The community development initiatives of the Tennessee Primary Care Association focus on strengthening existing community health centers and expanding services to underserved areas. Our work with communities promotes expanding comprehensive and preventive health care and improving the health status of underserved populations. We help to strengthen the existing network of community health centers by providing networking opportunities (Administrator meetings) on pertinent topics, providing timely information, and linking communities with necessary resources.

Our expansion activities involve working with communities to access, provide and enhance services to underserved areas in Tennessee. Our work brings communities together to build a strong network to provide Tennesseans with access to health care - primary care, dental care and behavioral health care.

The following links provide information about TPCA's community development activities and resources for increasing access to primary care:

  • Expanding the primary care safety net - Primary Care Delivery Models
  • Strengthening the primary care safety net
    - Health Center Administrator meetings
    - Web site and data resources
  • Statewide Strategic Planning
  • MarketPlace Analysis

For more information on TPCA Community Development initiatives contact Kathy McLendon,
615/329-3836 ext. 17, mclendon@tnpca.org


Primary Care Delivery Models - Ways to increase access to primary health care in your community

  • Federally Qualified Health Centers (FQHC)
  • Federally Qualified Health Center Look-Alike
  • National Health Service Corps (NHSC) provider site
  • Rural Health Clinic (RHC)

    Federally Qualified Health Centers
  • Types of FQHCs
    o Community Health Center
    o Health Care for the Homeless
    o Migrant Health Center
    o Public Housing Primary Care
    o Health Schools/Healthy Communities

How to Become a FQHC

Federally Qualified Health Centers (FQHCs) are an important component of Tennessee's and the nation's health care safety net. The term FQHC refers to how certain health centers are reimbursed by Medicare and Medicaid. FQHCs receive a federal grant to see people regardless of their ability to pay. They are:

  • Private or public not-for-profit entities
  • Consumer-directed (At least 51% of the health center board must be comprised of patients who utilize the health center's services),
  • Serving a designated Medically Underserved Area or Population (MUA/MUP).
  • Providing high quality, cost-effective and comprehensive primary and preventive care, and
  • Providing care to people regardless of their ability to pay.

This network of safety net providers is primarily comprised of health centers that are supported by federal grants under Section 330 of the U.S. Public Health Service Act.
An FQHC may be a:

  • Community Health Center
  • Migrant Health Center
  • Health Care for the Homeless Program
  • Public Housing Primary Care Program and/or
  • Health Schools/Healthy Communities program

Section 330 funds are administered through the Health Resources and Services Administration (HRSA), Bureau of Primary Health Care (BPHC). You may call 1-877-HRSA-123 to request a full application. You may also contact Kathy McLendon at TPCA for technical assistance at 615/329-3836 or mclendon@tnpca.org.

The following web site links provide further detail to these programs.

Policy Information Notice 2005-01: Requirements of Fiscal year 2005 Funding Opportunity for Health Center New Access Point Grant Applications (http://www.bphc.hrsa.gov/pinspals/pins.htm).

Policy Information Notice (PIN) 98-23: Health Center Program Expectations (http://www.bphc.hrsa.gov/pinspals/default.htm#2003PIN)

www.bphc.hrsa.gov/dpspnewcenters - An interactive website to to determine eligibility and improve readiness for funding


