The Community Health Center Fund: In Brief
Elayne J. Heisler
Specialist in Health Services
April 24, 2015
Congressional Research Service
7-5700
www.crs.gov
R43911

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The Community Health Center Fund: In Brief

Contents
Background ...................................................................................................................................... 1
CHCF as a Percentage of Health Center Funding ........................................................................... 2
CHCF Grants Awarded .................................................................................................................... 2

Figures
Figure 1. The CHCF and Health Center Funding ............................................................................ 2

Tables
Table 1. CHCF-Supported Grant Programs ..................................................................................... 3
Table 2. CHCF Funds Awarded, by State and Territory ................................................................... 4

Contacts
Author Contact Information............................................................................................................. 6
Acknowledgments ........................................................................................................................... 6

Congressional Research Service

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The Community Health Center Fund: In Brief

Background
The Health Center Program, which is administered by the Health Resources and Services
Administration within the Department of Health and Human Services, awards grants to outpatient
health care facilities that provide care to medically underserved populations.1 The program’s
annual funding has more than doubled between FY2002 and FY2015, increasing from $1.3
billion to $4.9 billion. This funding increase—a result of both increases in annual discretionary
appropriations and supplemental funding2—has resulted in more health centers, more patients
seen and more services available to these patients.3 The program’s funding increase is due, in
part, to the Community Health Center Fund (CHCF),4 a mandatory multibillion dollar fund
established in the Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended).
This fund is available between FY2011 and FY2017. It was intended to increase health center
appropriations above the level the program received in FY2008;5 however, the CHCF has
partially supplanted annual appropriations since it began. The CHCF also supports the National
Health Service Corps, a scholarship and loan repayment program that places providers in
underserved areas including at health centers. Since FY2012, the CHCF has been that program’s
sole funding source.6
CHCF funds have been used for a range of health center activities including funding new health
centers, increasing services provided at existing health centers, and implementing care
coordination initiatives.7 The CHCF represents more than 70% of the Health Center Program’s
FY2015 funding. Funding for the CHCF was recently extended in the Medicare Access and CHIP
Reauthorization Act of 2015 (MACRA, P.L. 114-10), which provided $3.6 billion to support
health center operations in each of FY2016 and FY2017 (a total of $7.2 billion). This report
provides information on the CHCF. Specifically, it includes information on the types of grants
awarded, total funds disbursed, and the amount of CHCF funds that centers in each state and
territory received.

1 For more information on health centers, see CRS Report R43937, Federal Health Centers: An Overview.
2 Annual discretionary appropriations during this time period and the American Recovery and Reinvestment Act (P.L.
111-5) provided supplemental funding in FY2009 and FY2010. See Table 3 in CRS Report R43937, Federal Health
Centers: An Overview, and CRS Report R40181, Selected Health Funding in the American Recovery and Reinvestment
Act of 2009.
3 Peter Shin et al., Community Health Centers: A 2012 Profile and Spotlight on Implications of State Medicaid
Expansion Decisions, The Kaiser Commission on Medicaid and the Uninsured, Issue Brief, Washington, DC,
September 2014.
4 Section 10503 of the Patient Protection and Affordable Care Act (ACA) established the CHCF. Though the fund is
named for community health centers (the most common type of health center), its funds are available for use by all four
types of health centers: (1) community health centers, (2) health centers for the homeless, (3) migrant health centers,
and (4) health centers for residents of public housing.
5 The FY2008 appropriation was $2.1 billion; see Table 3 in CRS Report R43937, Federal Health Centers: An
Overview.
6 CRS Report R43920, National Health Service Corps: Changes in Funding and Impact on Recruitment.
7 See Table 1.
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The Community Health Center Fund: In Brief

CHCF as a Percentage of Health Center Funding
The CHCF as a total percentage of federal funding for health centers has increased from 40% to
72% from FY2011 through F2015 (see Figure 1).
Figure 1. The CHCF and Health Center Funding

Source: CRS analysis of HRSA’s Congressional Budget Justifications.
CHCF Grants Awarded
ACA’s language creating the CHCF specified rather broad purposes—that the fund be used to
“provide for expanded and sustained national investment in community health centers.”8 CHCF
funds have been used to support operating grants at existing health centers and to support a
number of specific grant programs (see Table 1).9

8 ACA Section 10503(a).
9 The ACA also provided, for use between FY2011 and FY2015, $1 billion dollars to be used for health center
construction and renovation. Grant awards from this program were made in FY2011 and FY2012 and supported 398
projects at 190 centers; see CRS Report R42433, Federal Health Centers.
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The Community Health Center Fund: In Brief

