Special Populations: Public Housing Primary Care Program

 The federal Public Housing Primary Care (PHPC) program  is a federal grant program created in 1990 under the Disadvantaged Minority Health Improvement Act to include section 340A, to “provide for the delivery of primary care services, referrals, and health counseling and education services to residents of public housing.” The PHPC Program was reauthorized under the Health Centers Consolidation Act of 1996 as Section 330(i) of the Public Health Service Act. In establishing the program, Congress sought to address glaring health disparities and access issues faced by public housing residents. Testimony presented at Congressional hearings that led to the program’s enactment painted a compelling picture:

“While one in fourteen District Black women reported having diabetes, one in four Black women in public housing have diabetes. One in five District Black men and women report suffering from hypertension, one in two Black public housing residents report this disease.”

There are more than 2 million people  living in public housing units. Thirty-seven percent of public housing residents are children, age seventeen or younger, while 16% are ages sixty two or older. The average income of a family living in public housing is well below the federal poverty line, and Social Security payments comprise the virtually the entire income of 55% of public housing residents. (NCHPH, HUD).  About 36% of public housing households include a member who is disabled. The poverty experienced by residents of public housing is compounded by a lack of access to health care services, which elevates the risk of poor health outcomes. 

The Public Housing Primary Care Program enables health centers to provide an integrated approach to primary care for residents to address disparities and improve outcomes. The mission of the PHPC Program is to provide residents of public housing with increased access to comprehensive primary health care services through the direct provision of health promotion and disease prevention activities and primary health care services. The Public Housing Primary Care Program enables health centers to provide an integrated approach to primary care for residents to address disparities and improve outcomes. Services are provided on the premises of public housing developments or at other locations immediately accessible to residents of public housing.  Some community health centers receive grant support from the PHPC program. Program grants, administered by the Health Resources and Services Administration (HRSA) support the creation of both additional sites of care and enriched health services. Care sites may be located either within or immediately adjacent to public housing complexes. Services encompass primary and preventive care that includes enabling services such as case management and outreach, nutritional services through the Women, Infants, and Children (WIC) program, oral health care, and behavioral and substance abuse services.

In 2017, 12.8% percent of health center patients were served at CHCs located in, or immediately adjacent to, a public housing  site.