Community Health in the ’80s
The early 1980s were marked by a severe economic recession. When Ronald Reagan began his presidential term in 1981, he proposed the elimination of hundreds of federal programs, including community health centers. Reagan also proposed consolidating nearly 90 categorical grants (grants that must be used for a specific purpose) into seven block grants (grants that local authorities can allocate to a wide range of services), and reduced funding for the remaining federal programs by about 25 percent.
Federal efforts to reduce public health resources were met with enormous resistance from community health centers. Activists rallied and gained enough bipartisan support to repeal the block grants and return the program to a direct federal-local partnership. Unfortunately, funding for federal programs, including housing and social services, was still cut and the number of people experiencing homelessness increased rapidly.
In 1984, the Robert Wood Johnson Foundation and the Pew Charitable Trust responded to the growing homeless problem by awarding Health Care for the Homeless (HCH) grants to 19 major U.S. cities to support the delivery of health care services to people experiencing homelessness. Many of the grantees were co-located in existing community clinics with services provided by a combination of doctors, nurses, social workers, psychologists, psychiatrists, advanced practice nurses and physician assistants. By June 1986, the 19 HCH grantees had provided care to 30,000 homeless patients, including 2,000 patients aged 15 years or younger. The work done by Health Care for the Homeless grantees helped pave the way for future homeless programs, including Neighborcare Health's Homeless and Housing programs.
In 1986, National Health Care for the Homeless Council (NHCHC) (of which Neighborcare Health is currently a member) was formed to provide training for HCH staff. Each year the NHCHC sponsors a meeting where HCH grantees share their experiences and strategies for serving the homeless population.
Neighborcare Health in the '80s
As the economy struggled in the 1980s, community health centers, including Neighborcare Health, continued to provide outstanding and innovative care to low-income and marginalized patients.
Throughout the ‘80s, community health centers (CHCs) were on the front lines of the AIDS/HIV crisis. At the peak of the AIDS epidemic, CHCs provided leadership and a welcoming health care home to people who were often stigmatized. On July 11, 1983, Seattle and King County declared AIDS a health emergency and allocated $80,000 to the Public Health Department, making Seattle and King County two of the first jurisdictions in the nation to set aside funding for AIDS treatment and research (San Francisco was the first).
In 1987, Washington Governor Booth Gardner signed the Health Care Access Act. The bill included the first state-subsidized health insurance program in the U.S., the Basic Health Plan (BHP). BHP paved the way for low-income adults without children to gain access to low-cost insurance and helped CHCs care for more patients.
Community health centers became an essential part of the Seattle health care system in the ‘80s by forming enduring partnerships with area hospitals, Public Health and government. With the support of their partners, CHCs were able to develop more sophisticated approaches to delivery of care and reach more at-risk residents.
As the health care landscape in Seattle continued to change, several clinics consolidated into Puget Sound Neighborhood Health Centers, later renamed Neighborcare Health, to better meet the needs of the community. This consolidation foreshadowed the robust and sophisticated health care system that Neighborcare Health is today.