Table 1. CHCF-Supported Grant Programs
Name
Description
Funds Awarded
New Access Points
Grants to support new health center
$28.8 million (FY2011); $128.6
sites.
mil ion (FY2012); $19 million

(FY2013); $150 million (FY2014);

$100 million (FY2015, expected)
Expanded Services
Grants for hiring new staff to extend
$295 million (FY2014)
hours and expand care that a health
center provides.
Health Center Outreach and
Grants to hire staff for in-person
$150 million (FY2013); $58 million
Enrol ment Assistance
enrollment and eligibility assistance to
(FY2014)
uninsured individuals.
Behavioral Health Integration
Grants to expand behavioral health
$54.6 million (FY2014); $51.3 million
services by increasing the number of
(FY2015)
providers and services offered.
Patient-Centered Medical
Grants to assist facilities with meeting the
$32 million (FY2011); $44 million
Homes (PCMH)
requirements to be certified as a PCMH.
(FY2012)
Quality Improvement/ Base
Adjustments to health center base funding $48 million (FY2013)
Adjustment
for ongoing operations and quality
improvement activities.
PCMH Facility Improvement
Grants for PCMH construction and facility $35.7 million (FY2014)
renovations.
Health Center Controlled
Grants to expand the use of advanced
$21 million (FY2013)
Network- Health Information
HIT.
Technology (HIT)

State and Regional Primary
Cooperative agreements with state and
$5.2 million (FY2011); $6.4 million
Care Association
regional organizations to provide health
(FY2013)
center training and technical assistance.
HIV Service Integration
Grants to support HIV services with
$5 million (FY2012); $6.2 million
primary care service integration.
(FY2014)
Planning and Development
Grants to support organizations to plan
$10 million (FY2011)
and become health centers.
Beacon Community
Grants to support health center HIT
$8.4 million (FY2011)
Supplemental Funding
adoption so as to improve health
outcomes, improve care quality, and
achieve cost efficiencies.
Training and Technical
Cooperative agreements to provide
$2.8 million (FY2011)
Assistance
technical assistance to organizations that
support health centers.
Sources: CRS analysis of data from the HRSA data warehouse; CRS communication with HRSA’s Office of
Legislation, January 5, 2015; and HRSA and HHS press releases obtained by searching http://www.hrsa.gov and
http://www.hhs.gov/news/.
CHCF funds were awarded from FY2011 through FY2015 to facilities and organizations in each
of the 50 states, the District of Columbia, and the territories (see Table 2).
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The Community Health Center Fund: In Brief

Table 2. CHCF Funds Awarded, by State and Territory
(Dollars in Thousands)
State FY2011
FY2012
FY2013
FY2014
FY2015a
Total
Alaska $15,176
$16,651
$21,855
$31,370
$1,042
$86,094
Alabama $19,803
$23,584
$29,280
$39,000
$1,680
$113,347
Arkansas $11,603
$13,637
$16,951
$23,823

$66,014
American
Samoa
$1,089 $901 $1,146 $1,899
$5,035
Arizona $18,945
$20,195
$24,729
$37,004
$2,100
$102,972
California $120,920
$140,404
$178,975
$275,331
$12,176
$727,806
Colorado $25,431
$29,531
$37,523
$45,921
$3,057
$141,464
Connecticut
$12,973
$15,168
$18,923
$22,080

$69,144
District of Columbia
$4,644
$5,147
$5,731
$8,542
$128
$24,192
Delaware $3,290
$4,372
$6,164
$6,280

$20,106
Florida $48,926
$59,567
$73,248
$117,934
$4,873
$304,549
Federated States of
$423 $438 $476 $1,123
$2,459
Micronesia
Georgia $21,263
$26,182
$37,181
$47,576
$1,901
$134,102
Guam $501
$519
$683
$1,059

$2,762
Hawaii $6,879
$6,795
$8,606
$13,448
$1,048
$36,777
Iowa $8,507
$9,537
$12,555
$16,899
$378
$47,875
Idaho $9,026
$10,223
$13,255
$18,743
$889
$52,137
Illinois $41,748
$50,684
$64,450
$88,207
$1,365
$246,454
Indiana $12,420
$13,695
$17,216
$28,441
$1,707
$73,479
Kansas $7,397
$9,633
$13,030
$18,278
$1,167
$49,504
Kentucky $13,683
$17,800
$21,803
$31,162
$406
$84,854
Louisiana $17,792
$19,316
$24,680
$43,095
$2,742
$107,625
Massachusetts $24,757
$26,155
$32,222
$54,646
$2,577
$140,358
Maryland $13,633
$13,585
$16,069
$27,776
$1,701
$72,765
Maine $8,751
$9,965
$11,100
$17,724
$1,744
$49,283
Marshall Islands
$295
$306
$338
$704

