Community, Migrant, Homeless, and 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 Awardees
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 (awardees and look-alikes, see below) 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 2016 there are more than 1,400 organizations operating over 10,000 health center sites in the United States and serving nearly 26 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 Awardee: 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” (1,367 nationwide as of 2016)
  • Health Center Program Look-Alike (previously known as FQHC Look-Alike): health center that has been certified as meeting all Health Center Program requirements, but that does not receive funding under the Health Center Program (58 nationwide as of 2016)
  • 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 an overview of the Health Center Program, including how health centers increase access to care, improve health outcomes, and reduce health care costs, view the August 2017 HRSA Health Center Program Fact Sheet.

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 How Health Centers Make a Difference.

To explore a dynamic, multi-media website dedicated to the living history of the Community Health Center movement, please link to CHroniCles.

To access a compendium of health center data and infographics on topics such as expanding access to care, reducing health disparities, and the health center workforce, please link to NACHC’s Community Health Center Chartbook

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.

Please note: the links listed above may include information for health service sites that are not Health Center Program grantees.

Click HERE for a map of Region VIII Health Center Program Awardees and Look-Alikes.

UNDERSTANDING HEALTH CENTER PROGRAM AWARDEES

Health Center Program awardees (“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 Awardee 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.

Health Center Data:

The federal government compiles statistics from all health center awardees and FQHC Look-Alikes 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 awardees and reported at the awardee, 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 Grantee 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 awardees 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.

A health center’s Scope of Project defines the activities that are supported by Health Center Program budget. Specifically, scope of project defines the approved service sites, services, providers, service area(s) and target population(s). A health center’s scope of project may evolve over time and may expand through new grant awards or approval of a Change in Scope request.

Program Requirements:

There are 18 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, Clinical Staffing, Accessible Locations and Hours of Operation, Coverage for Medical Emergencies During and After Hours, Continuity of Care and Hospital Admitting, Sliding Fee Discount Program, Quality Improvement/Assurance
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 community’s 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, Contracts and Subawards, Conflict of Interest, Collaborative Relationships, Financial Management and Accounting Systems, Billing and Collections, Budget, Program Monitoring and Data Reporting Systems
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
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, see Health Center Data, above), each grantee must emphasize health outcomes and demonstrate the value of care delivered by reporting on specific Clinical and Financial Performance Measures within the following areas:

1. Quality of Care
Prenatal Care, Immunizations, Cervical Cancer Screening, Weight Assessment/Counseling for Children and Adolescents, Body Mass Index (BMI) Screening and Follow-Up, Tobacco Use Screening and Intervention, Asthma Medication, Coronary Artery Disease Therapy, Ischemic Vascular Disease Antithrombotics, Colorectal Cancer Screening, Depression Screening and Follow-Up, HIV Linkage to Care, Dental Sealants

2. Health Outcomes/Disparities
Uncontrolled Diabetes, Controlling High Blood Pressure, Low Birth Weight

3. Financial Viability/Costs
Total Cost per Patient, Medical Cost per Medical Visit, Health Center Program Grant Cost per Patient

For more information about Program Requirements, Performance Measures, and additional Health Center Program details, visit the following BPHC webpages:

OTHER ONLINE RESOURCES

Association for Utah Community Health (AUCH)
Video explaining the nature of care at Community Health Centers, including statistics about health centers in Utah
What is a Community Health Center?

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?

Documentary featuring Dr. Licona’s contributions to the Community Health Center movement from the early 1970s to the present day in Colorado
Through the Eye of a Visionary: Dr. Virgilio Licona

Community Health Association of Mountain/Plains States (CHAMPS)
Video about working at a health center, as expressed by health center providers and staff
Working at Health Centers in Region VIII

Community Health Association of Mountain/Plains States (CHAMPS)/Northwest Regional Primary Care Association (NRWPCA)
Recording of a 2016 CHAMPS/NWRPCA Annual Conference presentation addressing the BPHC Health Center Program
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

Community HealthCare Association of the Dakotas (CHAD)
An infographic breaking down what is true and what is false about community health centers and the care patients receive.
Infographic: Busting Community Health Center Myths
Video explaining the nature of care at Community Health Centers, including statistics about health centers in the Dakotas
What is a Community Health Center?

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)
HRSA Video, Community Health Centers: Quality Care, Satisfied Patients, which describes the accomplishments of health centers
HRSA’s YouTube Channel
HRSA’s standardized review instrument used to conduct Operational Site Visits and, when appropriate, other types of site visits at health centers. It includes review questions used by the team conducting the site visit to assess compliance with each program requirement, as well as to review progress on clinical and financial performance and capital grants (if applicable), and, when possible, to identify any best practices established by the health center. Health centers also may use this guide to assess compliance with program requirements and to identify clinical and financial performance improvement areas.
Health Center Program Site Visit 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

Montana Primary Care Association (MPCA)
Page of information explaining the characteristics of and nature of care at a Community Health Center
What is a Community Health Center?

National Association of Community Health Centers (NACHC)
A chartbook with data on Community, Migrant, and Public Housing Community Health Centers
A Sketch of Community Health Centers (2016)
Fact sheet illustrating how health centers play a vital role in reducing avoidable emergency department visits
The Role of Health Centers in Lowering Preventable Emergency Department Use
Summaries of articles related to community health centers’ access to and quality of care, cost effectiveness, and health care disparities
Research and Data on CHCs

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

Out in the Rural
A 23-minute video focusing on the Tuft’s-Delta community health center, one of the first community health centers in the nation, founded with the aim of using the clinic as a lever for social change; features Dr. Jack Geiger, at that time Project Director for the health center and considered a founder for the health center movement nationwide
Out in the Rural
A book by Thomas J. Ward, Jr., also exploring the origins of the community health center movement through the story of the Tufts-Delta Health Center in Mound Bayou, Mississippi
Out in the Rural: a Mississippi Health Center and Its War on Poverty

Pennsylvania Association of Community Health Centers (PACHC)
A guide to running an FQHC including an introduction, glossary terms, human resources, governance, reimbursement and scope of project information
The Pennsylvania Community Health Center Manual

Rural Assistance Center (RAC)
Website of health center resources including Frequently Asked Questions
Federally Qualified Health Centers

Wyoming Primary Care Association (WYPCA)
Page of information about the Community Health Centers in Wyoming
About the Health Centers