2. Key Characteristics of Health Centers
Community Health Centers (CHCs), aka Federally Qualified
Health Centers (FQHCs) and FQHC-Look Alikes
Not-for-profit (Public or private)
Provide a Comprehensive Scope of Services
Located in or serve a high need community - Medically
Underserved Area (MUA) or a Medically Underserved Population (MUP)
Govern with community involvement (51%-user
Board of Directors)
Treat patients regardless of ability to pay
3. Who are health center patients?
Collectively, health centers are the Health Care
Home for 24 Million Americans
• 1 of 7 Uninsured Persons, including
– 1 of 5 Low-income Uninsured Persons
• 1 of 7 Medicaid Beneficiaries
• 1 of 3 Individuals Living in Poverty
– 1 out of 4 Minority Individuals Living in Poverty
• 1 of 7 Rural Americans Source: NACHC, 2012. Includes patients
of federally-funded health
• 923,400 Farmworkers centers, non-federally funded health
centers, and expected patient growth
• 1.1 Million Homeless Persons for 2012.
4. Who are health center patients?
Over 200%
7%
151-200%
0%
Health Center Patients
7%
Are Predominately Low
Income
101-150% Source: Federally-funded health centers only.
14% 2010 Uniform Data System, Bureau of Primary
Health Care, HRSA, DHHS.
Note: Federal Poverty Level (FPL) for a family of
three in 2010 was $17,600. (See
http://aspe.hhs.gov/poverty/08poverty.shtml.)
Based on percent known. Percents may not total
100% due to rounding.
100% and
below
72%
5. Who are health center patients?
Private
Other 14% Most Health Center Patients
Public are Uninsured or Publicly
3% Insured
Medicare Uninsured
7% 38%
Other public may include non-Medicaid SCHIP and state-funded
insurance programs.
Source: Federally-funded health centers only. 2010 Uniform Data
Medicaid/ System, Bureau of Primary Health Care, HRSA, DHHS.
SCHIP Note: Percents may not total 100% due to rounding.
38%
6. Where are health centers located?
There are more than 1,200 health center
organizations serving more than 24 million
patients in over 8,000 rural and urban
communities.
>>Locate a Community Health Center<<
7. Why support health centers?
Proud History: 45+ years of bringing high-quality health care to
underserved communities, giving people served ownership & control
of delivery system
Largest National Primary Care Network: 24+ million people served
Record of Achievement: cited by IOM, OMB, and GAO for excellence
in care, disparities reduction, cost-effectiveness, and community
benefit
Bipartisan Support: Congressional majority and two Presidents praise
work, mission of health centers, call for continuation & growth
9. Health Center Program Requirements
A. Need
B. Services
C. Management and Finance
D. Governance
10. Health Center Program Requirements
A) Patient Need
• Needs Assessment: Health center demonstrates and documents the
needs of its target population, update its service area when appropriate.
• Required and Additional Services: Health center provides all required
primary, preventive, enabling health services and additional health
services as appropriate and necessary, either directly or through
established written arrangements and referrals
Note: CHCs requesting funding to serve homeless individuals and their
families must provide substance abuse services among their required services.
11. Health Center Program Requirements
B) Services
• After Hours Coverage: Health center provides professional coverage
during hours when the center is closed.
• Hospital Admitting Privileges & Continuum of Care: Health center
physicians have admitting privileges at one or more referral hospitals, or
other such arrangements to ensure continuity of care.
In cases where hospital arrangements (including admitting privileges and
membership) are not possible, the health center must firmly establish
arrangements for hospitalization, discharge planning, and patient
tracking.
12. Health Center Program Requirements
B) Services
• Sliding Fee Discounts: Health center has a system in place to determine
eligibility for patient discounts adjusted on the basis of the patient’s ability
to pay.
System must provide a full discount to individuals and families with annual
incomes at or below 100% of the Federal Poverty guidelines (only nominal
fees may be charged) and for those with incomes between 100% and 200% of
poverty, fees must be charged in accordance with a sliding discount policy
based on family and income.
13. Health Center Program Requirements
B) Services
• Quality Improvement/
Assurance Plan: Health center
has an ongoing quality
improvement/assurance program
that includes clinical services and
management, and that maintains
the confidentiality of patient records.
