Community, Migrant, Homeless, & Public Housing Health Centers
CHAMPS’ mission, in part, is to provide a variety of services to potential and existing Health Center Program Grantees ("health centers") in Region VIII (CO, MT, ND, SD, UT, and WY).
In order to better understand Health Centers, please click or scroll down for:
Health Center Introduction
Finding a Health Center in Region VIII
Understanding Health Center Program Grantees
Health Center Program Requirements & Performance Measures
Other Online Resources
Health Center Terms & Acronyms
HEALTH CENTER INTRODUCTION
The health centers within the Bureau of Primary Health Care (BPHC) Health Center Program provide high-quality, affordable and accessible primary health care to primarily indigent, medically underserved, and underinsured populations in a wide range of communities, from inner cities to rural frontiers. As of 2011 there are more than 1,100 organizations operating over 8,000 health center sites in the United States and serving over 20 million people. These include community health centers, school-based health centers, migrant health centers, health care for the homeless centers, and public housing primary care centers. Collectively these organizations have historically been known as "Community Health Centers" (or "CHCs"). Common Health Center Program terms include:
- Health Center Program Grantee: organization that receives grants under the Health Center Program as authorized under section 330 of the Public Health Service Act, as amended; also sometimes referred to as “federally-funded health center” or “HRSA-funded health center”
- FQHC Look-Alike (FQHC LA): health center that has been certified as meeting all Health Center Program requirements, but that does not receive funding under the Health Center Program
- Federally-Qualified Health Center (FQHC): term defined in Medicare and Medicaid statues to identify an organization/entity approved to be reiumbursed under Medicare and Medicaid using specific methodologies; individual sites (not organizations) for enrolled/approved Health Center Program grantees, FQHC Look-Alikes, and outpatient health clinics associated with tribal or Urban Indian Health Organizations are considered separate FQHCs
For a history of the Health Center Program, please link to the National Association of Community Health Center’s (NACHC’s) About Our Health Centers webpage or view this national Health Center Fact Sheet.
To explore a dynamic, multi-media website dedicated to the living history of the Community Health Center movement, please link to CHroniCles.
FINDING A HEALTH CENTER IN REGION VIII
Follow the links below to locate Community, Migrant, Homeless, and Public Housing Health Centers throughout Region VIII and the nation.
- Colorado - Colorado Community Health Network (CCHN)
- Montana - Montana Primary Care Association (MPCA)
- North and South Dakota - Community Healthcare Association of the Dakotas (CHAD)
- Utah - Association for Utah Community Health (AUCH)
- Wyoming - Wyoming Primary Care Association (WPCA)
- National - Health Resources and Services Administration (HRSA)
Please note: the links listed above may include information for health service sites that are not Health Center Program grantees.
Visit the CHAMPS Region VIII Health Center Links webpage to access available website addresses for health centers in Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming.
Click HERE for a map of Region VIII Health Center Program Grantees.
UNDERSTANDING HEALTH CENTER PROGRAM GRANTEES
Health Center Program grantees ("health centers") receive Public Health Service (PHS) Act Section 330 funds and serve medically underserved areas (MUAs), or serve a medically underserved population (MUP), or meet the statutory requirements for receiving federal health center program funds.
For more information about MUAs and MUPs, link to our Understanding HPSAs and MUAs page.
Health Center Advantages:
- Health centers receiving Section 330 federal funds are automatically eligible for certification as Medicaid and Medicare FQHCs, receiving cost-based reimbursement for Medicaid and Medicare patients. (Health centers not receiving federal funding must complete an application through the Health Resources and Services Administration’s Bureau of Primary Health Care to obtain this certification.)
- Health Center Program Grantee status may offer health centers certain other benefits, such as access to federally-funded and supported technical assistance, higher rates of payment under Medicaid managed care, and eligibility for the PHS Drug Pricing Program.
