14.7.1: Community Health Centers
Community Health Centers or local clinics provide comprehensive medical services to underserved populations - including those who lack health insurance or housing, those with low incomes, seniors (over age 65), and immigrants or refugees. Patients may be charged for medical services, but on a sliding scale - which means that fees are set based on what patients are able to pay (HRSA, 2024). These health centers receive funding in multiple ways: through block grants from the Health Resources & Services Administration (HRSA), the Centers for Disease Control and Prevention (CDC), Title X Service Grants (for sexual and reproductive health services), and reimbursement from Medicare, Medicaid, and CHIP or the VA. In order to become a Federally Qualified Health Center (FQHC), the clinic must:
- Be located in or serve a high need community.
- Be governed by a community board that is at least 51% made up of health center patients.
- Provide comprehensive healthcare services on a sliding fee scale based on ability to pay.
- Become a Health Center Program award recipient or Health Center Program look-alike. (CA Department of Health Care Services, n.d.)
- These clinics provide a broad range of services including:
- Primary care
- Dental and vision care
- Physical and occupational therapy
- Mental health services
- Substance abuse and addiction treatment
- STI/HIV testing and treatment
- Reproductive, maternal and pediatric healthcare
- Vaccines
- Health education
In order to receive Title X funding for reproductive healthcare, clinics must provide a variety of family planning methods, including contraception and infertility assistance. They must provide testing and treatment for sexually transmitted infections (STIs) including HIV. They may not provide abortion services, or even discuss abortion as an option (OASH, 2022). If the clinic does provide abortion services, there are recent (2019) requirements for clearly designating physical separation of those services in a different part of the clinic which receives a different source of funding. These requirements for separation caused many clinics to withdraw from title X funding (Seabert et al., 2021).