health and related services to residents of a defined geographic area, specifically a medically underserved area. Located in 55 states and territories, there are more than 685 federally qualified community-based organizations receiving federal money that serve more than 10 million people a year with a network of 5,500 primary care providers. Under the authority of the Federal Bureau of Primary Health Care and community boards, these organizations fund 3,032 service delivery sites, including freestanding health clinics (1,889), shelters (298), schools (195), social service centers (123), health departments (106), mobile vans (80), substance abuse treatment facilities (71), HIV/AIDS clinics (41), mental health clinics (38), migrant camps (37), hospitals (37), and public housing (36). There are more than 100 clinics that meet the statutory requirements for a health center but do not receive federal funds. These clinics qualify for the same cost-based reimbursement from Medicaid and are referred to as federally qualified health center (FQHC) "look-alikes." There are an additional 200 nonprofit community-based clinics that do not receive federal money and have not applied for "look-alike" status.

Population served: Although this varies from community to community, the target populations are the medically underserved, the poor, and disadvantaged, including minorities, women of childbearing age, infants, persons with HIV infection, substance abusers and/or homeless individuals and their families. Women of childbearing age constitute almost one-third of the population served; children account for 42%. In 1966, 10% of females (age 13–44) served were known to be pregnant with less than 1% known to be HIV-positive; 65% were below the federal poverty level and 20% fell between 100% and 200% of poverty.

Services provided: These also vary according to the needs of the community. The most common services are those that target mothers and children, including the provision of such enabling services as case management, education, outreach, interpretation, transportation, child care, and discharge planning. Obstetrical and gynecological care is provided by 90% of grantees; 75% provide perinatal services and less than 50% provide labor and delivery services. Less than 1% of patient encounters included HIV testing, although 85% of grantees report providing this service.

Funding: Sources of funding for community, migrant, and homeless health centers include, in order of frequency, the Bureau of Primary Health Care, Medicaid, the Ryan White CARE Act, state and local grants, private insurance, Medicare, patient fees, and foundation grants and contracts.

Family Planning Clinics4

Under the authority of the Office of Population Affairs (OPA), Department of Health and Human Services (DHHS), this national network of clinics is funded

4  

Data from the National Family Planning and Reproductive Health Association (1998).



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