$1,643
Michigan $23,757
$27,282
$33,868
$55,030
$3,745
$143,681
Minnesota $8,829
$10,938
$13,775
$18,646
$547
$52,736
Missouri $20,092
$22,840
$28,811
$45,233
$794
$117,770
Northern Mariana

$608
$732
$738

$2,078
Islands
Mississippi $18,919
$19,150
$23,681
$34,055
$149
$95,953
Montana $8,669
$10,250
$13,772
$18,292
$64
$51,046
North Carolina
$26,443
$31,974
$42,027
$57,132
$948
$158,522
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The Community Health Center Fund: In Brief

State FY2011
FY2012
FY2013
FY2014
FY2015a
Total
North Dakota
$1,902
$1,818
$2,447
$4,211
$580
$10,959
Nebraska $3,830
$4,891
$6,211
$9,385
$59
$24,376
New Hampshire
$4,280
$4,927
$7,334
$10,909
$557
$28,006
New Jersey
$18,029
$18,509
$25,263
$37,524
$1,253
$100,578
New Mexico
$17,132
$19,064
$25,423
$32,981
$877
$95,476
Nevada $3,963
$3,802
$7,030
$6,265
$562
$21,622
New York
$54,430
$69,550
$84,280
$114,257
$5,420
$327,937
Ohio $27,229
$32,877
$37,969
$60,811
$2,820
$161,706
Oklahoma $12,270
$15,626
$19,901
$22,992
$1,507
$72,296
Oregon $18,770
$23,679
$29,405
$41,563
$1,515
$114,932
Palau $358
$371
$292
$577

$1,597
Pennsylvania $27,426
$31,807
$40,399
$55,918
$2,230
$157,779
Puerto Rico
$19,894
$24,701
$30,063
$38,782
$265
$113,706
Rhode Island
$7,259
$6,713
$7,671
$11,673
$1,043
$34,360
South Carolina
$20,082
$23,988
$31,938
$37,320
$113
$113,441
South Dakota
$4,150
$4,523
$5,597
$8,434

$22,705
Tennessee $17,968
$21,473
$26,127
$36,560
$3,515
$105,643
Texas $60,559
$68,428
$86,323
$121,729
$5,110
$342,149
Utah $6,805
$6,834
$10,814
$16,712
$1,250
$42,414
Virginia $19,176
$22,143
$27,601
$38,361
$2,295
$109,576
Virgin Islands
$673
$789
$959
$1,339

$3,761
Vermont $3,791
$4,126
$5,439
$10,222
$59
$23,636
Washington $27,932
$30,811
$40,902
$57,496
$4,004
$161,145
Wisconsin $8,326
$11,069
$13,051
$18,617
$1,247
$52,311
West Virginia
$13,499
$15,001
$20,198
$29,218
$640
$78,556
Wyoming $1,730
$1,921
$2,386
$3,999
$475
$10,512
Totalb
$978,047 $1,136,477 $1,439,875 $2,075,045 $86,321,866 $5,716,765
CHCF Allocation
$1,000,000
$1,200,000
$1,465,000c $2,145,000c $3,509,000c $9,319,000
Source: CRS communication with HRSA’s Office of Legislation, January 5, 2015.
Notes: Blank cells indicate that no funds were received by that state or territory in that year.
a. Data available as of January 5, 2015. Blank cel s indicate that no funds were awarded to health centers
in that state as of January 5, 2015. This report will be updated throughout FY2015 to reflect additional
grants awarded to facilities in each state.
b. Total indicates amount of grants awarded; it is lower than the amount appropriated to the CHCF as
some funds are used by HRSA to administer these grant programs.
c. The FY2013, FY2014, and FY2015 amounts were reduced by the sequester required under the Budget
Control Act (P.L. 112-25). For more information, see CRS Report R43937, Federal Health Centers: An
Overview.
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The Community Health Center Fund: In Brief



Author Contact Information

Elayne J. Heisler

Specialist in Health Services
eheisler@crs.loc.gov, 7-4453


Acknowledgments
LaTiesha Cooper, Research Assistant, prepared the tables and figures included in this report.
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