By Darryl Fears
Washington Post Staff Writer
Wednesday, August 18, 2010; A02
Health centers across the country are lining up for a shot in the arm from the Obama administration: $250 million in federal grants to build clinics and bolster services at existing clinics for low-income patients such as public housing residents, the homeless, seasonal farmworkers and others who struggle to pay for care.
The administration announced last week that the nation's 1,100 health centers, which operate nearly 8,000 clinics in medically underserved areas, can apply for the grants through the Health Resources and Services Administration (HRSA).
"We expect significant competition," said Jim Macrae, associate administrator for primary health care at HRSA. In the past, Macrae said, about a third of the applicants received grants.
In the three years since health centers last competed for grants, Macrae said, his office has fielded numerous calls from health center administrators clamoring for funding, saying the number of patients has grown by 10 percent.
The grants represent the first release of funding for health centers under the Patient Protection and Affordable Care Act, signed in March, and will allow health centers to build 350 clinics in 2011, add to the services they provide and update to technology such as electronic medical records.
Applicants must "demonstrate a high level of need in the community, present a sound proposal to meet this need, and show that the organization is ready to quickly put their proposal to work," Mary Wakefield, another HRSA administrator, said in a statement. The deadline for submissions is Nov. 17.
The administration set aside $11 billion to expand and bolster community health centers over the next five years as more Americans gain medical insurance through health-care reform. About 45 million people live in areas designated by the federal government as medically underserved.
Rural and urban health centers served 19 million people last year, a number federal officials hope to double when the health-care law is fully implemented in 2014.
"We've done study after study on the remaining level of underserved, and it's tens of millions of people," said Craig Kennedy, an associate vice president of the National Association of Community Health Centers. "There are millions of people who need health centers today. This money is a step toward addressing that need."
Health centers are often the last safety net for uninsured people who fall through the cracks in the health-care system. They provide comprehensive medical care, including pharmacy services, mental health care, substance abuse treatment and dental care, and as family practices they place an emphasis on preventive care.
But they are beset by problems. Rural health centers in particular have a difficult time attracting doctors and nurses. Although 21 percent of Americans live in rural areas, only 10 percent of doctors practice there, according to a report on http://familydoctor.org, a Web site operated by the American Academy of Family Physicians. The administration has devoted at least $1 billion to doctor recruitment.
The grants will allow rural health centers to augment clinics with a service that young doctors who are recruited to work there say they lack -- technology. Ten percent of remote health clinics lack Internet and cellphone service. Kennedy said frontier clinics in Alaska, Wyoming and Montana are almost entirely cut off.