Community Health Centers (CHCs) go by many names: Federally Qualified Health Centers (FQHCs), Health Centers, Patient-Centered Medical Homes, and valuable community partners. The titles may be different, but the mission and role of Community Health Centers are the same. They are community-based, non-profit primary health care providers located in medically underserved areas where there are few primary care providers and/or large numbers of low-income people.
CHCs have played a critical role in our country’s health care system since their inception in 1965 when President Lyndon B. Johnson’s signed Medicaid and Medicare into law in conjunction with the approval of a pilot program for FQHCs. From the modest beginnings of health centers in Massachusetts and Mississippi, they have grown into the largest primary care network in the nation. Nationally, Community Health Centers (or FQHCs) serve over 27 million people, or one in 12 people in the United States, including 645,768 patients in Arizona. Community Health Centers are located in over 1,300 communities in every state, U.S. territory, and Washington D.C. There are 23 FQHCs with over 150 sites in Arizona.
Community Health Centers are consumer-driven and patient-centered healthcare organizations that serve as a high quality, comprehensive, cost-effective primary health care option for most underserved communities. The not-for-profit, community-based organizations are driven by community-based boards with 51% of the board members being patients of the community health center. This arrangement allows the CHC to adequately address the community’s more urgent health needs.
CHCs serve everyone regardless of insurance status. Their charge is to increase access to integrated primary health care services. The broad range of healthcare and enabling services provided by CHCs offers a unique approach to healthcare delivery by offering a wide range of services under one roof, making access to healthcare more convenient for patients and their busy lifestyles. As preferred medical homes for the families they serve, CHS services may include family practice, internal medicine, pediatrics, OB/GYN, pharmacy, dental, behavioral health, dietary counseling, physical therapy, podiatry, lab, immunizations, vision, chronic disease management, WIC, mobile clinics and much more. Non-clinical services that support the delivery of basic health services include case management, eligibility assistance, health education, translation, transportation, and housing assistance. The range of services are based on the unique needs of the communities they serve. Attending to social determinants of health have been key to the patients’ positive healthcare outcomes.
Outcomes for CHC patients must be reported to the Health Resources Services Administration (HRSA) and the bar is set high. However, CHCs continue to demonstrate that they deliver quality care, which allows them to have a substantial impact on our nation’s healthcare system.
The high expectations for CHC’s to continue to provide access to healthcare to populations with high health disparities and the CHC’s increasingly large patient volume requires a large, highly qualified provider workforce. A strong vibrant workforce is critical. The need for high-quality physicians and other healthcare providers is indisputable.
Provider recruitment and retention can be achieved in a number of ways. Often, the most effective approach is a legislative remedy. A Legislative approach to building and strengthening a viable healthcare provider workforce requires a strong coalition of healthcare organizations for a successful outcome. Success is contingent upon a good working relationship with ARMA and our other healthcare organizations with whom we partner on legislation.
There are several examples of this partnership. For example, in the last legislative session, the Arizona Alliance for Community Health Centers (AACHC) partnered with Arizona Medical Association (ArMA), Arizona Hospital and Healthcare Association (AzHHA), and others to expedite the credentialing process for new providers. The bill, H.B. 2322- health insurers; provider credentialing, requires health insurers to establish an electronic process for the submission of credentialing applications and supporting documentation. It requires that the process of credentialing and loading an application must conclude within 100 days after a health insurer receives a completed application. This requirement is vital for Community Health Centers in small rural communities that have a difficult time recruiting providers due to their remote location. It often takes months to recruit a provider and when a CHC secures a qualified provider it is essential to get them to work as soon as possible. In the past, the credentialing process could drag on for months and the new provider often leaves due to the delay in credentialing. This new policy of commercial health plans expediting credentialing is tremendously helpful for provider recruitment efforts.
Another example is the Medical Licensure Compact legislation which ARMA worked on with AACHC and other healthcare organizations. In 2016, ARMA lead the effort to implement the compact in Arizona. The Interstate Medical Licensure Compact (HB 2502) outlines eligibility requirements for an expedited medical license for providers who want to practice in another compact state. It creates another path to state licensure. When a full and unrestricted medical license is granted to an eligible physician through the compact agreement, it can help build a viable physician workforce. The physician remains under the jurisdiction of the medical board in the compact state in which they are practicing, but it allows more flexibility to work in multiple compact states. Thanks to the coalition of ARMA, AACHC, and others, Arizona is now one of those states.
As Arizona’s population continues to grow and the demand for healthcare services grows as well. Access to healthcare is dependent upon a strong, reliable provider workforce. Community Health Centers will remain a critical component of the healthcare system.
Tara McCollum Plese
Tara Plese is the Chief External Affairs Officer for the Arizona Alliance for Community Health Centers (AACHC). She represents Arizona’s Community Health Centers’ at the state and federal level and advocates for access to quality, affordable primary health care.
Tara serves on a variety of boards and committees for health care; including the State Medicaid Advisory Committee, the AHCCCS Policy Committee, the National Association for Community Health Centers Rural Health Committee and Legislative Committee, Asian Pacific Community in Action (APCA).
She graduated from ASU with a bachelors’ degree in Political Science and a Master’s degree in Public Administration.