Community health centers in the United States
The community health center (CHC) in the United States is the dominant model for federal grant funding for primary care in the country's health care safety net. The U.S. safety net consists of health care professionals willing to provide services to the nation’s uninsured and underserved population. According to the U.S. Census Bureau, 50.7 million people in the country (16.7% of the population) were uninsured in 2009. Many more Americans lack adequate coverage or access to health care. To receive health care services, this group of people must use providers who are either personally chosen or are legally required to provide care despite the patients being unable to pay. CHCs represent a provider group for this group.
CHCs are organized as non-profit clinical care providers that operate under comprehensive federal standards. The two types of clinics that meet CHC requirements are those that receive federal funding under Section 330 of the Public Health Service Act and those that meet all requirements applicable to federally funded health centers and are supported through state and local grants. Both types of CHCs are designated as “Federally Qualified Health Centers” (FQHCs), which grants them special payment rates under Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). To receive Section 330 grant funds, CHCs must meet the following qualifications:[1][4]
Uniquely in community health centers, at least 51% of all governing board members must be patients there. A sliding fee scale based on income is implemented to decrease the cost of care. The purpose of these stipulations is to ensure that health centers improve access to care and serve the community.
Integration of health care services is a major focus. Administrative and health care personnel meet regularly to focus on location health care needs. Services are provided that vary depending upon the site including primary care, dental care, counseling services, women's health, health promotion and education, podiatry, physiotherapy, case management, advocacy and intervention. The mission of community health centers depends on collaborative relationships with industry, government, hospitals and other health services.
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