What is an FQHC?
A Federally Qualified Health Center (FQHC) is more commonly known as a Community Health Center (CHC) and is a provider of primary care services in a center that is community based and patient-directed. By mission and design, CHCs exist to serve those who have limited access to health care, although all are welcome. Unlike most private practices, CHCs welcome low income individuals, the uninsured and underinsured, immigrants, migrant and seasonal farm workers, those who are homeless and those who live in public housing.
FQHCs are locally-based nonprofit organizations governed by a board of directors comprised of area volunteers.
At FQHCs, payment is based on ability to pay.
Uninsured patients, who are income eligible, pay based on a federally approved sliding fee scale to ensure income or lack of insurance is not a barrier to health and dental care. TCCH also assists those insured but having very high deductibles, by considering their income and family size.
As an FQHC, TCCCH receives some funding under Section 330 of the Public Health Service Act by the Health Resources and Services Administration (HRSA), a division of the United States Department of Health and Human Services (DHHS). Funding must be used for approved program purposes; generally this funding represents between 20-25% of TCCH's annual budget, yet the majority of patients who are seen at TCCH have earnings of less than 100% of federal poverty guidelines and pay a reduced amount.
What are the basics of a CHC?
- Located in a Medically Underserved Area or an area that has Health Professional Shortages, though some FQHCs are designed for specific high-risk target populations such as homeless or migrant workers. Indian River County is a low income, medically underserved area.
- Governed by a Board of Directors who are from the community and a majority (51% or more) must be health center patients who represent the population served.
- Provide comprehensive high quality primary health care as well as helping individuals get access to health care through specialists and others.
- Provide available services to all with a sliding fee scale based on ability to pay (family size and income) for those who live at 200% or below of the federal poverty level (FPL). Those who are above 200% FPL pay full fee, which are required to align with the area’s average fees.
Sliding Fee Scale
FQHCs must use a sliding fee scale with discounts based on patient family size and income in accordance with federal poverty guidelines. FQHCs must be open to all, regardless of their ability to pay. For more information, see HRSA’s Health Center Program Requirements.
Board of Directors
At least 51% of an FQHC’s Board members must use the health center’s services. The volunteer Board must meet monthly and it is responsible for a variety of areas, including:
- Legal and fiduciary oversight for TCCH operations and grants
- Strategic planning and evaluation of progress
- Approve Annual Budget & Grant Application
- Full authority over all aspects of TCCH operations
No other entity/individual can have the ability to override or veto governing board decisions.