Community Health Center (CHC) Program
What is a Community Health Center?
Community Health Centers (CHCs) are private, non-profit entities that deliver health care services based on consumer influence and participation. Typically, CHCs provide primary and preventive care to medically underserved and uninsured people.
The intent of CHCs differs from other health care clinics in several ways.
- CHCs are mandated to improve the health status of the entire community in addition to the health of individual patients;
- CHCs provide services that are accessible to their target population and are comprehensive and coordinated with other community services; and
- CHCs are accountable to the communities they serve and community members are involved in program planning and organizational governance.
The Primary Care Office (PCO) assists the development and sustainability of Community Health Centers by providing ongoing assessment of community health needs, and technical assistance regarding program development and evaluation.
The United States Department of Health and Human Services has the following basic requirements for Federally Qualified Community Health Centers (FQHCs):
- CHCs must serve areas that are designated as either a Medically Underserved Area or Medically Underserved Population (MUA/MUP). The designation criteria include areas such as:
- poverty levels;
- number of providers; and
- health status indicators such as infant mortality rate, substance abuse prevalence, and number of women of child-bearing age.
- CHCs must provide comprehensive primary and preventive primary care, and dental and mental health services (on site or by arrangement);
- A volunteer Board of Directors, representative of the communities served, must govern the CHC. In addition, a majority of the board members must be users of the health center;
- CHCs must serve all patients regardless of age or income, within a designated service area. Health care services are not provided for free. CHCs offer sliding fee scales for patients without insurance;
- CHCs must be non-profit or public organizations;
- In Alaska the term CHC is used to denote single clinic or a managing organization with multiple clinic sites.
How does a community apply for Community Health Center status?
The community contacts the PCO or the Alaska Primary Care Association (APCA). The PCO determines if their community is or possibly could become a designated MUA/MUP.
The community would:
- Form a Board of Directors. The Board of Directors determines if the clinic they are proposing can provide access to comprehensive health care including primary, behavioral and dental health. Services do not always have to be provided on-site; they may be provided through contracts or a referral system;
- Determine if the population to be served is large enough to submit a competitive application for a CHC;
- Develop a business plan that would allow the organization to be sustainable;
- Submit an application to United States Health Resources and Services Administration (HRSA) and Bureau of Primary Health Care (BPHC).
Will a CHC in a community put the private practice providers out of business?
The CHC federally funded programs have a policy of not competing with private enterprise. One of the primary expectations of a CHC is for its board to collaborate with the other health care providers in the area. Typically, CHCs serve patients that are not served by private providers.
Current status of Community Health Centers in Alaska.
Alaska currently has 27 organizations that receive funding for community health centers in over 150 sites. In 2012 community health centers served approximately 98,568 Alaskans. In Alaska, community health centers are operated by not for profit organizations, tribal health corporations, and governmental entities, and may serve one community or multiple sites in several communities.
Alaska has experienced significant growth in the Community Health Center program since 1974, when its first Community Health Center was funded. To a great extent this has been due to the Alaska Frontier Health Project, which the Alaska Primary Care Office helped to frame, participate in, and implement. Major funding initiatives in fiscal years 2001 through 2005 increased the federal health dollars for community health centers in Alaska by about $20 million, and expanded the number of community health center sites from five managing organizations to 24, increasing the number of clinics from 10 to 72.
Since 2005 there has been a steady increase in CHCs based on availability of “New Access Point” federal funding. In the latter part of 2013, five CHCs received funding, resulting in 14 new clinic sites.
The State of Alaska through its Primary Care Office monitors the availability of federal funding for new Community Health Centers. During those times when federal funding is available for new Community Health Centers, the Alaska Primary Care Office, in partnership with the Alaska Primary Care Association and with the federal Health Resources and Services Administration, works cooperatively with organizations and communities in Alaska to take advantage of this funding opportunity. For more information please contact Susan.Mason-Bouterse@alaska.gov.
Resources for Community Health Clinic applications and technical assistance:
Alaska Primary Care Office
Alaska Primary Care Association