This section includes information and answers to questions about the CVHN and community health centers:
1. What does "federally designated" mean?
2. How do federally qualified and non-federally qualified clinics differ?
3. What is a "safety net" provider?
4. What is the Bureau of Primary Health Care grant program?
5. Are there other clinic consortia in California?
1. What does it mean to say that a health center is "federally designated"?
All CVHN clinics are designated by the federal Bureau of Primary Health Care as community health centers. Under their federal designation, Community Health Centers (CHCs) provide primary and preventive health care for persons living in rural and urban medically underserved communities identified by the Bureau of Primary Health Care.
Back to top
2. What is the difference between federally qualified health centers and non-federally qualified health centers?
Federally qualified health centers are defined in federal law as those organizations that receive funding under Section 330 of the federal Public Health Services Act – community health centers, migrant health centers, Health Care for the Homeless and Health Care in Public Housing. To receive grants under these programs, health centers must be public or nonprofit and must have a majority of health center users on their governing boards. Most importantly, CHCs must provide services to all persons in their catchment area regardless of ability to pay 42 (CFR 51c.303(u)). Federal law also severely limits non-user board participation by those who derive more than 10 percent of their income from health care. In addition, federal program requirements govern the array of services health centers must provide, standards for services provided and detailed financial management and reporting requirements.
To support their mission of caring for the underserved, Federally Qualified Health Centers (FQHCs) are eligible for a cost-based reimbursement rate from Medicare and Medicaid under the FQHC program. Health centers participating in Medicaid and Medicare are reimbursed at a "cost-based" rate that reflects allowable and audited costs for caring for Medicare and Medi-Cal patients. The FQHC cost-based rate was enacted by Congress to ensure that federal grant funds for the uninsured do not subsidize low rates in Medi-Cal or Medicare.
The Bureau of Primary Health Care also designates health centers that meet the statutory requirements for the PHS programs listed above but do not actually receive federal grant funds as federally qualified "look-alikes." FQHC "look-alikes" are also eligible for cost-based reimbursement. 11 of the 12 CVHN health centers are FQHCs and one is an FQHC "look-alike."
Health centers that are not federally qualified operate without being subject to the federal requirements discussed above, and may or may not choose to function as a safety net provider.
Back to top
3. What is meant by the term "safety net" provider?
According to the federal Bureau of Primary Health Care, the safety net is the national network of providers of primary health care to underserved and vulnerable populations. The term "safety net" is used because for many low-income and vulnerable populations, safety net providers are the provider of last resort (an invisible net of protection) when their income, lack of health coverage or other social and economic vulnerabilities limit their ability to access mainstream medical care.
In California, the "safety net" is composed of nonprofit community health centers, (such as CVHN members), county health departments, public hospitals and any other providers who share the common mission of providing services to everyone who comes through their door, regardless of ability to pay. The overwhelming majority of the patients of CVHN CHCs are low-income, and are uninsured or are recipients of government sponsored health coverage programs such as Medicaid.
Back to top
4. Tell me more about the federal Bureau of Primary Health Care program that provides funding to the CVHN as a Network – an "Integrated Delivery System"?
Since 1994, the federal Bureau of Primary Health Care has encouraged and supported the development of networks among its grantee programs, including federally qualified health centers. The Central Valley Health Network was formed, in large part, in response to the Bureau's policy of encouraging network development and integration among BPHC grantees.
Support of network activities is based on the Bureau's vision of a community-oriented system of care that strives toward 100-percent access to primary health care and 0-percent disparities in health status. According to the Bureau, one avenue to meet these goals is through the development of a system of care that is broad in nature and appropriate to both the patient and community.
The CVHN is participating in the development of a "Practice Management Network" which is focused on integrating and coordinating functions among network collaborators to maximize quality of services and access to care. Specifically, the CVHN is working at the Network level to develop common definitions and standardized tools for collecting, managing and reporting key operational and financial data the centers use to manage and improve their services.
For more information on the Bureau of Primary Health Care and its programs, visit its Web site.
5. Are there other clinic networks or consortia in California?
The CVHN operates as one of 11 regional clinic networks in California which are members of the California Primary Care Association, the statewide trade association for primary care clinics in California. The Clinic Consortia offer an array of services to their regional members, including public education and advocacy, shared services and expertise, group purchasing, and peer networking. Several other clinic consortia are participating in network development activities sponsored by the Bureau of Primary Health Care. For more information on specific regional consortia, go to our Links and Resources section.