Brief Background of the Policy
Section 330 acts as a federal law regulating the establishment of care facilities by enabling funding for treatment and programs. The section terms the facilities as the Federally Qualified Health Centers abbreviated as FQHC (Public Law 117.356, 2023). It provides healthcare services in these facilities for people with vulnerabilities, such as mental health disorders, homelessness, and those with underlying diseases. Section 330 is among the most active parts of the Public Health Services since its original enactment in 1975 (Public Law 117.356, 2023). Amendment that comes with it opines from the need to provide vulnerable and underserved civilians with more fulfilling healthcare than before. The Obamare policy or Affordable Care Act is among the recent amendments that the act enabled to support the majority of low-income American families (Public Law 117.356, 2023). Section 330 of the Public Health Services Act aims to reduce the service delivery disparities in healthcare across American communities. In other words, Federally Qualified Health Centers form the baseline for which the Department of Health and Health Service and the government reach the deserving but economically-unable civilians across the United States to obtain better healthcare.
The potential benefit of section 330 is the provision of better healthcare to underserved populations as a counter to universal healthcare through enabled funding. The guarantee offered by the Federally Qualified Health Center to provide cost-free services saves the lives of millions of Americans. The uninsured public gain potentially as health coverage is expensively competed against by private care facilities and the insurance company (McIntyre & Song, 2019). Moreover, underserved communities such as the Native Indians are inclusively protected in the policy through the Indian Health Services. In this regard, the vulnerable public populations are the policy’s primary beneficiaries, hence better healthcare outcomes. As a country, healthcare disparity can be determined simply through the policy, as most people are covered. For example, the impacts of the Affordable Care Act 2010 demonstrate better healthcare outcomes (McIntyre & Song, 2019). In other words, increased access to quality health care offered in Federally Qualified Health Centers enables predictability of positive health outcomes.
While the policy helps to address the healthcare disparities across the country, it also creates positive economic income through the multiple jobs it creates. FQHC is a broadened facilitation of healthcare services, meaning that physicians, caregivers, community health officers, and social workers have careers aligned within these facilities, as reflected in public policy formulations by Popple et al. (2019). The provisions of section 330 reveal that groups, such as the homeless, disabled, and marginalized from the economically despaired, benefit more from government-supported healthcare programs (Public Law 117.356, 2023). When analyzed against the services they receive with or without fees shows that lives are economically transformed for the better, bringing close to a gap in disparity and positive economic reflection. In summary, access to better healthcare improves outcomes and creates multiple economic opportunities while emphasizing reduced health disparities.
The beneficiaries of Section 330 are vulnerable people whose health coverage is supported by the government. Beneficiaries of the funding are also public and private healthcare-related agencies and federally qualified community support organizations. The government facilitates funding through grants to cover treatment for people with mental illnesses, people experiencing homelessness and diabetes, and those in rural settings as marginalized groups (Public Law 117.356, 2023). On the other hand, private research organizations, universities, laboratories, and individual experts are stakeholders in the policy. In summary, all the listed stakeholders work to benefit the general public.
Social Analysis of the Policy
The Planned Behavior theory is implicit in the Federally Qualified Health Centers policy. Planned Behavior theory is a conceptual exemplification of human behaviors based on subjective norms, attitudes, and control of behaviors (Bosnjak et al., 2020). Whereas the policy centers on eradicating the human infliction factors such as poverty, environment, physical disability, mental health, and underlying diseases like diabetes, planned behavior theory integrate the factors as normative subjects (Bosnjak et al., 2020). More precisely, a person is likely to develop respiratory disease from living in a polluted environment. When some societies deem the beliefs about food, treatment, and medicine as culturally accepted, the outcomes have implications in the social work context, a career where the sociopolitical policies manifest (Popple et al., 2019). The theory of planned behavior creates leeway to dissect how primary healthcare policies integrate the sociocultural beliefs and control of human behaviors.
