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.

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Where Can I find a Community Health Center in my area?

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:

• Location in a federally designated medically underserved area.
• Have nonprofit, public, or tax exempt status.
• Provide comprehensive primary health care services, referrals and other services needed to facilitate access to care, such as case management, translation, and transportation.
• Provide services to all in their service area, regardless of ability to pay, and offer a sliding fee schedule that adjusts charges for care according to family income.

Who Do Health Centers Serve?

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:

• Are located in high-need areas identified by the government as high poverty and where few physicians practice;
• Are open to all residents, regardless of insurance status and ability to pay;
• Tailor their services to fit the community and are linguistically and culturally appropriate
• Offer services that help their patients access health care
• Provide pharmacy assistance, mental health and dental services

How Do Health Centers Make A Difference?

• Patient involvement in service delivery.
  Governing boards - the majority of which must be patients according to grant requirements - manage health center operations.
  
  
• Improve Access to Primary and Preventive Care.
  Health centers provide preventive services to vulnerable populations that would otherwise not have access to certain services, such as immunizations, health education, mammograms, pap smears, and other screenings. Health centers have also made significant strides in preventing anemia and lead poisoning. Low income, uninsured health center users are also much more likely to have a usual source of care than the uninsured nationally.
  
  
• Effective Management of Chronic Illness.
  Health centers meet or exceed nationally accepted practice standards for treatment of chronic conditions such as diabetes, cardiovascular disease, asthma, depression, cancer, and HIV. Health centers' efforts have lead to improved health outcomes for their patients, as well as lowered the cost of treating patients with chronic illness.
  
  
• Reduction of Health Disparities.
  A recent landmark study found that health centers are associated with reducing racial, and ethnic disparities in such key areas as infant mortality, prenatal care, tuberculosis case rates, and death rates.
  
  
• Cost-Effective Care.
  Several studies have found that health centers save the Medicaid program in annual spending for health center Medicaid beneficiaries due to reduced specialty care referrals and fewer hospital admissions, thereby producing significant savings in combined federal and state Medicaid expenditures.
  
  
• High Quality of Care.
  Studies have found that the quality of care provided at health centers is equal to or greater than the quality of care provided elsewhere. Moreover, 99% of surveyed patients report that they were satisfied with the care they receive at health centers.
  
  
• Fewer Infant Deaths.
  Several studies have found that communities served by health centers have infant mortality rates between 10 and 40% lower than communities not served by health centers.