- Visit the Centers for Medicare and Medicaid Services' (CMS) Federally Qualified Health Center Fact Sheet for more details.
For more information about the advantages and benefits enjoyed by Health Center Program grantees and their communities, visit the BPHC Program Benefits webpage.
Health Center Data:
The federal government compiles statistics from all health center grantees on an annual basis. This information, called the Uniform Data System (UDS), tracks a variety of information, including patient demographics, services provided, staffing, clinical indicators, utilization rates, costs, and revenues. UDS data are collected from grantees and reported at the grantee, state, and national levels.
For more UDS details, please link to the Bureau of Primary Care (BPHC) Health Center Data page.
For summarized Region VIII Health Center Program UDS information relating to selected users, staffing, encounter types, business plan performance measures, and clinical outcomes and disparities, please click HERE.
HEALTH CENTER PROGRAM REQUIREMENTS & PERFORMANCE MEASURES
All Health Center Program grantees are required to:
- Be located in a medically underserved area or serve a medically underserved population
- Provide comprehensive primary care (directly and/or by contract)
- Serve all patients regardless of age or income, within a defined service area
- Have a sliding-fee schedule based on the patient’s ability to pay
- Be a public or not-for-profit organization
- Have a community-based board of directors; to be federally funded, a majority of the board members must use the health center and must represent the community served in terms of demographic factors such as race, ethnicity, sex, age, and socioeconomic status
- Comply with program expectations for a federally funded health center
To receive federal funding a community health center must meet the program requirements of the U.S. Public Health Service. These requirements describe aspects of organizational structure and processes that are associated with successful health center programs. Every health center should have a sound infrastructure able to respond to the needs of its community within the constraints of its resources, and should develop processes and procedures designated to ensure the provision of high quality health services supported by strong management and governance.
Program Requirements:
There are 19 key Health Center Program requirements with four areas:
1. Need
Needs Assessment
Health centers are required to assess the health needs of the population to be served and the resources available in the community to meet those needs. Health centers are required to work closely with other safety net providers in defining and revising an appropriate role for the health center in addressing community health care needs. Factors used to determine need are geographic, demographic, and economic.
2. Services
Required & Additional Services, Staffing Requirement, Accessible Hours of Opereation/Locations, After Hours Coverage, Hospital Admitting Privileges & Continuum of Care, Sliding Fee Discounts, Quality Improvement/Assurance Plan
Health centers are required by law to operate a system of care that contributes to the desired outcomes of availability, accessibility, quality, comprehensiveness, and coordination. Centers must ensure that basic primary care services, coordinated with other levels of care, and support services appropriate to the communities defined health care needs are available and accessible. Centers must also have qualified providers and a clinical management system that ensures quality and continuity of care.
3. Management and Finance
Key Management Staff, Contractual/Affiliation Agreements, Collaborative Relationships, Financial Management & Control Policies, Billing & Collections, Budget, Program Data Reporting Systems, Scope of Project
To operate efficiently and effectively, the center must have appropriate management. The long-term mission and goals of the organization should guide center management. Management of a health center is a team process with well-defined lines of authority and responsibility. Adequate infrastructure must be in place including finance, management information systems, and communications.
4. Governance
Board Authority, Board Composition, Conflict of Interest Policy
A board of directors must govern community health centers, which has full authority and responsibility to establish program policies. The board of directors should govern within the context of a long-term strategic mission and goals, as well as an annual operating plan. A majority of the board members must represent users of the center’s services. A set of by-laws governing the organization should be maintained by the center. The by-laws should describe the structure and functions of the Board, and meet the requirements of federal, state, and local laws and regulations.
