Community Health Care in the United States

‘Community health care’ is a broad term used for community-based and/or patient-directed health care. The term ‘community health care’, as used within this article, refers to the community-based health care system and services that arose after the privatization of the U.S. health care system and out of the U.S. civil rights movement in the 1960s. In addition to services funded through Medicaid and Medicare, community health care services have become an alternative form of care to private and/or insurance-based health care for those that are low-income and/or medically underserved.


Community-based health care services are funded through donors, patients, private or public insurance, and/or other state or local funding, but many also receive federal funding through Section 330 (added in 1975) of the Public Health Service Act (42 USCS § 254b, 1944). Community health centers that receive federal grants receive that support under one or more of the following mechanisms: Community Health Centers, Migrant Health Centers, Health Care for the Homeless Programs, and Public Housing Primary Care Programs. These federal grant-supported health centers (also known as Federally Qualified Health Centers or FQHCs) must adhere to multiple requirements, including charging uninsured patients on a sliding fee scale based on their annual income and family size, in order to qualify for and retain their federal grant.

The use of community health care services has been on the rise, as has the amount of federal funding provided to them. In 2009, federally-funded health centers alone served over 18 million patients, including over 70 million visits. Of those patients who visited federally-funded health centers in 2009, 92% were low-income (living in a family earning under 200% of the federal poverty level), 71% were living in families earning incomes below the federal poverty level, 38% were uninsured, and about half lived in rural areas. Community-based health centers are known to increase access to high quality, cost-effective primary and preventative care, which helps to reduce reliance on hospitals and specialists.

The recently-passed health reform bill includes $11 billion for the Health Center Program for operations and capital over a five year period. These funds and other provisions in the bill will allow the Health Center Program to serve 20 million new patients.

As discussed above, community health centers have become an important source of care for low-income residents, the uninsured, and the medically underserved in the United States. For further information on these services and health care reform, explore community health care in your community and visit the resources regarding the federally supported Health Center Program below.

Further Reading and Resources on U.S. Community Health Care

HRSA: The Health Center Program (bphc.hrsa.gov)

U.S. Health Care System and Reform Information (healthcare.gov, U.S. Department of Health and Human Services)

National Association of Community Health Centers: Policy Issues: Health Reform

HRSA Geospatial Data Warehouse

The UDS Mapper


-Health Resources and Services Administration. 2010. The Health Center Program: Section 330 of the Public Health Service Act (42 USCS § 254b). Retrieved 26 October 2010.

-Health Resources and Services Administration. 2010. The Health Center Program: What is a Health Center?. Retrieved 27 October 2010.

-Health Resources and Services Administration. 2010. The Health Center Program: Summary of Key Health Center Program Requirements. Retrieved 27 October 2010.

-Health Resources and Services Administration. 2010. Health Center Data. Retrieved 27 October 2010.

-National Association of Community Health Centers. 2010. Policy Issues, Health Reform, Health Reform FAQs. Retrieved 27 October 2010.

-National Association of Community Health Centers. August, 2010. Fact Sheet #0309, America’s Health Centers.

-U.S. Department of Health and Human Services. 2006. Testimony on Health Centers Program. Retrieved 26 October 2010.

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