About CHCs

people in a waiting roomCommunity Health Centers (CHCs) are nonprofit organizations located in medically under served areas (MUAs), providing comprehensive primary health care to anyone seeking care. In addition to treating individual patients, a health center emphasizes health promotion and disease prevention for entire communities. A Community Health Center does not deny anyone primary health care services — all community residents have equal access regardless of ability to pay, geographic location, culture, age, sex, or religion. The three key aspects of CHCs — universal access, cost effectiveness, and community governance — continue to prove to be the most effective long term solution for meeting primary health care needs in medically under served areas. As Federally Qualified Health Centers (FQHC), CHCs provide a wide range of services to their patients. Among the core services are:

  • Physician care
  • X-Ray services
  • Laboratory services
  • Preventive services (mammography, well-child, etc.)
  • Immunizations
  • Transportation for health services
  • Case management
  • Specialty referrals

Some CHCs also offer inpatient physician care, dental care, and behavioral health services. Additionally, in order to maximize limited resources, CHCs develop linkages in the community with other private and public providers, pharmacies, nursing homes, and local business.

Few primary care delivery systems do more than CHCs to ensure and measure the quality of health care they provide. In fact, according to several studies, the CHC model consistently shows high quality measurements.

To that end, all CHCs regularly undergo an in-depth evaluation process conducted by the U.S. Public Health Service. Called the Primary Care Effectiveness Review, the three day evaluation reviews all clinical, governance, and administrative procedures, and provides guidance for future improvements. And now, many CHCs are also becoming JCAHO accredited.

CHCs provide a strong positive economic impact on the communities they serve. Along with quality health care services vital for economic growth, they provide local jobs. CHCs employ more than 700 full time employees in Virginia. CHCs also bring over $36 million in outside grants and non-patient revenues to these areas, adding to the economic base and development of these regions of the state.

Community Health Centers are Federally Qualified Health Centers.
In 1989 and 1990 the federal government passed laws identifying certain community-based health care organizations as unique providers of services to Medicaid and Medicare recipients. These laws, established in the Omnibus Budget Reconciliation Acts of 1989 and 1990:

  • Designate the Federally Qualified Health Center (FQHC) as a unique type of health care provider
  • Establish a certain set of FQHC health care services that Medicaid and Medicare must cover for those beneficiaries who receive these services from the FQHC
  • Require reimbursement of reasonable cost to the FQHC for the FQHC services.

By passing FQHC legislation to cover the reasonable cost of covered Medicare and Medicaid services for eligible individuals, Congress recognized two goals of the FQHC program:

  • To provide adequate reimbursement to community-based primary health care organizations (FQHCs) so that they, in turn, may better serve large numbers of Medicare and Medicaid recipients and provide more services, thus improving access to care;
  • To enable FQHCs to use other resources previously subsidizing Medicare and Medicaid to serve uninsured individuals who, although not eligible for Medicare or Medicaid, have a difficult time obtaining primary care because of economic or geographic barriers.

FQHC laws define two types of providers that may qualify for the program. First, those who receive federal grants under the Public Health Service Act, Section 330, which include Community Health Centers, Migrant Health Centers and Health Care for the Homeless programs.

The second type of provider that may qualify are those meeting all requirements under Section 330 but do not actually receive federal funding assistance. To receive FQHC status a provider must apply. For details on the FQHC program and assistance in applying, contact the U.S. Bureau of Primary Health Care, the Virginia Community Heathcare Association (804-237-7677), or the Virginia Department of Health (VDH) Center for Primary Care Resource Development (804-864-7435)

These are sites that are not designated as Federally Qualified Health Centers (FQHCs), however they operate much like a CHC including being private, nonprofit organizations, offering universal access through a sliding-fee-scale, and governed by a local volunteer board of directors including users of the center.

Who can apply to establish a Community Health Center?
In order to apply for grant funding under section 330 an applicant must be a public or private, nonprofit entity, including faith-based and community-based organizations. The applicant must request funding to establish a new access point for comprehensive primary and preventive health care services. Applicants must propose to serve a defined geographic area that is federally designated, in whole or in part, as a Medically Underserved Area (MUA) or a Medically Underserved Population (MUP). Those applicants applying for Migrant Health Center, Health Care for the Homeless Programs, or Public Housing Primary Care Programs are exempt from this requirement. Applicants must not propose a new access point to provide a single service (i.e., prenatal services), age group (i.e., children) or life cycle (i.e., geriatrics). Further criteria can be found in the Bureau of Primary Health Care Program Information Notice (PIN).

For an excellent guide through the journey to becoming a Community Health Center check out the National Association of Community Health Centers’ So You Want To Start A Health Center…? (NACHC membership required for discount pricing).

Whether your community has just decided to assess its healthcare resources and may be planning to apply for federal assistance or an established Community Health Center in need of technical assistance, the Virginia Community Heathcare Association has many services and resources to assist in planning and action! We have assisted communities with increasing access to comprehensive health care services for almost 30 years.

The Association offers resources and technical assistance to:

  • Identify, Organize, and Convene Community Leaders — help you communicate with those concerned about primary health care access and willing to take action;
  • Research Primary Care Needs — assistance with needs assessments, health status indicators, barriers to care, and community, and marketplace dynamics;
  • Analyze Delivery System Gaps — consider physical, geographical, financial, or cultural access barriers
  • Develop Strategic Plans and Enhance Boards Through Comprehensive Training — we can help plan for the future, review community needs, strengths and weaknesses;
  • Help Communities Understand Delivery Systems and Models — define different alternatives to address health -care needs, assess appropriateness of CHC health care delivery model for your community;
  • Facilitate Partnership Development & Coalition Building — identify, educate, and motivate potential partners who can assist;
  • Identify Various Financial Resources — assist with identification of fundraising and grantwriting resources;
  • Provide Comprehensive Assistance With Regulatory and Legislative Guidelines — we can help you navigate the federal assistance guidances and regulatory expectations;
  • Provide Mentoring And Support Services for Newly Established Community Health Centers.

For further information, questions or assistance in determining if the Community Health Center model is right for your community, please contact us.