Service Act. They include community health centers, migrant health centers, Healthcare for the Homeless centers, and Public Housing Primary Care centers. These health centers are required to report administrative, clinical, and other information to the Bureau of Primary Health Care within HRSA.

The second class of health center comprises federally qualified health center (FQHC) look-alikes, health centers that do not receive grant funding under Section 330 but have been identified by HRSA and certified by the Centers for Medicare & Medicaid Services (CMS) as meeting Section 330 requirements. Although FQHC look-alikes do not receive Section 330 funding, they report to the Bureau of Primary Health Care and are eligible for other FQHC1 benefits through CMS.

As mentioned in Chapter 3, this report uses the term “health center” to refer to Health Center Program grantees and FQHC look-alike organizations. The term does not refer to FQHCs that are sponsored by tribal or urban Indian health organizations, except for those that receive Health Center Program grants.

All HRSA-supported health centers are required to meet certain criteria to maintain their health center designation. Health centers must meet performance and accountability requirements established by HRSA. They must be governed by a community board, at least 51 percent of whose members represent the population served by the center. Additionally, health centers must provide comprehensive primary health care and supportive services and use a sliding-scale system to charge patients without health insurance. These services include well-child care, nutritional assessment and referral services, blood pressure and weight management, clinical breast examination, and prenatal services. Most important, health centers must be located in a medically underserved area or serve a specified medically underserved population (HRSA, 2011b).

Migrant health centers are a strong example of health centers that serve a medically underserved population, focusing on communities of migrant and seasonal farm workers who face unique health care challenges. These challenges may be due to a relatively small number of individuals requiring care over a large geographic area, the transient nature of migrant and seasonal farm work, and/or the inability of existing health centers to handle the cyclical nature of seasonal work and the influx and outflow of patients. Approximately 90 percent of migrant health centers are funded as Health Center Program grantees serving special populations; the remaining 10 percent

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1The term FQHC is a designation determined and used by CMS to indicate that an entity can be reimbursed using specific methodologies statutorily designed for FQHCs. Here the term FQHC is used to indicate these CMS-designated entities, and includes designated Health Center Program grantees, FQHC look-alikes, and outpatient health clinics associated with tribal or urban Indian health organizations that are not administered or overseen by HRSA.



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