As part of the upcoming Safety Net Clinic Week (Aug. 19 – 23), here is a fact sheet on Colorado’s community safety net clinics and rural health clinics:
Who We Serve
Colorado’s Community Safety Net Clinics (CSNC) and federally certified Rural Health Clinics (RHC) include 95 clinics throughout Colorado. Annually, Colorado’s CSNCs and RHCs provide approximately 750,000 visits to 300,000 Colorado residents, many in rural and underserved parts of our state. A majority of patients served are low-income uninsured or underinsured. Patients who are uninsured and do not qualify for Medicare, Medicaid or other government insurance are often asked to pay for services as a flat fee or on a sliding fee scale, if possible. Clinics will not turn away a patient based on an inability to pay and some clinics are strictly free.
CSNCs and RHCs do not receive any supplemental federal funding to provide services to uninsured or underinsured patients. Additionally, they are not eligible for the federal 340B reduced price prescription drug program and, with the exception of free clinics, are not eligible for the Federal Tort Claims Act (FTCA) free medical malpractice insurance.
Rural Health Clinics
A Rural Health Clinic is a federally designated clinic located in a non-urban health care professional shortage area. As of June 2011, there are 50 RHCs in Colorado which serve an approximate 175,000 unique patients per year. An RHC may be a public or private, for-profit or not-for-profit entity and can be housed in a permanent structure or a mobile clinic. RHCs are certified as provider-based or independent, free-standing. Provider-based RHCs are affiliated with a parent entity which is typically a rural hospital or hospital system. RHCs must be staffed by at least one nurse practitioner, physician assistant or certified nurse midwife who must be on-site to see patients at least 50% of the time the clinic is open. A physician (MD or DO) must supervise the midlevel practitioner in a manner consistent with state and federal law. The greatest benefit of the program is cost-based (enhanced) reimbursement from Medicare and Medicaid; however, RHCs do not receive any additional federal funding to operate.
Community Safety Net Clinics
While some safety net clinics began in part because of federal policy movements and related funding, others have grown organically in communities large and small across Colorado. Civic-minded individuals, health care professionals and systems, churches and other community organizations have seen that despite the presence of Community Health Centers/FQHCs and other safety net providers in their communities, there are countless individuals that still need access to outpatient services.
CSNCs are very diverse in their models and include non-profit community clinics, residency clinics, free clinics (predominately faith-based), and select private practices that fund their operations through grants, patient revenue and/or donations – none receive enhanced reimbursement or federal funding. Clinic staffing models vary greatly but often include volunteer providers and support staff. Forty Five CSNCs serve approximately 150,000 patients annually and provide some 350,000 visits each year. They are not federally certified or qualified and therefore do not receive enhanced reimbursement for Medicare or Medicaid.
How You Can Help
Please help support Colorado’s safety net clinics! To learn more about Colorado’s health care safety net and Safety Net Clinic Week 2013 contact Amber Burkhart or visit the Colorado Rural Health Center or ClinicNET websites.