Are Neighborhood Health Centers Providing Services Efficiently to the Most Needy?

HRD-77-124: Published: Jun 20, 1978. Publicly Released: Jun 20, 1978.

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Federally funded neighborhood health centers provide a wide range of ambulatory health services to residents, primarily the urban poor, of the areas designated as medically underserved. The Department of Health, Education, and Welfare (HEW) funds 112 neighborhood health centers; such centers received most of the $197 million appropriated in fiscal year 1976 for the HEW Community Health Centers Program.

There are five basic situations in need of improvement in the neighborhood health center program: (1) centers are understaffed for the number of patients treated, and the underuse of physicians, dentists, support personnel, and services costs more than $1 million annually; (2) demand for health services from neighborhood health centers is not likely to increase beyond present levels and could decline; (3) HEW has not made sure that centers are serving residents of medically underserved areas and does not know the number of percentages of users who live in these areas; (4) HEW no longer requires centers to become financially self-sufficient; and (5) although the Public Health Service Act requires the centers to provide preventive health care, most patients use the health centers to cure illness instead of for prevention. HEW needs to develop and more strongly enforce productivity standards for all health center employees.

Recommendation for Executive Action

  1. Status: Closed

    Comments: Please call 202/512-6100 for additional information.

    Recommendation: The Secretary, HEW, should: (1) reduce the Public Health Service's capacity at inefficient centers to levels consistent with the demand for services; (2) enforce compliance with existing productivity and staff-size criteria; (3) develop criteria for measuring the productivity of dentists; (4) ensure closer evaluation of the reasonableness of costs at each center in relation to the level of service provided; (5) compile and maintain records to identify center registrants who live in medically underserved areas and identify centers whose registrant work load is not primarily from those areas; (6) stop funding centers which service only or primarily people who do not live in medically underserved areas; (7) continue to encourage and assist centers to bill and collect money when it is due them; and (8) have health centers promote participation in preventive health care services.

    Agency Affected:


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