraged from seeking help for mental health concerns due to stigma and pressure to focus on academic and professional success.[7] Additionally, the “model minority” myth plays a role in Asian Americans not seeking support for mental health.
Asian Health Services Youth Program (AHSYP) attempts to address these concerns using methods that Asian American immigrant youth claim would help. In a study on school-based mental health for Asian American immigrant youth, students suggested engaging students and parents, using peers to share their experiences to reduce stigma, and providing educational videos and materials.[8] AHSYP also provides educational material through its social media outlets and workshops.[9][10]
Project: Revive Chinatown!
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In the early 2000s, Asian Health Services envisioned a project called Revive Chinatown! that would create a safer pedestrian environment, while also transforming Oakland, California Chinatown's commercial district into a regional shopping destination. The key to securing the funding and support for this project was in re-defining the issue from one of public health into one of environmental justice. In doing so, Asian Health Services hoped to address the issue of pedestrian safety by simultaneously working on a long-term solution for increased quality of life.[11] The Revive Chinatown! movement has gained traction and is cited as a success story of a CHC being able to successfully create a more public health-friendly environment, which bolsters their case and contributes to the trend towards further healthcare accessibility by means of CHCs.[12]
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References
edit- ^ Taylor, Jessamy (31 August 2004). The fundamentals of community health centers (PDF) (Report). Washington, DC: National Health Policy Forum. Archived from the original (PDF) on 5 September 2017. Retrieved 12 May 2017.
- ^ a b c "Community health center financing: The role of Medicaid and section 330 grant funding explained".
- ^ "Federal grant funding".
- ^ Katz, Mitchell H.; Brigham, Tangerine M. (2011-02-01). "Transforming A Traditional Safety Net Into A Coordinated Care System: Lessons From Healthy San Francisco". Health Affairs. 30 (2): 237–245. doi:10.1377/hlthaff.2010.0003. ISSN 0278-2715. PMID 21289344.
- ^ "Community Health Centers Past, Present, and Future: Building on 50 Years of Success" (PDF).
- ^ a b "Our Mission – ASIAN HEALTH SERVICES". Retrieved 2022-05-05.
- ^ Shih, Kristy Y.; Chang, Tzu‐Fen; Chen, Szu‐Yu (2019-08-12). "Impacts of the Model Minority Myth on Asian American Individuals and Families: Social Justice and Critical Race Feminist Perspectives". Journal of Family Theory & Review: jftr.12342. doi:10.1111/jftr.12342. ISSN 1756-2570.
- ^ Arora, Prerna G.; Algios, Alexa (2019-06). "School-based mental health for Asian American immigrant youth: Perceptions and recommendations". Asian American Journal of Psychology. 10 (2): 166–181. doi:10.1037/aap0000142. ISSN 1948-1993.
{{cite journal}}: Check date values in:|date=(help) - ^ "Community Programs – ASIAN HEALTH SERVICES". Retrieved 2022-05-05.
- ^ "AHS YP". Ahsyp. Retrieved 2022-05-05.
- ^ Liou, J., & Hirota, S. (2005). "From pedestrian safety to environmental justice: The evolution of a chinatown community campaign". AAPI Nexus. 3 (1): 1–11.
{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: numeric names: authors list (link) - ^ Wells, R., Morrissey, J. P., Lee, I., & Radford, A. (2010). Trends in behavioral health care service provision by community health centers, 1998–2007. Psychiatric Services, 61(8), 759-764.