FQHC's

How It Works

Federally Qualified Health Centers (FQHC) are community-based providers of comprehensive preventative and primary health care, which receive Federal funding under Section 330 of the Public Health Service Act. They must fulfill Federal Health Center requirements, which include:

Being located in a HRSA-designated Medically Underserved Area/Population
Operate under a consumer Board of Directors governance structure
Provide comprehensive primary health, oral, and mental health/substance abuse services to persons in all stages of the life cycle
Provide services without regard for patients’ ability to pay
Charge for services on a Board-approved sliding-fee scale that is based on patients’ family size and income, and
Comply with all other program expectations/requirements and all applicable Federal and State regulations

Some health centers meet these requirements but do not receive funds. These can receive designation as Federally Qualified Health Center Look-Alikes (FQHCLA) by the Health Resources and Services Administration (HRSA) and the Centers for Medicare and Medicaid Services. FQHCs and FQHCLAs are eligible to receive enhanced reimbursement from Medicare and Medicaid, to participate in the 340B Program which enables them to purchase drugs at lower prices, and they have access to medical malpractice insurance through Federal Tort Claims Act.

There are four types of health centers:

Community Health Centers: serves medically underserved and low-income people, including school-based sites, receives 81.5% of total program appropriations
Migrant Health Centers: serve migrant workers and seasonal agricultural workers and their families, receives 8.6% of total program appropriations
Homeless Health Centers: serve homeless adults, families and children, receives 8.7% of total program appropriations
Public Housing Health Centers: serve residents of public housing, receives 1.2% of total program appropriations

Health Centers cared for 13.1 million people in 2004 and HRSA funds 1,000 Health Centers.

History

The Migrant Health Center Program was established by the Migrant Health Act of 1962. The first Community Health Centers were funded in the mid-1960s as neighborhood health centers and by the mid-1970s, approximately 100 neighborhood health centers had been established under the Economic Opportunity Act of 1964.

In 1975, the Community Health Center Program was authorized under Section 330 of the Public Health Service Act. The law also reauthorized the Migrant Health Center Program.

In 1987, the Healthcare for the Homeless Program was established under the Stewart B. McKinney Homeless Assistance Act. This Act authorized 15 programs providing services to homeless people, including emergency shelter, transitional housing, job training, education, some permanent housing and primary health care. In 1992, an amendment to the McKinney Act authorized Health Center Programs targeting homeless children.

In 1993, the Public Housing Primary Care Program was established under the Disadvantaged Minority Health Improvement Act of 1990. The Program supported preventive and primary health care for residents of public housing.

In 1996, the Health Centers Consolidation Act brought together the migrant, community, homeless and public housing primary health care programs under one authority

Policy Update

In 2002, President Bush announced the Health Center Initiative to increase the number of health centers and increase access to primary care. The initiative is a 5-year plan to increase health center funding by $2.2 billion through fiscal year 2006. The first four years of this initiative, through FY 2005, supported the creation of 428 new access points, the provision of 349 grants to expand the medical capacity of existing service delivery sites, and increased access for an estimated 3.65 million people.

The President’s FY 2007 Budget proposed to continue investing in this initiative.

Links

U.S. Department of Health and Human Services, Health Resources and Services Administration

References

Health Resources and Services Administration. About Health Centers. May 16, 2006. Available at: http://bphc.hrsa.gov/about/healthcenters.htm. Accessed January 24, 2006.