The History of the Community Health Centers
The first Community Health Centers (originally called Neighborhood Health Centers) were funded as a demonstration project under the Federal Office of Economic Opportunity, the lead federal agency in President Lyndon Johnson’s War on Poverty. Learn more about the Community Health Center Story.
These health centers empowered local communities through patient-majority governing boards to direct health services, using a combination of local resources and federal funding.
The National Association of Neighborhood Health Centers (which later became NACHC, the National Association of Community Health Centers) was founded by executives of these OEO- funded Neighborhood Health Centers.
The association played a crucial role in unifying and advocating for the interests of these community-oriented health centers. Through collaborative efforts and a shared commitment to accessible and quality healthcare, NACHC has since evolved into a cornerstone of support and representation for Community Health Centers nationwide, contributing to their continued growth and success.
Community Health Center Milestones
NACHC Emerged to Give Health Centers a Collective Voice
The pioneers of the Health Center Movement who created NACHC recognized that, if health centers were to grow as a primary care model for communities with unequal access to health care, they needed to unite.
They needed to set forth their vision of the future.
They needed a national presence as well as a collective voice on Capitol Hill to secure support and resources – and to survive and develop.
In 1977, after a successful campaign led by NACHC and member health centers, Congress authorized the first Community Health Center program under Section 330 of the U.S. Public Health Service Act (first under OEO and later under the U.S. Department of Health Education and Welfare).
The Migrant Health program was also reauthorized as Sec 329 in S. 66 (Public Law 94-63), but only after congressional override of President Gerald Ford’s veto. President Jimmy Carter subsequently called for major expansion of health centers, including the “Rural Health Initiative,” more than doubling program funding over four years.
Defending Health Centers From Challenges
In the 1980s, NACHC helped health centers survive the greatest threat in their brief history when lawmakers sought to roll back programs established as part of the War on Poverty. They proposed turning the Community and Migrant Health Center programs into block grants, handing control of the programs to individual states. NACHC and health centers successfully fought the proposal.
As the country faced an economic downturn in 1982-83, NACHC led the effort to secure $65 million in Jobs Bill funding, equal to 20% of current annual health center funding. NACHC was also instrumental in Congress allocating federal funding to support the development of State and Regional Primary Care Associations (PCAs).
Advocacy Leads to $1 Billion in Health Center Funding
Around 2000, NACHC and health centers introduced the REACH initiative – a proposal to double health center funding over 5 years. The initiative garnered bipartisan support and both Republican and Democratic candidates for president endorsed a call to expand the health center program. Federal funding for health centers surpasses $1 billion.
In 2010, after much advocacy by NACHC and other health care organizations, Congress passed the Patient Protection and Affordable Care Act (aka the Affordable Care Act), which fueled an expansion of Community Health Centers.
The Affordable Care Act (ACA) established the Health Center Fund, providing health centers with $9.5 billion to support ongoing health center operations, create new health center sites, or expand preventive and primary health care services at existing health center sites. The ACA also included the Teaching Health Center Program.
Congress has extended the Health Center Fund several times. View our federal funding page for current status.
Building the Health Center Movement for the Future
As Community Health Centers expanded, so did NACHC. In addition to advocating for stable funding and equitable policies, NACHC’s mission to strengthen the Health Center Movement expanded to include a robust training and technical assistance program.
The nation’s health centers now serve nearly 1 in 10 people, cementing health centers’ role as the largest primary care network. Today there is recognition, as never before, of the value and need for a patient-governed system of primary care anchored in communities to improve health – protect communities – and address longstanding health inequities.
NACHC is committed to providing the training, resources, and advocacy to support this system. We will continue to leverage our collective voice on issues impacting the health and lives the over 30 million patients health centers serve. We will continue to grow in resources and partnership to spur initiatives and innovation in health care delivery. We have strengthened trainings and support services to help all of our health centers succeed. We know there is more we can and must do to improve the health of the nation’s communities. We stand ready to lead and to build on our proud 50-year legacy as we advance the Health Center Mission and preserve, strengthen and expand the health center foundation.
