Become a FQHC - The Road to Designation

So, you want to become a Federally Qualified Health Center (FQHC) in 2017 but you don’t know where to start? This article is for you.

HEALTH CENTERS UNDER THE ACA / OBAMACARE

Health Resources and Services Administration (HRSA) under the Bureau of Primary Health Care (BPHC) oversees the Health Center Program, a national network of community health centers that exist in areas where economic, geographic, or cultural barriers limit access to primary health care for a substantial portion of the population. These health centers provide primary care services without regard to a patients’ ability to pay and charge for services on a sliding fee scale, relative to family size and income. Health centers improve patient outcomes while reducing health disparities, despite serving a population that is often sicker and more at risk than the general population. They also reduce costs to health systems; the health center model of care has been shown to reduce the use of costlier providers of care, such as emergency departments and hospitals. In calendar year 2015, a network of 1,375 health centers served 24,295,946 people. Today, it is estimated that health centers serve one in 13 people and one in 10 children in the United States.

The Affordable Care Act (ACA) was highly instrumental to the expansion of community health centers across the nation, as these clinics were largely responsible for absorbing many of the newly insured. The ACA provided $11 billion over a five-year period to community health centers, to support operation, expansion, and construction of health centers throughout the nation. $9.5 billion was targeted to: support ongoing health center operations; create new health center sites in medically underserved areas, and; expand preventive and primary health care services, including oral health, behavioral health, pharmacy, and/or enabling services, at existing health center sites. $1.5 billion was targeted to support major construction and renovation projects at community health centers nationwide. As of January 2017, this funding stream has run out and whether additional funds will be pushed toward the health center program by the current administration, is largely speculative and rather unlikely.

THE ROAD TO DESIGNATION

So, you want to become a FQHC but you don’t know where to start? Let us help you. Becoming a FQHC at this moment in time comes with no guarantee you’ll receive grant funding, but also know the program has its perks. First, know that there are three different types of FQHCs: grantees, subrecipients, and look-alikes. In short, grantees receive designation and grant funding, subrecipients receive designation and grant funding under contract with a grantee, and look-alikes receive designation but do not receive grant funding.

When the ACA was shelling out dollars to improve access and create new health centers, HRSA published many grant opportunities known as New Access Point (NAP) grants. NAP grants allow a new organization to apply for FQHC designation and base funding under a 330 grant, becoming a grantee. NAP grants also allow an existing grantee to propose opening a satellite clinic location. Therefore, when applying for a NAP grant, you’re competing with existing grantees and new organizations. HRSA released several rounds of NAP funding under the roll-out of the ACA. Prior to, it was expected that NAP grants would be announced every two to three years and, based on available funding, only a handful of applications would be funded.

There is no news on the horizon of NAP grant applications becoming available, as the last round was awarded in calendar year 2016, bringing a close to the ACA’s funding stream. However, FQHC Look-Alike applications are accepted year-round, at any time. Look at the table below to better understand the perks of becoming designated.

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As noted, FQHC Look-Alikes are eligible for FQHC rate reimbursement for both Medicare and Medicaid programs, and participation in the 340B Discount Drug Program. Should grant funding be released down the road, a health center operating as a Look-Alike will have significant advantage in competing for the opportunity. New Access Point (NAP) funding applications use an objective scoring review and often award additional points to Look-Alikes. A Look-Alike will already be following HRSA’s program requirements, having a better understanding of what is required to maintain compliance with the health center program as a grantee.

To apply for FQHC Look-Alike designation, there are several steps toward completing the application process. Your state Primary Care Association (PCA) will be happy to provide you with further assistance in understanding the specifics of this program in your region. CLC has helped numerous organizations attain FQHC Look Alike designation and will walk you through the entire process, to develop an understanding of the FQHC program, policies that strengthen your compliance with the program, FQHC specific roles and responsibilities to develop within your organization, and an application worthy of designation. Contact us today!