User:Doatucsd/CHC sandbox

Patient Demographics[edit]
Community health centers primarily provide health care to patients who are uninsured or covered by Medicaid. In 2007, almost 40% of all CHC patients lacked insurance, and 35% were Medicaid patients. In 2008, 1,080 CHCs provided comprehensive primary care to more than 17.1 million people. CHC patients typically have low family incomes, live in medically under-served communities, and have complicated health conditions. 70% of CHC patients in 2007 had family incomes of no more than 100% of the federal poverty level; more than 90% of patients had family incomes at or below twice the poverty level. Health center patients are also ethnically diverse. In 2007, half of all CHC patients were minorities, a third of which were Hispanic. All together, CHCs serve one in four low-income, minority residents. CHC patients are more likely to reside in rural areas relative to the rest of the population. They tend to be younger in age and are more likely to be female. In 2008, 36% of all CHC patients were children, and almost three in five patients were female.

Many CHC patients suffer from chronic conditions such as diabetes, asthma, hypertension, or substance abuse. CHC patients are more likely to report these chronic conditions than adults of from the national population. Characteristics linked to serious health problems, such as smoking and obesity rates, are also significantly higher in adult CHC patients compared to the general population. High rates of mental health conditions, including depression and anxiety, also contribute to the overall high rates of chronic illness in CHCs. Nonetheless, as of 2016, 91% of CHCs report having met at least one or more of Healthy People 2020 goals.

Services[edit]
Integration of health care services is a major emphasis of community health centers, in addition to the provision of preventive and comprehensive care. Services provided can vary depending upon the site, but frequently include primary care, dental care, counseling services, women's health services, podiatry, mental and behavioral health services, substance abuse services, and physiotherapy. Often, CHCs are the only local source of dental, mental health, and substance abuse care available to low-income patients.

Most recently, CHCs have played an increasing role in the opioid epidemic by facilitating access to treatment. CHCs have experienced an increase in the number of patients with opioid use disorder (OUD) from 2015 to 2018. As part of the substance use disorders (SUD) component of services provided by CHCs, services have been added and expanded relating to the prevention and treatment of opioid use disorder. The number of CHCs that provide services for SUD has increased from 20% in 2010, to 28% in 2018. There has been a 36% increase in the number of full-time staff at CHCs who are trained to provide SUD services. As of the federal budget for the 2019 fiscal year, over $5 billion has been requested for the Department of Health and Human Services to use over the upcoming five years towards addressing the opioid epidemic. Of that request, $350 million has already been available for grants to be awarded by the start of the 2019 fiscal year.

Because patients can come from a diverse range of socioeconomic, educational, cultural, and linguistic backgrounds, CHCs offer additional public health services unrelated to direct care, such as health promotion and education, advocacy and intervention, translation and interpretation, and case management. CHCs emphasize empowerment, so they also have programs to help eligible patients apply to federally funded health coverage programs, such as Medicaid.

Additionally, CHCs place great emphasis on meeting community needs. To meet this goal, administrative and health care personnel meet regularly to focus on the health care needs of the particular community that they are trying to serve. Individual CHCs will often provide specialized programs tailored to the populations they serve. These populations could include specific minority groups, the elderly, or the homeless. To determine what the community's needs may be, CHC staff may decide to engage in community-based participatory research. The success of community health centers depends on collaborative relationships with community members, industry, government, hospitals and other health care services and providers.