14. Health Center Program Requirements
C) Management and Finance
• Program and Reporting Requirements: Health center has
systems that accurately collect and organize data for program
reporting.
• Financial Management & Control Policies: Health center
maintains accounting and internal controls systems. Health
center ensures that an annual independent financial audit is
performed in accordance with federal audit requirements.
15. Health Centers’ Revenue Sources Do Not
Resemble Those of Private Physicians
10.0% Self-Pay/Uninsured
11.6%
Private Insurance
4.5%
9.9% 64.0%
Other Public
Medicare
6.8%
64.0% Medicaid/SCHIP
25.3% Source: Private Physician data: 2009
National Ambulatory Medical Care Survey
(visits). NACHC, 2012. Based on Bureau of
Primary Health Care, HRSA, DHHS, 2010
Uniform Data System. Note: Private
15.5% Physicians does not equal 100% due to
reporting in NAMCS.
Health Center Private Physicians
17. Health Center Program Requirements
D) Governance
• Board Authority: CHC governing board maintains appropriate authority to
oversee the operations of the center.
• Board Composition: CHC has a governing board of between 9 and 25
members. A majority (51%) of the governing board members MUST BE
patients of the center and they represent the individuals served by the
center in terms of demographic factors such as race, ethnicity, and
gender. The non-consumer members of the board must be
representative of the community, and no more than half of them may
derive more than 10% of their annual income from the health care
industry.
18. Interested in Becoming a Federally
Qualified Health Center?
Follow this link to our guide
http://tiny.cc/NewStartFQHC
19. Partners
There are several state and national partner
organizations who support health centers
through training and technical assistance:
NACHC
PCAs
PCOs
HRSA/BPHC
20. What is NACHC?
• National Association of Community Health Centers is
a membership-supported organization, providing
training, technical assistance, group purchasing
programs, leadership and professional
development, lobbying/advocacy, and group
purchasing programs.
• NACHC provides strong advocacy before Congress
and with federal administrative and regulatory
bodies on all major issues that affect health centers
and our mission.
21. What is HRSA?
Health Resources and Services Administration (HRSA)
HRSA, an agency of the U.S. Department of Health and Human
Services, is the primary Federal agency for improving access to
health care services for people who are uninsured, isolated or
medically vulnerable.
Within HRSA, the Health Centers Program is managed and
funded through the Bureau of Primary Health Care (BPHC)
>>Learn more about HRSA and BPHC<<
22. What are PCAs?
State/Regional Primary Care Associations (PCAs)
• PCAs are private, non-profit organizations that provide a wide
spectrum of services individualized to state needs and may
include:
– Training and technical assistance to health centers
– Support for the development of health centers in their state
– Operational diagnostics and support
– Leadership Development
– Group Purchasing Programs
– Workforce Retention and Recruitment
– Lobbying and Advocacy with state regulatory and legislative entities
– And More….! >>Complete listing of the PCA organizations<<
23. What are PCOs?
Primary Care Offices (PCOs)
PCOs are state-based offices that provide assistance to
communities seeking Health Professional Shortage Area (HPSA)
designations and funding for health centers such as Community
and Migrant Health Centers and Health Care for the Homeless
health centers. PCOs work collaboratively with Primary Care
Associations, relevant HRSA programs and offices and other
organizations to increase access to primary and preventive
health care and improve the status of underserved and
vulnerable populations.
>>Complete listing of the PCOs<<
24. America’s Voice for Community Health Care
National Association of Community Health
Centers Mission: To promote the provision of
high quality, comprehensive and affordable
health care that is coordinated, culturally and
linguistically competent, and community
directed for all medically underserved people.
Learn more about NACHC: www.NACHC.org
25. CFAHC, a project of NACHC
Campaign For America’s Health Centers Mission:
To do everything we can to stop threats to health
centers and health center patients! We want to provide
a way for every health center, every patient and every
community that has or needs a health center to act to
preserve, strengthen and expand America’s Health
Centers.
Join us! http://www.saveourchcs.org/join-the-campaign.cfm