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Health centers are community-based and patient-directed organizations (51% patient majority) located in medically underserved areas (MUA), serving populations with limited access to health care.  These include low income populations, the uninsured, and those with limited English proficiency.  Health Center Program grantees are organizations that receive grants under the Health Center Program as authorized under Section 330 of the Public Health Service Act, as amended.

Section 330 of the Public Health Service Act (42 USCS § 254b) Authorizing Legislation of the Health Center Program

Health Center Program Requirements

Health Centers are required to meet strict financial and administrative accountability as provided by HRSA.  There are 19 Key Program Requirements that fall under 4 main categories: Need; Services; Management and Finance, and; Governance. Please click Health Center Program Requirements for the complete listing.

Health Center Program Fundamentals

  • Located in or serve a high need community (designated Medically Underserved Area or Population). Find MUAs and MUPs
  • Governed by a community board composed of a majority (51% or more) of health center patients who represent the population served. More about health center governance
  • Provide comprehensive primary health care services as well as supportive services (education, translation and transportation, etc.) that promote access to health care.
  • Provide services available to all with fees adjusted based on ability to pay.
  • Meet other performance and accountability requirements regarding administrative, clinical, and financial operations.

Health Center Site Visit Guide

The Health Center Site Visit Guide is a review instrument used by the Health Resources and Services Administration (HRSA) to assess an organization’s compliance with key section 330 Health Center Program requirements as well as a resource to assist grantees in identifying areas for performance or operational improvements. Health centers may also use this Guide as a self-assessment resource as it provides a series of prompting questions for both program requirements and performance improvement.  Please click Health Center Site Visit Guide to be directed to the document.

Health Center Program Policies

HRSA provides guidance for health centers regarding program benefits and requirements through two main types of notifications.  Policy Information Notices (PINs) define and clarify policies and procedures that grantees funded under Section 330 must follow. Program Assistance Letters (PALs) summarize and explain items of significance for health centers, including, for example, HRSA program implementation activities, recently enacted laws, final regulations, and/or new HHS initiatives. Please click PINs and PALs to be directed to the complete listing of policies.

Types of Community Health Centers

Community Health Centers (Section 330E)

Community Health Centers were 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 Community Health Center 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.

Migrant Health Centers (Section 330G)

Migrant Health Centers were established in 1962 to provide comprehensive, high quality, culturally-competent preventive and primary health services to migrant and seasonal farmworkers and their families with a particular focus on the occupational health and safety needs of this population.  Principal employment for both migrant and seasonal farmworkers must be in agriculture.

Health Care for the Homeless Centers (Section 330H)

The Health Care for the Homeless program was initiated in 1987 as part of the Stewart B. McKinney Homeless Assistance Act.   In 1996, Congress joined the Health Care for the Homeless program to the Community, Migrant, and Public Housing Primary Health Care programs under a single authority called the Consolidated Health Center Program. The Health Care for the Homeless program provides federal grants to non-profit organizations to deliver  The Health Care for the Homeless Program is a major source of primary health care and substance abuse services to homeless individuals and families in the United States, serving patients that live on the street, in shelters, or in transitional housing.

Public Housing Health Centers (Section 330I)

The Public Housing Primary Care Program was established in 1990. Public The Public Housing Primary Care Program provides residents of public housing with increased access to comprehensive primary health care services through the direct provision of health promotion, disease prevention, and primary health care services. Services are provided on the premises of public housing developments or at other locations immediately accessible to residents.

Federally Qualified Health Center Look-Alikes (FQHC-LA)

FQHC look-alikes support the delivery of comprehensive, culturally competent, quality primary health care services to low-income, underserved, and special populations.  Look-Alikes are certified by the Centers for Medicare and Medicaid Services (CMS) and operate and provide services consistent with all statutory, regulatory, and policy requirements that apply to section 330-funded health centers, but do not receive funding under section 330. FQHC-LAs are eligible for cost-based reimbursement through CMS, participation in the 340B federal drug pricing program.

HRSA & BPHC Announce the Health Center Program Update and Initial Designation Application

The purpose of the Health Center Program is to improve the health of the Nation’s underserved communities and vulnerable populations by increasing access to comprehensive, culturally competent, quality primary health care services. Both Health Center Program grantees and look-alikes are essential to the success of the program.

The Health Center Program Update and Initial Designation Application Instructions for 2013.

*Health Centers can have multiple designations.

Thinking about developing a Federally Qualified Health Center for your community?

The National Association of Community Health Centers (NACHC) has developed a comprehensive guide covering the many requirements of the health center program.  The guide “So You Want to Start a Health Center” is a great resource for communities and organizations to use as they begin the process. 

The practical guide for starting an FQHC includes the following topic areas:
Chapter I – Health Center Basics
Chapter II – Ensuring Broad Community Support and Investment
Chapter III – Needs Assessment and Planning
Chapter IV – Looking for a Home (Organizationally and Physically)
Chapter V – Developing Community Governance
Chapter VI – Human Resources
Chapter VII – Business Planning
Chapter VIII – Before You Open Your Doors: Insurance
Chapter IX – Information Technology/Data Systems
Chapter X - Conclusions and Final Recommendations
Chapter XI – Resources and Websites


For additional information or questions please contact Teresa Rios-Bishop at or 614-884-3101.