In order to receive (and maintain) grant money as a Federally Qualified Health Center (FQHC), community health centers (CHC) must meet 19 Program Requirements. PR #1 requires health centers to document an assessment of the needs of the target population. For health organizations considering becoming an FQHC or FQHC Look-alike, one of the first steps is completing a needs assessment. Unlike the community health assessments frequently done by local hospitals and public health jurisdictions, a health center needs assessment must address a specific set of questions. These same questions are addressed in the Service Area Competition (SAC) and New Access Point (NAP) grants.
Requirements for an FQHC/FQHC Look-Alike Needs Assessment
Overall, the needs assessment should assess the need for health services in the service area you intend to serve. Do your health center’s services meet the health care needs of the population served or proposed to be served?
The first step is to define your service area. Define the boundaries and catchment area of the area you are serving. Does it serve a medically underserved area (MUA) or medically underserved population (MUP)? You can check that here.
In order to successfully meet the health center service area requirements, the health center must accomplish the following goals:
- Services provided must be available and accessible to the residents of the area.
- The service area boundaries must greatly reduce or eliminate barriers to access to health care including the region’s residential patterns, public transportation, economic and social groupings and physical traits.
- The boundaries of the service area must conform as much as possible to boundaries established for school districts, political subdivisions and areas served by federal and state health and social service programs.
Define your target population. In general, CHCs serve low-income, uninsured, underinsured, and medically underserved populations. The Bureau of Primary Health Care has defined three additional special populations – migrant and seasonal agricultural workers, people experiencing homelessness and people living in public housing. If planning to serve a special population, your needs assessment should address their unique health care needs.
Needs Assessment questions
Once you’ve identified the service area and defined your target population, the needs assessment must answer or address the following questions:
Identify barriers to primary care
- Population to primary care physician ratio
- Percent of the population living at or below 200 percent of the federal poverty level
- Percent of the population that is uninsured
- Distance traveled to health care providers for low-income uninsured people
What are the geographical and transportation barriers? Is the area isolated? Is transportation available?
What are the unique health care needs of target population? Identify the health disparities. What are the social barriers – unemployment, income levels, uninsured rates, literacy levels, cultural and linguistic issues?
What other health care services are available in the area for low-income, uninsured patients?
- Community health centers (FQHC or FQHC Look-Alikes)
- Critical area hospitals
- Rural health clinics
- Free clinics
- Public health services
Address the local health care environment
- Did your state expand Medicaid?
- What’s the impact of the ACA?
- Who accepts Medicaid, Medicare, CHIP coverage?
- Are there state or local uncompensated care programs?
- Major economic shifts or demographic shifts in the area?
- Any natural disasters or emergencies that have impacted access to health services or health care needs?
How does a health center demonstrate compliance?
Current health centers comply with PR#1 every three years when they write their Service Area Competition (SAC) grant, Look-Alike recertification or when submitting a New Access Point (NAP) application because the needs section is the first portion of the narrative for each of these applications. For reviews, simply take the first section of your most recent applications and put them in a binder for site visit reviewers.
How can Health Center Solutions help?
Health Center Solutions consultants are experienced allies of community health centers. We can help you ensure that your needs assessment is complete and addresses all the required elements. We help health centers comply with requirements to pass their assessment.
Health Center Solutions’ dedicated professionals are focused on providing outcome-focused, customer-driven solutions. To schedule a meeting, a mock OSV or to request more information about program compliance, please contact us today!