Today, 32 Michigan Community Health Centers (CHCs)
provide quality, comprehensive, community-oriented primary health care for nearly 500,000 patients annually
at 160 sites across the state.Of those 32 CHCs,
29 are Federally Qualified Health Centers (FQHCs)
and 3 are FQHC 'Look-Alike.'

“Health Center” is a broad term for a diverse range of public and non-profit organizations and programs that focus on improving the health of individual patients and their communities by providing high-quality, affordable primary care and preventive services. Nationwide, they are the health care home for over 16 million patients.

Each Health Center’s staffing models, facilities, scope of services, and approaches are tailored to meet the unique needs of its patients and the surrounding communities. Many individuals have difficulty accessing medical care because of where they live, the language they speak, and their complex health care needs. Health Centers provide culturally appropriate health care that is close to where patients live, at times that are convenient, and in languages the patients can understand.

Health Centers have professionally trained health care teams. These teams may include board-certified or board-eligible physicians, nurses, nurse practitioners, physician assistants, certified nurse midwives, medical assistants, mental health and substance abuse professionals, dentists, and dental hygienists. The clinicians of each team work together to provide a core of primary health services to individuals and families throughout all life stages, from pediatric through geriatric.

Four types of Health Centers as described below are funded under Section 330 of the Public Health Service Act. These Health Centers may also be called Federally Qualified Health Centers (FQHCs) and they must meet the following requirements:

Be located in or serve a Medically Underserved Area/Population (MUA or MUP) as designated by the Health Resources and Services Administration; these are areas where health care is needed but scarce
Operate under a patient-majority board of directors
Provide comprehensive primary health, oral, and mental health/substance abuse services, as well as supportive services such as translation and transportation services that promote access to health care, to everyone in the community in all stages of the life cycle
Provide services without regard for patients’ ability to pay or insurance status
Charge for services on a sliding-fee scale that is based on patients’ family size and income

Section 330E: Community Health Centers

Community Health Centers (CHCs) were first developed in 1965 in response to community need for improved health services for inner city populations. As part of the federal government’s War on Poverty, funding was made available for communities to establish primary care centers to provide comprehensive health services, regardless of ability to pay.

Although there have been many changes in the CHC program over the years, its foundation remains the same—to provide high-quality primary and preventive health care to people in rural and urban medically underserved areas. Medical underservice is defined by a shortage of professionals or health services, high rates of poverty and infant mortality. It may also include special considerations, such as lack of Medicaid providers, lack of bilingual services, or a large percentage of uninsured persons.

Section 330G: Migrant Health Centers

Migrant Health Centers (MHCs) were established in 1962 to provide
comprehensive primary care services to migrant and seasonal agricultural workers and their families in a culturally sensitive way. As do Community Health Centers, MHCs provide comprehensive health care services to their target population, regardless of ability to pay. Approximately 60% of MHC users are people of color, most of who are of Hispanic origin. MHCs use culturally-sensitive clinical protocols, bilingual health personnel, and lay outreach workers. In 2006, four MHC served 15,809 migrant and seasonal farmworkers in Michigan.

Section 330H: Health Care for the Homeless Centers

Modeled after a demonstration project jointly funded by The Robert Wood Johnson Foundation and Pew Charitable Trust, the Health Care for the Homeless (HCH) program was initiated in 1987 as part of the Stewart B. McKinney Homeless Assistance Act. In 1996, Congress passed the Health Centers Consolidation Act, which joined the HCH program to the community, migrant, and public housing primary health care programs under a single authority called the Consolidated Health Center Program. The HCH program provides federal grants to non-profit organizations to deliver primary health care and substance abuse services to homeless individuals and families.

Like the Community Health Center program, the HCH program provides a
multidisciplinary approach to the delivery of care by combining systems of primary care, substance abuse and mental health services, patient management, and education with aggressive outreach.

Either through direct provision or through established links with other community agencies, four HCH programs serve 18,501 homeless individuals in Michigan.

Section 330I: Public Housing Health Centers

The Public Housing Primary Care Program was established in 1990 to support the provision of accessible and comprehensive preventive and primary health care services to residents of public housing. Health promotion and disease prevention are emphasized, and primary health care services are provided on the premises of public housing developments or at other locations immediately accessible to residents of public housing. There are currently no Public Housing Health Centers in Michigan.

Federally Qualified Health Center 'Look-Alikes'

Some organizations meet the same requirements as the Federally Qualified Health Centers (FQHCs) previously described but do not receive Section 330 funding. They are known as FQHC 'Look-Alikes’. This certification makes them, like FQHCs, eligible for enhanced Medicaid and Medicare reimbursement and participation in the 340B federal drug pricing program, and assists in recruiting and retaining providers through the National Health Service Corps and the State Loan Repayment Program.

Indian Health Service

The most prominent provider of health services to American Indians is the Indian Health Service (IHS). The IHS provides both direct care and contract care to members of federally recognized tribes on or near federal reservations.

In Michigan, 12 tribes contract with the IHS under P.L. 93-638 to provide comprehensive health care to federally recognized American Indians. At least five of the centers also provide care to non-Indian people within their geographic service area. The IHS also funds the American Indian Health & Family Services to provide urban Indians in the Wayne County area with comprehensive health care services, which include medical, community health, dental, and mental health/substance abuse services.

On the 2000 census, 60,675 people in Michigan described themselves as American Indian; however, only 24,353 federally recognized Indian patients used health services at Indian clinics in the past four years. Therefore, 40% of Michigan residents who identified themselves as American Indian on the 2000 census accessed health care at an IHS clinic. Funding for IHS activities is provided under the Indian Health Care Improvement and Education Act and the Indian Self-Determination Act (P.L. 93-638).

Ryan White CARE Title III Clinics

Clinics funded under the Ryan White CARE Act Title III Early Intervention Services Program provide a comprehensive continuum of outpatient HIV primary care services including HIV counseling, testing, and referral; medical evaluation and clinical care; other primary care services; and referrals to other health services. Community Health Centers, Migrant Health Centers, and Health Care for the Homeless sites funded under Section 330 of the Public Health Service Act may receive Title III grants.

In addition to representing all 32 Michigan Community Health Centers (27 Federally Qualified Health Centers and 3 FQHC 'Look-Alikes'), Michigan Primary Care Association also represents three community-based providers and six associate members.

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