Rural Health Clinics and FQHC Look-Alikes
The community health center (CHC) program is not the best fit for all organizations. Two other programs which may be better suited are the Rural Health Clinic (RHC) program and the Federally Qualified Health Center (FQHC) Look-Alike program.
RHCs may be public, private, or not-for-profit organizations. They receive enhanced reimbursement for providing Medicare and Medicaid services in rural areas. RHCs must be located in a rural, underserved area and must employ one or more physician assistants or nurse practitioners.
The FQHC Look-Alike program is for organizations who meet all of the statutory, regulatory, and legislative requirements of an organization that receives PHS Section 330 CHC funding, but does not receive a federal grant. Currently, there are no FQHC Look-Alikes in either North Dakota or South Dakota.
The following table illustrates the differences between federally-funded CHCs and RHCs.
Community Health Center |
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Rural Health Clinic |
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Must be either a not-for-profit or public facility. |
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May be either a for-profit or not-for-profit. |
Governed by a Board of Directors of which at least 51% must be patients of the community health center. |
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Not required to have a Board of Directors. |
Must provide care for all ages. |
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May be limited to a specific type of primary care practice. (pediatrics, OB/Gyn) |
Must provide primary health care; maternity and prenatal care; preventive care for infants, children, and adults; some emergency care; and pharmaceutical services. |
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No minimum service requirements. |
Required to provide emergency care on a 24 hour basis. |
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No requirement for after-hour emergency care. |
Required to serve all residents of their service area with charges on a sliding fee scale based upon ability to pay. |
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Required to provide services to low-income patients or to provide sliding fee reductions. |
Required to have an ongoing quality assurance program that identifies and takes actions necessary to correct problems. |
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No specific requirements for quality assurance plans. |
Must be located in a rural or urban area which is underserved or lacking health professionals. (MUAs and HPSAs). |
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May retain status regardless of the designation of their service area. |
Required to be open at least 32 hours per week and provide emergency coverage after normal business hours. |
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No minimum hours or emergency coverage requirements. |
Required to submit an annual independent audit as well as regular financial reports. |
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Must submit an annual audit but have no specific financial reporting requirements. |