FQHC Look-Alike

An FQHC Look-Alike meets all the requirements of the Section 330 grant program, but does not receive the grant. The FQHC Look-Alike receives no section 330 Federal funding, but is eligible for cost-based reimbursement under Medicaid and Medicare and can participate in the 340(b) Federal Drug Pricing program. The guidelines and application package for FQHC Look-Alike designation and recertification are found in Policy Information Notice (PIN) 2003-21 (http://www.bphc.hrsa.gov/pinspals/pinsarchive.htm): Federally Qualified Health Center Look-Alike Guidelines and Application and PIN 2005-17: Revisions to Policy Information Nontice 2003-21 (http://www.bphc.hrsa.gov/pinspals/pins/2005-17.htm). Applicants for FQHC Look-Alike designation must be fully operational at application date and meet the following requirements:
1. Be a public or a private nonprofit entity;
2. Serve, in whole or in part, a designated Medically Underserved Area (MUA) or Medically Underserved Population (MUP);
3. Meet the statutory, regulatory and policy requirements for grantees supported under section 330 (formerly 329, 330 and 340) of Public Health Service Act; and
4. Comply with the policy implementation documents for the Balanced Budget Act (BBA) of 1997 amendment which added the requirement that an FQHC Look-Alike entity may not be owned, controlled or operated by another entity.

National Health Service Corps provider site
Another way to increase access to primary health care in underserved areas is to recruit a National Health Service Corps (NHSC) provider to your community. Some of the clinicians the NHSC recruits are obligated to serve in community-based systems of care in return for scholarship or loan repayment support. Many NHSC clinicians remain in underserved communities after fulfilling their NHSC service commitments.

Your health center must be in a designated Health Professional Shortage Area in order for a NHSC provider to work at your center. See the following link to find out if your community is in a HPSA - www.bphc.hrsa.gov/shortage or call Patrick Lipford, Director, Office of Rural Health and Health Access, Tennessee Department of Health, 615-741-0388, plipford@state.tn.us

To learn more call NHSC at 1-800-221-9393 or visit http://nhsc.bhpr.hrsa.gov.


Rural Health Clinic

The Rural Health Clinic (RHC) program is to encourage and stabilize the provision of out-patient primary care in underserved rural areas through the use of physicians, physician assistants (PAs), Nurse Practitioners (NPs) and Certified Nurse Midwives (CNMs).
Rural Health Clinics:
  • Must be located in communities that are both "rural" and "underserved"
  • Must be staffed by one or more physicians; one or more PA, NPs or CNMs;
    a PA, NP or CNM must be on-site and available to see patients 50% of the time the clinic open for patients.
  • May be a for-profit or non-profit entity.

    For more information about the requirements of a Rural Health Clinic visit the National Association of Rural Health Clinics website www.narhc.org or contact:
    Patrick Lipford, Director, Office of Rural Health and Health Access, Tennessee Department of Health
    615-741-0388, Email: plipford@state.tn.us

Strengthening the Safety Net

Administrator Meetings

The community development program focuses on strengthening existing health centers. We provide links to resources and technical assistance and trainings for health center administrators. Health Center Administrators meet together three times a year to discuss pertinent topics regarding strengthening community-based care in underserved areas. Meeting topics include:

  • Capital Development
  • Marketing your Community Health Center
  • TennCare updates
  • JCAHO
  • 340B Drug Pricing Programs

Data Resources

Statewide Strategic Planning (SSP)

In response to President Bush's Initiative for Growth to increase the number of people who access health care through Federally Qualified Health Centers, each state has been asked by the Bureau of Primary Health Care to define and identify health access needs over the next five years. SSP identifies those strategic initiatives and corresponding resources that support the President's goal to double the number of people served be health centers over the next five years.

SSP is a Five Year Growth and Resource Plan identifying the resources needed to meet the comprehensive primary medical, dental and behavioral health care needs of targeted unserved and underserved individuals within the state for the next five years.

Contact Kathy McLendon for more information: 615/329-3836 ext. 17, mclendon@tnpca.org


Marketplace analysis

The National Association of Community Health Centers (NACHC) and the Bureau of
Primary Health Care (BPHC) support the State market place analysis initiative.

The elements of a market place analysis include an assessment of:

  • The State's legislative/regulatory environment
  • Market place competition -- provider supply and demand
  • Demographic trends by market place
  • Managed care trends by market place
  • Provider trends by market place
  • Trends in health insurance coverage

Please contact Kathy McLendon, 615/329-3836 ext. 17, mclendon@tnpca.org

Off Site Link - please return