Someone’s Knocking at the Door

by Chris Shea, Executive Director, Cherry Street Health Services (as published in the Michigan Primary Care Association’s newsletter, News & Notes, Spring 2010 issue)

“Someone’s knocking at the door…Open the door and let ’em in…”  

Paul McCartney and Wings  Congratulations!  We’ve all worked so hard to assure that millions more underserved people in this state have access to health care.  Now – with health reform – the opportunity to open our doors to them is here!  But will we really be ready to let them come in?  I’ve taken a look at health care dollars available to Federally Qualified Health Centers (FQHCs) over the next five years, how much is available and when it is available.  My conclusion is that unless we are very aggressive in seeking these new funds, FQHCs will not be able to double in the number of people served or even come close to that.  We will be successful though if we start right now. 

  • Figure out what you want your FQHC to be when it grows up – what geographic territory it should cover, how many patients it will serve, what types of programs it will specialize in, and what federal and other resources will be needed to accomplish that.  Possibly there is no significant expansion in your future, or possibly your view of the future has not been expansive enough to provide care for all of the underserved in your area.
  • Do whatever you can to win one or more New Access Point (NAP) grants or to get expansion grants in fiscal year (FY) 2011. (Request for Proposals are likely to be published in the next couple of months).  If you don’t get these grants this coming year, your next really good chance to get them is probably not until FY2014.
  • If you do get a New Access Point Grant in FY 2011, market hard because you are unlikely to get a shot at another NAP until you’ve filled the first.  Apply for medical and service expansions early and often.
  • Do whatever you can to (legally) divert funding from operations to capital.  The $1.5 billion federal set-aside for capital is not nearly enough (even in combination with tax credits, capital campaigns, etc.) to meet the demand for capital that will be generated by the increase in operational funding.  Success in providing the facilities needed to serve our patients will require all the creativity we’ve got, including reliance on leased space. 
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