Performance Measures
As a component of the required data that Health Center Program grantees report each year (Uniform Data System-UDS), each grantee must emphasize health outcomes and demostrate the value of care delivered by reporting on specific Clinical and Financial Performance Measures within the following areas:
1. Outreach/Quality of Care
Prenatal Care, Immunizations, Cervical Cancer Screening (Pap Tests), Body Mass Index (BMI), Tobacco Use, Asthma
2. Health Outcomes/Disparities
Diabetic Patient Outcomes, Hypertnsion Patient Outcomes, Low Birth Weight Births
3. Additional Measures
Health Center's Choice: one additional Behavioral Health measure (e.g., Mental Health or Substance Abuse) and one additional Oral Health meaure
4. Financial Viability/Costs
Total Cost per Patient, Medical Cost per Medical Visit, Change in Net Assets to Expense Ratio, Working Capital to Monthly Expense Ratio, Long Term Debt to Equity Ratio
For more information about Program Requirements, Performance Measures, and additional Health Center Program details, visit the following BPHC webpages:
- Health Center Program Requirements
- Health Center Program Clinical and Financial Performance Measures
- Health Center Site Visit Guide
- Health Center Program Policy Information Notice (PIN) 98-23: Health Center Program Expectations
- Additional Health Center Program Policy Information Notices (PINs) and Program Assistance Letters (PALs)
OTHER ONLINE RESOURCES
Colorado Community Health Network (CCHN)
Video explaining the nature of care at Community Health Centers, including statistics about health center services in Colorado
What is a Community Health Center
Community Health Association of Mountain/Plains States (CHAMPS)/Northwest Regional Primary Care Association (NRWPCA)
2010 CHAMPS/NWRPCA Annual Conference session presentation slides
CHC 101: Introduction to the Community Health Center System
Community Health Care Association of New York State (CHCANYS)
Information and links to help existing Health Center Program grantees, and organizations in the planning stages, become and remain compliant with the Health Resources and Services Administration’s (HRSA) 19 Health Center Program Requirements
FQHC Resource Page
Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS)
Part of the Rural Health Fact Sheet Series, this resource contains official CMS information for Medicare fee-for-service providers
Federally Qualified Health Center Fact Sheet
Health Resources and Services Administration (HRSA), Bureau of Primary Health Care (BPHC)
Webpage with information about HRSA-supported health centers
What is a Health Center?
HRSA Video, Community Health Centers: Quality Care, Satisfied Patients, which describes the accomplishments of health centers.
HRSA's YouTube Channel
Online resource tool to help new and existing BPHC grantees assess the status and quality of operations, improve programmatic performance, and get answers to a variety of grantee-related questions; includes information on 340B Drug Pricing, Federal Tort Claims Act (FTCA), Health Information Technology issues, National Health Service Corps (NHSC), Policy Information Notices (PINs), Program Assistance Letters (PALs), health center program requirements, and more
New Start Web Guide
Kaiser Family Foundation, Kaiser Commission on Medicaid and the Uninsured
Resources that examine the role of community health centers (CHCs) as a key components of the US health care system
CHC Fact Sheet
Issue brief on the role of CHCs in the health system
Report on how CHCs fared in the wake of health reform in Massachusetts
KUED - the University of Utah
Utah Community Health Centers were highlighted in a PBS documentary that aired on affiliate KUED looking at the barriers to health care, particularly among the uninsured. Website includes film transcript, Q&A with the director, interviews, and the film
Healthcare: Facing Barriers
National Association of Community Health Centers (NACHC)
Practical guide to starting a Federally Qualified Health Center (FQHC)
So You Want to Start a Health Center...?
National Conference of State Legislatures
Ten-minute video including legislators, state health officials, and a primary care association representative talking about the role of community health centers in their state
Community Health Centers: A Guide for State Policymakers
Rural Assistance Center (RAC)
Website of health center resources including Frequently Asked Questions
Federally Qualified Health Centers
US Department of Health and Human Services, Health Resources and Services Administration, Office of Rural Health Policy
Report helping practitioners understand the differences between Rural Health Clinics and Federally Qualified Health Centers
Comparison of the Rural Health Clinic and Federally Qualified Health Center Programs
