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4/29/2019 » 4/30/2019
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Becoming an FQHC
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The Health Resources and Services Administration's Bureau of Primary Health Care (BPHC), a unit of the US Department of Health and Human Services, supports Federally Qualified Health Centers as a major component of America's health care safety net – the nation's system for providing care to low-income and other vulnerable populations. Federally Qualified Health Centers care for 17 million people across the US, and the Bureau of Primary Health Care funds over 1,080 FQHC organizations. Photo

Federally Qualified Health Centers care for people regardless of their ability to pay and their health insurance status. They provide primary and preventive health care, as well as enabling services such as transportation and translation. Many FQHCs also offer dental, mental health, and substance abuse care on-site.

General criteria for starting a Federally Qualified Health Center are as follows:

  • Must address the health care needs of a Medically Underserved Area (MUA) or Medically Underserved Population (MUP)
  • Must be not-for-profit (public or private)
  • Must provide comprehensive primary health care, directly or via contract
  • Must ensure that patients can access care regardless of ability to pay
  • Must provide:
    • Primary medical care
    • Diagnostic labs/radiological services
    • Preventive services
    • Eye, ear, and dental services
    • Voluntary family planning services
    • Preventive dental services
    • Emergency medical services
    • Pharmaceutical services
    • Substance abuse and mental health services (directly or by formalized referral)
    • Patient case management services
    • Enabling services: outreach, transportation, translation
    • Health education
  • Must have appropriate clinical and administrative leadership
  • Must utilize adequate practice management systems
  • Must use clinical processes to guide provision of services
  • Must have a Quality Management Plan and related programs
  • Must use a sliding fee scale for patients at or below 200% of the Federal Poverty Level
  • Must have a community-based Board that independently exercises key authorities:
    • Hiring the CEO / ED
    • Adopting policies / procedures
    • Establishing services and hours of operation
    • Establishing sliding fee scales, discount schedules, and annual budget
    • Conducting strategic planning, quality assessment, and other functions
  • Must have at least 51% of Board members who are regular patients of the Center
  • Must have a management team working with the Board to develop community needs assessments and marketplace trend assessments, to ensure that true needs are met
  • Must have financial systems that provide internal controls, safeguard assets, maintain adequate cash flow, assure access to care, and maximize revenue from non-Federal sources
  • Some health centers must provide additional supplemental services that are important to their patient populations and communities. For example, centers serving migrant seasonal farmworkers should be knowledgeable about the Environmental Protection Agency’s Worker Protection Standards and pesticide risks and must provide occupational related health services such as pesticide screening and injury prevention programs related to pesticide and other occupational exposures, as well as screening for and control of parasitic and infectious diseases.
  • Have a management team that works with the governing board to achieve the mission of the health center and to ensure that the organization adapts to community needs and marketplace trends. The organizational chart should have a line of authority from the board to a chief executive who is employed by the board. The management team is employed by the chief executive and should include individuals with the skills to provide leadership, fiscal management, clinical services and quality assurance, and management information system expertise.
A new health center could be a new organization starting from scratch or it could be an existing organization that "converts" its governance structure and/or operations to the health center model. The types of organizations that may wish to convert to a health center include FQHC "Look-Alikes,” family planning clinics, rural health clinics, public health departments, free clinics, hospital outpatient programs, other social service organizations, or even certain for-profit primary care practices.

For more information on starting a Federally Qualified Health Center in your community, please visit the web site below for free information supported by the Bureau of Primary Health Care: