“Stand and Deliver”: Building Health Center Infrastructure with Economic Stimulus Funds

1. “Stand and Deliver”: Building Health Center Infrastructure with Economic Stimulus Funds Alliance for Health Reform Briefing February 23, 2009 Presented by: Allison Coleman, Chief Executive Officer Capital Link

2. Capital Link Overview • Mission: Capital Link is a nonprofit organization that • assists health centers in planning and obtaining financing for building and equipment projects, and • assists PCAs and other partners in leveraging capital resources for health centers on a statewide, regional and/or national basis. • Founded as a joint effort of the National Association of Community Health Centers (NACHC), the Community Health Center Capital Fund (CHCCF) and Primary Care Associations in MA, IL, NC, and TX. • National Organization with offices in nine states: MA, CA, DC, LA, MD, MO, NC, WA and WV

3. Speaking From Experience Since 1998, Capital Link has: • Assisted health centers in obtaining almost $412 million for 162 capital projects totaling $549 million • Assisted Primary Care Associations in leveraging $341 million for capital programs for their member health centers in several states • Worked with HRSA, NACHC and numerous PCAs to document health center capital needs and the economic impact of investments in health centers

4. Health Center Capital Needs • In December 2007, Capital Link completed a HRSA-supported analysis that indicated that health centers would need $4.4 billion over 5 years to improve, expand and upgrade their current facilities. • In March 2008, Capital Link, NACHC and Community Health Ventures completed a study that indicated that health centers would need $10.5 billion in capital investments to enable them to reach the goal of serving 30 million people by 2015.

5. Economic Stimulus Funding • $1.5 billion represents the largest investment in health center infrastructure in the history of the health center program! • As such, health centers have a tremendous opportunity to build on past successes to achieve a new level of visibility and stature • … and to build their capacity to play an important role within any health reform effort

6. Shovel-Ready Projects • HRSA has made significant investments in providing capital-related TA to health centers through Capital Link over the past 11 years. • As a result of this investment and health centers’ commitment to growth, there are many “shovel-ready” projects that are prepared to move ahead as soon as HRSA can make funds available • Some projects will likely be 100% grant funded; • Others will leverage the federal investment with other funds from a variety of sources including New Markets Tax Credits, other state and foundation grants and loans • These projects will create construction and permanent jobs

7. Economic Stimulus Impact • Jobs created as a result of capital project spending • An investment of $1.5 billion over 2 years should result in the following: • Approximately $3 billion in overall economic impact, including direct, indirect and induced stimulus effect • More than 20,000 construction-related jobs • Permanent health center jobs by 2010: • Based on new capital projects coming on line and growth resulting from $500 million in new funding for health center operations: • 48,000 new permanent health center jobs • 28,000 additional jobs in low-income communities, based on the health centers’ spending in their communities

8. What Capital Link Will Be Doing to Help Health Centers Succeed • Collaboration with NACHC and HRSA to provide basic information regarding funding availability and application process • Direct one-on-one TA to get projects ready: • Feasibility analyses, market assessments, space planning, design-related advice and assistance, financial projections and business planning and assistance with leveraging multiple sources of funds • Advice and assistance to HRSAas they gear up to make grant funds available rapidly • Ongoing economic impact analysisof funded projects to document outcomes Investment by United Health Foundation will assist Capital Link in rising to meet the historic challenge and opportunity we have before us!

9. www.caplink.org Main Office Massachusetts 40 Court Street 10th Floor Boston, MA 02108 Phone: (617) 422-0350 Fax: (617) 542-0191 California 979 Osos Street Suite B3 San Luis Obispo, CA 93401 Phone: (805) 544-2355 Fax: (805) 544-7919 District of Columbia 1400 Eye Street, NW Suite 330 Washington, DC 20005 Phone: (202) 331-4602 Fax: (202) 296-3526 Louisiana 4550 North Boulevard Suite 120 Baton Rouge, LA 70806 Phone: (225) 927-7662 x207 Fax: (225) 927-7688 Maryland 7200 Wisconsin Avenue Suite 210 Bethesda, MD 20814 Phone: (301) 347-0400 Fax: (301) 347-0459 Missouri 443 North New Ballas Road Suite 201 St. Louis, MO 63141 Phone: (314) 991-8777 Fax: (314) 991-8999 North Carolina 2500 Gateway Center Suite 100 Morrisville, NC 27560 Phone: (919) 297-0013 Fax: (919) 469-1263 Washington 1920 Main Street Suite 18 Ferndale, WA 98248 Phone: (360) 312-0481 Fax: (360) 312-0489 West Virginia 140 Hummingbird Lane Shepherdstown, WV 25443 Phone: (304) 876-6996 Fax: (304) 876-3767