Health-care Reform May Mean More Federal Clinics

By Commissioner Jeff Koons

During the presidential campaign, Barack Obama promised to reform our health-care system, making health insurance affordable and accessible to all, and lowering annual health-care costs by $2,500 for a typical family. Mr. Obama wants to make insurance companies more accountable and force them to cover pre-existing conditions, placing greater emphasis on preventive services, such as cancer screenings. He also intends to create a new health-care tax credit for small business owners.

Although the current financial crisis may wind up pushing health-care reform to the back burner in Washington, I assure you that will not be the case locally. As your new chairman of the Board of County Commissioners, I expect us to aggressively pursue federal funding to set up more Federally Qualified Health Centers (FQHC) in Palm Beach County.

FQHCs receive a lump sum from the federal government, as well as enhanced Medicaid reimbursement for the services they provide to vulnerable populations. While the primary clients are those who are uninsured and/or poorer residents, FQHCs serve all patients, including insured patients, with care that is equal to that of “regular” primary care providers.

Around the country, FQHCs meet the comprehensive primary care needs of the populace, while serving as neighborhood economic development engines. FQHCs continue to enjoy strong, bipartisan support from our federal lawmakers because they have a sustainable business model. They employ fully qualified doctors, nurses, and other health professionals, and draw patients away from crowded hospital emergency rooms.

FQHCs are located in places that have been identified by the Health Resource Services Administration (HRSA) as “hot zones” -- geographically defined regions or communities that are medically underserved areas (MUAs); have medically underserved populations (MUP’s) and/or are designated as health professional shortage areas (HPSAs). HRSA hot zones in Palm Beach County include Riviera Beach, Westgate, Boynton Beach, Lake Worth, Delray Beach, Lantana, Greenacres, Belle Glade/Pahokee, and a small area in West Boca Raton.

The Palm Beach County Health Department has operated a successful FQHC for the past several decades in Belle Glade and in the past five years opened an FQHC-extension in West Palm Beach (45th Street). In 2008, the Palm Beach County Health Department was awarded a new-site FQHC grant for its Delray clinic. The Health Department’s clinic in Lantana is being converted to an FQHC, and a new Health Department clinic is under construction in Lake Worth that will be eventually eligible for an FQHC designation with associated funding. In 2007, the Health Care District of Palm Beach County provided start-up funding for an FQHC in Pahokee.

Private nonprofit organizations have stepped up, too. Foundcare is developing an FQHC in Palm Springs, while the Quantum Foundation has committed $100,000 for the Pahokee facility and more than $400,000 in direct financial support for construction and development of the Palm Springs FQHC. Quantum has also created an FQHC fund, which as of June 2008 had $200,000 available for new projects. This leaves four hot zones still without services: Boynton Beach, Westgate, Boca Raton and Riviera Beach.

Through the Palm Beach County Federally Qualified Health Center (FQHC) Initiative, we have an opportunity to establish new centers in these communities and to expand existing FQHCs into full-service general health clinics, enabling the public sector to leverage private financial support to benefit the county’s 230,000 uninsured people. It will require more public/private partnerships and the full support of our lawmakers to fill this health-care gap. I urge everyone to get behind the FQHC Initiative as we seek to secure more federal dollars for these much-needed facilities.

As always, I welcome your comments and suggestions. Please feel free to contact me or my staff at 355-2202.