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Access grants face uncertain future in Congress

The Community Access Program helps areas better coordinate charity medical care for low-income, uninsured patients.

By Amy Snow Landa, amednews staff. Nov. 26, 2001.

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Washington -- As Congress rushes to complete its massive spending bills this year, a small grant program that helps communities improve their health care safety net faces uncertain prospects.

For the past two years, the Community Access Program has awarded grants to local communities to help them better integrate health care services for low-income, uninsured residents, who often fall through the cracks in the health care system.

Established as a $25 million demonstration project in fiscal year 2000, CAP saw its funding grow to $125 million the following year. So far, it has awarded grants to more than 130 communities in urban and rural areas and on tribal lands.

The program has been widely praised -- both in Congress and among safety net providers -- for enabling communities to build links between health centers, public hospitals, volunteer physicians, health departments, and other public and private organizations.

Many communities have used their grants, for example, to build organized referral networks that link community health centers, which provide primary care services, to volunteer specialty physicians.

But earlier this year, the Bush administration proposed eliminating CAP. Health and Human Services Secretary Tommy Thompson explained in a letter to Congress that the administration's priority is to support the "direct provision" of services, not their integration or coordination.

But CAP supporters say that by better coordinating the uncompensated care that is provided, they are able to increase its effectiveness and have a larger impact. [...]