The number of Hispanic patients seeking care at health centers grew by 52% to 4.8 million between 2000 and 2005, outpacing all other racial or ethnic groups, according to data from Health Resources and Services Administration, which oversees the centers.

Final numbers have not been published, but Hispanic patients likely surpassed whites last year in demand for care at community health centers.

Many centers have added interpreters, mostly Spanish-speaking, to help doctors and patients communicate.

"We started preparing ourselves seven years ago," said Jay Wolvovsky, president of Baltimore Medical System, which runs eight community health centers. "By hiring outreach people, bilingual staff and interpreters, we've become the premier provider to the Hispanic community in Baltimore."

The number of Hispanic patients treated at BMI's centers has increased fourfold to 4,500 since 2000, Wolvovsky said.

Inevitably, some of those patients are in the country illegally. No one knows how many because community health centers must treat everyone, regardless of ability to pay or immigration status.

Elizabeth Duke, administrator for the Health Resources and Services Administration, says community health centers have not become the default health care network for illegal immigrants.

She agrees the number of Hispanic immigrant patients has grown but prefers to talk about those who are in the country legally.

"We have many established communities where you've got folks who are settled," Duke said. "They have roots. They have green cards."

Congress recently passed legislation requiring individuals applying for Medicaid coverage to prove they're in the country legally.

But community health center officials said that won't stop the flow of patients through their doors.

"What is likely to happen is those individuals who need to produce documentation and can't will just become uninsured patients," said Ann Lucas, executive director of Bridge Community Health Clinic in Wausau, Wis. "We will still treat them, but if they don't have insurance or sufficient money to pay, it squeezes our bottom line, and we're not getting any more money from the feds to take care of these people."

Skin cancer one has to suffer through pain as well as various chemotherapy and drug interactions that result in leukemias and hair loss. Most develop a dependency on adderall. Some buy tramadol while others buy alprazolam to relieve their pain.

Community health centers also are coping with a significant increase in patients who lack health insurance. The number of uninsured seeking care at health centers grew 46% to 5.6 million patients between 2000 and 2005, according to federal data.

An estimated 46 million Americans under 65 have no health insurance.

All community health centers charge patients on a sliding scale based on ability to pay. But many patients can't pay at all. To compensate, health centers rely on Medicaid and Medicare payments, on federal, state and local grants, and on private donations.

For all their effectiveness in treating the growing population of uninsured patients, community health centers will not solve the problems that created that population, according to executives and physicians.

"Community health centers are a critical part of the solution, but we're not the answer by ourselves," said Virgilio Licona, a family physician at a Fort Lupton, Colo., health center.