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Quarterly Claims and Operations

General Information for Starting a Health Center
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Choose the Right Entity Type

Nonprofit

  1. Prepare to file Article of Incorporation in Indiana
  2. Indiana Nonprofit Registration 
  3. Apply for IRS Tax Exempt Status

Public

To qualify as a public entity eligible for funding, the organization must be:

  • A state or a political subdivision of a state with one or more sovereign powers.
  • An instrumentality of government, such as those exempt under Internal Revenue Code section 115, or a subdivision, municipality, or instrumentality of a U.S.-affiliated sovereign state that is formally associated with the United States.

Learn more about Health Center Program Eligibility here

Considerations regarding Special and Vulnerable Populations
Section 330(g): Migrant and seasonal farmworkers and their families

  • Provide a plan that ensures the availability and accessibility of required primary health care services to migratory and seasonal agricultural workers and their families in the service area, which includes:
    • Migratory agricultural workers who are individuals whose principal employment is in agriculture, and who have been so employed within the last 24 months, and who establish for the purposes of such employment a temporary abode;
    • Seasonal agricultural workers who are individuals whose principal employment is in agriculture on a seasonal basis and who do not meet the definition of a migratory agricultural worker;
    • Individuals who are no longer employed in migratory or seasonal agriculture because of age or disability who are within such catchment area; and/or
    • Family members of the individuals described above.

Note: Agriculture refers to farming in all its branches, as defined by the North American Industry Classification System under codes 111, 112, 1151, and 1152 (48 CFR § 219.303).


Section 330(h): Individuals/persons experiencing homelessness

  • Provide a plan that ensures the availability and accessibility of required primary health care services to individuals:
    • Who lack housing (without regard to whether the individual is a member of a family);
    • Whose primary residence during the night is a supervised public or private facility that provides temporary living accommodations;
    • Who reside in transitional housing;
    • Who reside in permanent supportive housing or other housing programs that are targeted to homeless populations; and/or
    • Who are children and youth at risk of homelessness, homeless veterans, and veterans at risk of homelessness.
  • Provide substance use disorder services.

Section 330(i): Residents of public housing

  • Ensure compliance with PHS Act section 330(i); and, as applicable, section 330(e), program regulations, requirements, and policies.
  • Provide a plan that ensures the availability and accessibility of required primary health care services to residents of public housing and individuals living in areas immediately accessible to public housing. Public housing includes public housing agency-developed, owned, or assisted low-income housing, including mixed finance projects, but excluding housing units with no public housing agency support other than Section 8 housing vouchers.
  • Consult with residents of the proposed public housing sites regarding the planning and administration of the program.

 

Comparison of Indiana State-Funded Community Health Center, Rural Health Clinic, and Community Health Center

 

Indiana State-Funded Community Health Center

Rural Health Clinic

Community Health Center

Program Basics

Funding Source

Funding from ISDH & State Legislature via the Tobacco Settlement Fund

Designation only

Funding from HRSA via New Access Point and/or Service Area Competition opportunities

Reimbursement

No enhanced reimbursement

Enhanced reimbursement for Medicaid and Medicare

Prospective payment system rates

Location Requirement

Rural, urban, or multi-site

Non-urban rural areas

Rural or urban

Shortage Designation

MUA/P, HPSA, or designation by ISDH

Primary Care HPSA (Geographic-based and Population-Group); MUA; Governor Designated and Secretary Certified Areas

MUA/P

Organizational Structure

Public or not for-profit

Public, not-for-profit, or for-profit

Public or not for-profit

Governance Requirement

Board or advisory committee required, composition requires 30% user of the center

Not required

Board required, 9-25 members, 51% patient majority board representation

Midlevel management requirement

Recommended, as appropriate

Required, 50% of clinical schedule

No specific requirements

Service available to all regardless of ability to pay

Required

Not required

Required

Healthcare Services

Primary healthcare services

Physician or MLP, as appropriate; Core staff, 32 hours

By physician or MLP

No specific requirement; Core staff, 32 hours

Primary healthcare for all life cycles

Develop during first year of operations

Not required

Required

Diagnostic lab, x-ray, pharmacy

On site or through arrangement

On site or through arrangement[1]

On site or through arrangement

24-hour access

Required

Not required

Required

Preventive healthcare services

Required

Not required

On site through arrangement (preventive dental required)

Transportation

Preferred

Not required

Through site or by arrangement

Case management

Required

Not required

Required

Written clinical procedures

Required

Required

Recommended

Tracks patient outcomes

Required

Not required

Required

Finance and Operation

Financial, administrative, MIS capacity

Required

Required

Required

Independent financial audit

Preferred

Not required

Required

Financial solvency

Plan for self sufficiency

Has not declared bankruptcy

Revenues 90% of expenditure

Written policies and procedures

Required

Required

Required

Precepts primary care students/residents

Preferred

Not required

Not required



[1] Six basic lab procedures required. 

 


Strategic Planning and Initial Steps toward Health Center Development

Conduct Community Readiness Assessment

  • Examine Community Health and Healthcare Needs
  • Identify Community Health Resources/Capacity for Primary Care
  • Evaluate options for increasing access to primary care

Engage in Health Center Planning

  • Identify community stakeholders, such as government official, school districts, community and faith-based organizations
  • Utilize resources from HRSA, National Cooperative Agreement Recipients, and Primary Care Association
  • Develop realistic, workable project timeline and expectations
For more tips and ideas on planning, visit Community Tool Box: https://ctb.ku.edu/en/table-of-contents