Federally Qualified Health Centers: The Heart of Community Health Care

Jason Gregoire | April 30, 2021

I am a health care lawyer. In the first year of my health law practice, I had the good fortune of receiving an assignment from a partner for a “federally qualified health center.” At the time, I honestly did not know anything about federally qualified health centers, also known as “FQHCs,” but was amazed at what I uncovered as I researched these health centers and their role in our health care system. I now have the pleasure of working with several FQHCs and hope this article will give you a glimpse of the essential role they play in our community.

FQHCs are federally funded, non-profit community health centers that provide or arrange for the provision of primary care, oral health, pharmacy, behavioral health, substance use disorder treatment, and many other wrap-around services (e.g., transportation, translation, care coordination) to patients who have limited or restricted access to the health care system due to, among other things, being underinsured, uninsured, low income, migrant workers, or homeless.  Many patients of FQHCs would likely be forced to go without health care if it were not for FQHCs due to an inability to pay for or access care.

One of the first FQHCs ever created opened in 1965 in Dorchester, Massachusetts through funding allocated as part of President Johnson’s “War on Poverty.” This health center was a success and fueled the creation of health centers across the nation.  According to the U.S. Health Resources and Services Administration (HRSA), now nearly 1,400 FQHCs provide care at approximately 13,000 delivery sites to over 30 million people across the U.S. In fact, HRSA estimates that 1 in 11 people in the U.S. receive care from an FQHC.

To qualify as an FQHC, a health center must satisfy several criteria including serving a medically underserved area or population, offering a sliding fee scale based on the patient’s ability to pay, and being governed by a board of directors the majority of which receive care at the health center. FQHCs are funded through patient services revenue and federal grants. Medicaid is the largest source of health center revenue. Health centers use services revenue first and then use grant dollars to subsidize non-billable services or services provided to those patients who are uninsured.

There are 13 FQHCs in New Hampshire. The two FQHCs serving New Hampshire’s Seacoast are Lamprey Health Care and Greater Seacoast Community Health. Lamprey Health Care has operations in Newmarket, Raymond, and Nashua. In addition to primary care services, Lamprey provides other services including behavioral health, substance use disorder treatment, women’s health, laboratory, and mobile health services through. Lamprey Health Care also provides care coordinators to help its patients access vital community resources such as food, shelter, and education. In 2020, Lamprey Health Care was recognized as a Health Center Quality Leader achieving the best overall clinical performance among all health centers nationally.

Greater Seacoast Community Health (GSCH) was created in 2018 with the merger of Goodwin Community Health in Somersworth, Families First Health and Support Center in Portsmouth, and Lilac City Pediatrics in Rochester. Like Lamprey, GSCH provides a robust suite of services to its patients beyond primary care including behavioral health, prenatal and women’s health, pediatric, substance use disorder treatment, pharmacy, mobile health, and oral health. GSCH also provides extensive wrap-around services to help its patients access community resources.

In addition to playing a pivotal role in the day-to-day health care of many New Hampshire residents, FQHCs have helped respond to the COVID-19 pandemic through, among other things, becoming vaccination sites. Congress recently appropriated over $20 million to New Hampshire’s FQHCs through the American Rescue Plan Act to expand access to vaccinations and deliver care to those at higher risk for contracting COVID-19.

Although FQHCs receive federal grant funding, FQHCs have struggled in recent years due to low Medicaid reimbursement rates and attacks by pharmaceutical manufacturers on a federal drug discount program known as 340B that allows FQHCs to provide discounted drugs to its patients. COVID-19 also had a negative impact on health center revenues given the decline in patient visits. If, however, New Hampshire’s health centers are struggling, an outsider would not know it given their steadfast commitment to health care and consistent output of quality health care for anyone who walks through their doors.

As you can see, FQHCs are an important part of New Hampshire’s health care system. I am proud to help support FQHCs in carrying out their incredible missions. I hope you will take time to learn more about and support the FQHC in your community to ensure health centers are able to continue providing care to those in need.

This article was originally published in the Portsmouth Herald and can be found here.