COMMUNITY DEVELOPMENT
Starting an FQHC
Federally Qualified Health Centers (FQHCs)—often referred to as community health centers (CHCs)—are nonprofit, community-directed health care providers serving low income and medically underserved communities. Created by Congress, the national network of community health centers provides high-quality, affordable primary and preventive care for those whom other providers do not serve, regardless of an individual’s ability to pay.
Requirements and FAQ
In order to achieve the “federally qualified” status, CHCs must be located in or serve a high need community (designated Medically Underserved Area or Population) and must be governed by a community board composed of a majority (51 percent or more) of health center patients who represent the population served.
Federal grants to offset the costs of uncompensated care and other key enabling services (health center program grantees receive these grant funds).
Access to free medical malpractice coverage under Federal Tort Claims Act (FTCA).
Prospective Payment System reimbursement for services to Medicaid patients.
Cost-based reimbursement for services to Medicare patients.
Drug pricing discounts for pharmaceutical products under the 340B Program.
Federal loan guarantees for capital improvements.
Reimbursement by Medicare for “first dollar” of services because deductible is waived if FQHC is providing services.
Access to Vaccines for Children Program for uninsured children.
Access to National Health Service Corps (NHSC) medical, dental and mental health providers.
National network of similar organizations committed to improving the mission.
An FQHC is a great place for the whole community to received top-quality care. Underserved people can get the care they need, public health is improved, it reduces the burden on hospital emergency rooms, and helps administer needed services like free immunizations for uninsured children.
A voice through the consumer majority board of directors in the operation of the community health center.
Uninsured patients have better broader coverage options through Medicaid, CHIP and other public assistance programs.
Lower cost care for Medicare patients, whose Medicare deductible costs are waived for FQHC-provided services.
Whether you’re a public or private non-profit health care organization, you can apply for FQHC grant funding when there’s an opening listed. In addition, an organization may apply for Look-Alike status (see below) at any time. The application package includes detailed instructions, forms and everything you need to complete the process.
New FQHC grant opportunities are announced on the HRSA newsroom site and may be found on Grants.gov.
As a public or private non-profit health care organization, you can apply to become an FQHC Look-Alike at any time. FQHC Look-Alikes have to meet the same requirements as FQHCs that receive Federal funding and are eligible for many of the same benefits. The review process takes about four months.
However, Look-Alikes are not eligible for Federal Tort Claims Act (FTCA) medical malpractice coverage or federal loan guarantees for capital improvements. Look-Alikes don’t automatically receive federal grant funds, but they are eligible to apply and are well-positioned to be successful.
| Comparison of Federal Support for Section 330 Health Centers and FQHC Look-Alike Health Centers | Section 330 Health Centers |
FQHC Look-Alikes |
| Competitive application process |  |
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| Receive direct funding from federal government | |
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| Located in medically underserved area | |
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| Provide services based on ability to pay | |
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| At least 51 percent of governing board members represent active users of the health center | |
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| Provide a detailed scope of primary health care and enabling services | |
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| Enhanced Medicaid/Medicare Reimbursement | |
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| Access to National Health Services Corp/J-1 Visa Waiver programs | |
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| FTCA Coverage | |
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| 340B Drug Pricing Program | |
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| Federal Loan Guarantee Program | |
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| Comply with BPHC Uniform Data System (UDS) and Performance Review Protocols | |
HRSA provides a Look-Alike website with multiple resources.
The most recent version of the Look-Alike designation application and instructions are also available on their Technical Assistance page.
The Uniform Data System (UDS) is a core set of information reported to the BPHC annually for reviewing the operation and performance of health centers. The UDS tracks a variety of information, including patient demographics, services provided, staffing, clinical indicators, utilization rates, costs, and revenues. UDS data are collected, aggregated and reported at the grantee, state, and national levels.
The National Association of Community Health Centers (NACHC) serves as the national association for FQHCs, much like IPHCA does in Illinois. NACHC provides a broad range of services, including advocacy and training. NACHC created A Practical Guide for Starting a Federally Qualified Health Center in January 2005 to assist those interested in starting a federally qualified health center. In addition, NACHC has a Health Center Growth/Development page that includes a broad range of information on FQHC grant requirements, governance, data, clinical services and more that goes beyond the information provided by HRSA.
IPHCA has compiled a list of grant writing resources that are helpful to grant seekers, whether apply for FQHC designation or other funding
For more information, please contact Susan Gaines, Vice President of Community Development + Financial Services