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What is a Federally Qualified Community Health Center (FQHC)?
A Community Health Center is just that, a health center based in the community. The FQHC is a federal designation from the Bureau of Primary Health Care (BPHC) and the Center for Medicare and Medicaid Services (CMS) that is assigned to non-profit or public health care organizations that serve uninsured or medically underserved populations.
FQHCs are specifically located in an area that is designated as a Medically Underserved Area/Population (MUA or MUP). FQHCs provide their services to all persons regardless of ability to pay, and charge for services on a Board approved sliding-fee scale that is based on patients' family income and size.
Because they receive funds from the Federal government, all FQHCs must operate under a consumer Board of Directors governance structure, and provide comprehensive primary health, oral, and mental health/substance abuse services to persons in all stages of the life cycle. FQHCs must comply with Section 330 program expectations/requirements and all applicable federal and state regulations.
In Ohio: go to the Ohio Association of Community Health Centers link: State of Ohio Health Centers
Outside of Ohio: Go to the Bureau for Primary Health Care and put in your state and county.
History of Community Health Centers
Health centers owe their existence to a remarkable turn of events in U.S. history, and to a few determined community health and civil rights activists working in low-income communities during the 1960s. As President Johnson's "War on Poverty" began to ripple through America, the first proposal for the U.S. version of a community health center sprung to life at the Office of Economic Opportunity. The passage of the landmark Economic Opportunity Act of 1964 marked the birth of America's Community Health Centers. The health center model that emerged targeted the roots of poverty by combining the resources of local communities with federal funds to establish neighborhood clinics in both rural and urban areas around America. It was a formula that not only empowered communities, but also generated compelling proof that affordable and accessible health care produced compounding benefits. The passage of Medicare and Medicaid in 1965 also provided much needed benefits to the elderly, disabled, and families living in poverty.
In 1975, Congress permanently authorized neighborhood health centers as "community and migrant health centers," and in later years added primary health care programs for residents of public housing and the homeless to the portfolio of programs.
Today, almost forty years after they started out as a neighborhood demonstration project, America's health centers are helping communities meet escalating health needs. Health centers and their innovative programs in primary care and prevention span urban and rural communities across the nation, serving as the family doctor and health care home for more than 15 million people.
Currently, over 1,000 community, migrant, and homeless health centers serve 3,600 urban and rural communities in every state and territory. Their remarkable success has earned them broad bipartisan support among federal, state, and local policy-makers.
Requirements of Health Centers
Health centers now constitute an integral part of the nation's health delivery system. It is the only health care system controlled in partnership with patients.
Every Federally Qualified Health Center (FQHC), is governed by a community board with a patient majority. The patient-majority governing board is among the five core statutory requirements that every health center must meet in order to receive federal funding. The other requirements are:
Health centers serve as the medical home and family physician to 15 million people nationally - a number that is quickly growing. Health center patients are among the nation's most vulnerable populations - people who even if insured would nonetheless remain isolated from traditional forms of medical care because of where they live, who they are, the language they speak, and their higher levels of complex health care needs.
About half of health center patients reside in rural areas, while the other half tend to live in economically depressed inner city communities. Health centers serve one in five low income children. Nearly 70% of health center patients have family incomes at or below poverty. Nationally, 40% of health center patients are uninsured and another 36% depend on Medicaid, much higher than the national rates of 12% and 15% for the nation's population as a whole. Two-thirds of health center patients are members of racial, and ethnic minorities. Nearly a third of all patients are best served in languages other than English. The number of uninsured patients at health centers is rapidly growing - from around 3.9 million in 1998 to over 5.9 million today.
How Do Health Centers Overcome Barriers To Care?
Health centers are different from most private, office-based physicians. They:
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