Moreover, the policy constitutes socially accepted values of accountability, collective responsibility, and humanity on the part of the government and qualified healthcare centers. Accountability begins with people electing leaders to be accountable when problems occur and for effective governance (Popple et al., 2019). This way, policies in health services align with outcomes such as better service delivery, preparedness to tackle diseases, and desirable living standards. The government, the healthcare facilities, the housing department, research experts, and physicians are collectively responsible for ideating and implementing healthcare policies as contained in the policy (Public Law 117.356, 2023). Relatively, the interactions among the stakeholders lead to humanity-oriented behaviors between social institutions and the citizens. Consequently, the planned behavior theory envisages how society aligns with programs to eradicate normative aspects like poverty.
Value conflict is customary in public policy implementation. The involvement of interest groups in public policy development is described as value-based contravention that derails the achievement of previously aimed objectives (Zahariadis, 2019). The role of interest groups may arise from the private sector seeking involvement for profits and stakes in the system. For example, the Primary Health Care policy covers the role the department should play in addressing the cases of the homeless population at all times, including during the pandemic, as in the case by Bambra et al. (2020). However, reports indicate that the homeless population in the United States is almost over 550000 (Kim & Garcia, 2019). It means that the authoritative departments are affected by value conflicts when the industry influencers make it challenging to provide permanently affordable housing units. As a result, goal conflicts are evident in the policy. Goal conflicts hinder the achievement of optimal standards of the policy.
Economic Analysis of the Policy
The federal government covers the costs for sustaining functions of the Federally Qualified Health Centers. According to Myong et al. (2020), the federal government supports qualified community centers through consistent funding for populations living with HIV/AIDs, pregnant women, children, parents living in rural communities, and those with underlying conditions. Every year, the federal government provides billions of dollars to the policy. While Health Resources and Services Administration oversees that the right beneficiaries get the funds, Myong et al. (2020) sustain that increased uninsured populations, delivery sites, and scope of services contribute to frequent increases in FQHC funding over the years. Therefore, increasing access to primary healthcare requires elaborate funding in healthcare that should be unaffected by politics, as posited by Popple et al. (2019). Consequently, the Health Resources and Services Administration states that the federal government spent $6.8 billion in 2020 on FQHC grants and other allocations (HRSA, 2020). The grant constituted cover for over 1,400 qualified health centers, about 13,000 sites of delivery countrywide, and covered care costs for slightly over 30 million uninsured and low-wage earning patients (HRSA, 2020). It indicates that the policy works according to the set economic objectives.
The reliability of the public on the funding given to FQHC concludes that consistency in the revenue stream should be a priority. In other words, the funding given by the federal, state, and local governments to FQHC requires sustainability for staffing, equipment, facilities, and supplies. Moreover, World Health Organization posits that communities gain economically from health systems through initiatives such as community-wealth building (Boyce & Brown, 2019). Community wealth-building is a sustainable development strategy that enables members to organize the community assets to make them productive for wealth creation. Concerning social policies, welfare groups become the link through which social programs create jobs for social workers. Therefore, the economic influence of the policy incorporates discussions on funding, revenue sources, uses, and inclusive participation between FQHC facilities and the local people.
Political Analysis
The political reflection on the creation and funding of Federally Qualified Health Centers has been without much fuzz due to the increased primary healthcare benefits that the public obtains. At its deliberation before enactment, the Republican and Democrat representatives passed it unanimously. However, Popple et al. (2019) describe that public policies have players from interest groups who wield significant power. The presence of FQHC means the integration of private insurance companies and pharmaceutical corporations, among others, that supply equipment used within these facilities (HRSA, 2020). They form the base of those disagreeing whether or not the program receives too much funding and whether the funds should be redirected into other domains such as Medicaid and Medicare. Based on the changes in the Public Health Services Act, it is predictable that some groups are affected whenever policy reviews, and changes occur. Characteristically, every policy changes integrate the role of politics and the tyranny of numbers in Congress. Therefore, beneficiaries such as immigrants are highly likely to be affected. In summary, political manifestations continuously affect FQHC.
The promulgation of the Affordable Care Act 2010 was received with accolades because it involved political amendments in making healthcare benefits reach socioeconomically disadvantaged people. However, despite all the benefits, the Trump-led administration reduced its funding after claiming it unfit for public funding (Woolhandler et al., 2021). His attempt to appeal Affordable Care Act, which aligns directly with the primary healthcare provisions, led to an uninsured gap of up to 2.3 million people (Woolhandler et al., 2021). While he rode on the deteriorating life prospects of low and middle-income white Americans during election campaigns, turning them into xenophobic and racially charged masses, he weakened the public relations policy that served many disadvantaged groups. In short, health service policies depend on the majority representatives’ political standpoints.
