The patients are in

With the new Massachusetts health insurance law boosting the number of patients seeking care, community health centers northwest of Boston are scrambling to meet the demand.

Lowell Community Health Center recently converted administrative offices at its Warren Street facility to clinic space. The main clinic on Merrimack Street now stays open an extra night a week, and the center recently bolstered its staff, hiring two doctors and two nurses.

"We have had a significant increase," said Dorcas Grigg-Saito, chief executive officer of the Lowell center, which has 10 sites in the city and one in Tewksbury. "Some of it is word of mouth. People signing up for insurance have friends and relatives who come to see us, so they come, too."

The Lowell center and the Greater Lawrence Family Health Center are the two community health centers northwest of Boston. While the Lawrence center also has had more patient visits in recent months, officials there say they are not certain of the reasons for the increase.

The state's universal health insurance law, which is being rolled out this year, is bringing formerly uninsured people into the healthcare system. Many of these individuals and families are turning to community health centers, the locally based nonprofit organizations that arose from the antipoverty movement of the 1960s.

"We are front and center in the new healthcare legislation," said Kerin O'Toole, spokeswoman for the Massachusetts League of Community Health Centers. "We've seen quite a surge in demand. Although in many cases patients could go elsewhere, the health centers offer a whole range of services you can't get from a private provider."

The nation's first community health center opened at Columbia Point in Dorchester in 1965 as part of President Lyndon Johnson's war on poverty. Similar centers, supported by federal aid and private grants, opened across the country in poor and medically underserved areas. Today, the United States has more than a thousand centers, 52 in Massachusetts.

Business is thriving.

The Lowell Community Health Center had 16 percent more visits this April than in the same month last year. For the month of May, visits were up 12 percent this year.

The Greater Lawrence center saw a 4.5 percent increase in 2006 over 2005.

Statewide, patient loads at community health centers have been on the rise.

In 2006, centers in Massachusetts saw 760,301 patients, an increase of nearly 94,000, or 14 percent, over the previous year.

The surge in demand at community health centers with the new law was not fully expected. The centers have long been a safety net in the healthcare system - places where people could go whether they had insurance or not. The insured usually have many choices when seeking care.

But community health centers draw patients for a number of reasons. They offer "one-stop shopping," which can include dental care, substance abuse treatment, pediatric and prenatal care, and social services. Most have child care and translators on site for non-English speakers.

"One of our key strengths is that we can provide care in a culturally competent way," said Robert Ingala, chief executive officer of Greater Lawrence Family Health Center.

Community health centers also do outreach for Commonwealth Care, the new state health insurance program, and visitors to most centers can sign up for health insurance on the spot.

The heavy promotions the state is doing to get the uninsured to sign up and take advantage of healthcare also seems to be a factor in the increasing number of visits, according to Grigg-Saito. Once people have insurance, they are quicker to seek care, she said.

"People who are uninsured tend to wait longer to seek care, and they get sicker and wind up in the emergency room," she said.

In the past, institutions that treated the uninsured were compensated by a pool of money administered by the state and paid into by hospitals and other large providers.

Another reason that community health centers are seeing more patients is that three of the four insurers working with Commonwealth Care tend to direct subscribers to the centers, according to Alan Sager, director of the health reform program at the Boston University School of Public Health.

Sager said he is concerned that some community health centers may not be able to hire physicians quickly enough to meet the demand.

"If health centers were deluged by dozens more patients every day, how quickly could they respond?" he asked.

A Massachusetts Medical Society report issued last month warned of a growing shortage of primary-care physicians and some specialists, based on surveys of doctors and Massachusetts residents.

"The community health centers rely heavily on primary-care physicians, and if there is a shortage in the state, the centers would be exposed to that shortage," said B. Dale Magee, president of the Massachusetts Medical Society.

So far, directors of centers northwest of Boston say they have been able to hire qualified staff and otherwise meet the demands of new patients - in part by expansion.

Community Health Connections Family Health Center, the community health center for greater Fitchburg, opened a comprehensive care center in Gardner last year.

Ingala said the Lawrence center's status as a training facility for medical residents has helped recruiting efforts. The center now has 24 residents in training.

The Lawrence center has opened two new sites in the last six years. The Lowell center is looking to acquire a large building to consolidate services and allow for expansion.

Grigg-Saito said: "Our biggest constraint is our physical facilities."

Robert Preer can be reached at preer@globe.com.