Required and Additional Services: Health centers must provide all required primary, preventive, enabling health services and additional health services as appropriate and necessary, either directly or through established written arrangements and referrals per program requirements (Section 330(a) of the PHS Act). Note: Applicants requesting funding to serve homeless individuals and their families must provide substance abuse services among their required services (Section 330(h)(2) of the PHS Act).
Staffing Requirement: Maintain a core staff as necessary to carry out all required primary, preventive, enabling health services and additional health services as appropriate and necessary, either directly or through established arrangements and referrals (Section 330(a)(1) and (b)(1), (2) of the PHS Act).
Accessible Hours of Operation/Locations: Provide services at times and locations that assure accessibility and meet the needs of the population to be served (Section 330(k)(3)(A) of the PHS Act).
After Hours Coverage: Provide professional coverage during hours when the center is closed (Section 330(k)(3)(A) of the PHS Act).
Hospital Admitting Privileges and Continuum of Care: Health center physicians have admitting privileges at one or more referral hospitals, or other such arrangement to ensure continuity of care. In cases where hospital arrangements (including admitting privileges and membership) are not possible, applicant must firmly establish arrangements for hospitalization, discharge planning, and patient tracking (Section 330(k)(3)(L) of the PHS Act).
Sliding Fee Discounts: Health center has a system in place to determine eligibility for patient discounts adjusted on the basis of the patient’s ability to pay. This system must provide a full discount to individuals and families with annual incomes at or below the poverty guidelines (only nominal fees may be charged) and for those with incomes between 100 percent and 200 percent of poverty, fees must be charged in accordance with a sliding discount policy based on family size and income. No discounts may be provided to patients with incomes over 200 percent of the Federal poverty level (Section 330(k)(3)(G) of the PHS Act and 42 CFR Part 51c.303(f)).
Quality Improvement/Assurance Plan: Health center has an ongoing Quality Improvement/ Quality Assurance (QI/QA) program that includes clinical services and management and maintains the confidentiality of patient records; the QI/QA program must include:
A clinical director whose focus of responsibility is to support the quality improvement/assurance program and the provision of high quality patient care
Periodic assessment of the appropriateness of the utilization of services and the quality of services provided or proposed to be provided to individuals served by the applicant
Such assessments shall: be conducted by physicians or by other licensed health professionals under the supervision of physicians; be based on the systematic collection and evaluation of patient records; and identify and document the necessity for change in the provision of services by the applicant and result in the institution of such change, where indicated (Section 330(k)(3)(C) of the PHS Act and 42 CFR 51c.303(c)(1-2)).