Conclusion and Recommendations
The federal and state governments continuously sustain the operations of FQHC through elaborate funding and regularization. The outcomes of FQHC funding have been in tune with increased employment, staffing of qualified personnel, and servicing treatment programs for diverse groups. The Health Resources and Services Administration data proves that coverage for those with underlying diseases in rural settings, expectant women and children, and underserved communities exemplify the usefulness of the policy. Moreover, by defining health facilities, primary health, people perceptible to be covered, and the grants-in-aid terms, FQHC makes primary healthcare achieve a strong foundation that governments can rely on to be further accountable for public health. All Health and Human Sciences departments must strive to balance how the policy affects disparity. Disparities in the policy are contributed by the regional settings, where many minority groups receive less funding than those in the cities. There are also disparities in the number of underinsured and uninsured people benefit from FQHC. They form the rationale for recommendations to have the needs of the beneficiaries met. The strategies below demonstrate recommendations that policymakers and implementors should consider.
For policymakers and implementors:
- Since millions of Americans, including immigrants, benefit from FQHC funding, any amendment directed to a section of the population, such as the immigrants, should be measured against the gap it creates in the sustainability of universal healthcare. This recommendation focuses on the roles of policymakers.
- Because disparities in public health care are among the original reasons why FQHC funding was enacted, dealing with disparities created through social constructs such as racism/ ethnicity, nationality, and bureaucratic influence should be a central concern for policy implementors.
- Policy implementors should form an overall regulating agency under the Department of Health and Human Sciences to audit the implementation of approved programs in the community to help address increased social vulnerabilities such as homelessness and racially marginalized communities. For example, the objectives of Indian Health Services will be realizable as part of the underserved population.
References
Bambra, C., Riordan, R., Ford, J., & Matthews, F. (2020). The COVID-19 pandemic and health inequalities. J Epidemiol Community Health, 74(11), 964–968.
Bosnjak, M., Ajzen, I., & Schmidt, P. (2020). The theory of planned behavior: Selected recent advances and applications. Europe’s Journal of Psychology, 16(3), 352.
Boyce, T & Brown, C. (2019). Economic and social impacts and benefits of health systems. World Health Organization. Available at https://apps.who.int/iris/bitstream/handle/10665/329683/9789289053952-eng.pdf
Health Resources and Services Administration, HRSA. (n.d). Who we are. Available at https://www.hrsa.gov/
HRSA. (2020). 2020 health center data. Available at https://data.hrsa.gov/tools/data-reporting/program-data/national/table?tableName=Full&year=2020
Kim, K., & Garcia, I. (2019). Why do homeless families exit and return to the homeless shelter? Factors affecting the risk of family homelessness in Salt Lake County (Utah, United States) as a case study. International Journal of Environmental Research and Public Health, 16(22), 4328.
McIntyre, A., & Song, Z. (2019). The US Affordable Care Act: Reflections and directions at the close of a decade. PLoS medicine, 16(2), e1002752.
Myong, C., Hull, P., Price, M., Hsu, J., Newhouse, J. P., & Fung, V. (2020). The impact of funding for federally qualified health centers on Massachusetts utilization and emergency department visits. Plos one, 15(12), e0243279. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7714363/pdf/pone.0243279.pdf
Popple, P et al. (2019). Social Work, Social Welfare, and American Society (9th ed.). Hoboken, New Jersey: Pearson
Public Law 117.356. (2023). The Public Health Service Act. Title III of Chapter 373 of the 78th Congress. Available at https://www.govinfo.gov/content/pkg/COMPS-8773/pdf/COMPS-8773.pdf
Woolhandler, S., Himmelstein, D. U., Ahmed, S., Bailey, Z., Bassett, M. T., Bird, M., … & Venkataramani, A. (2021). Public policy and health in the Trump era. The Lancet, 397(10275), 705-753.
Zahariadis, N. (2019). The multiple streams framework: Structure, limitations, prospects. In Theories of the Policy Process (pp. 65-92). Routledge.
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