Attached are the revised guidelines and application package for the Federally Qualified Health Center (FQHC) Look-Alike Program. This document supersedes Policy Information Notice (PIN) 2003-21, “Federally Qualified Health Center Look-Alike Guidelines and Application,” dated August 26, 2003 and all corresponding amendments to PIN 2003-21, including PINs 2006-06, 2005-17, and 2009-04, “Revisions to PIN 2003-21, FQHC Look-Alike Guidelines and Application.”

The Health Resources and Services Administration (HRSA) is committed to improving the health of underserved communities and vulnerable populations. The FQHC Look-Alike Program supports the delivery of comprehensive, culturally competent, quality primary health care services to low-income, underserved, and special populations. In an effort to strengthen the FQHC Look-Alike Program and align it with the Health Center Program (authorized under section 330 of the Public Health Service (PHS) Act), HRSA has made extensive changes to the requirements for securing and maintaining FQHC Look-Alike designation. A summary of the changes is provided below.

· Requirements to Maintain FQHC Look-Alike Designation: Following initial designation, FQHC Look-Alikes must now submit a renewal of designation application every five years (or as determined by HRSA) to maintain the FQHC Look-Alike designation in addition to the established annual recertification application. The purpose of the renewal of designation application is for HRSA to periodically obtain complete and comprehensive information about the FQHC Look-Alike to ensure that the organization continues to maintain compliance with all program requirements. The renewal of designation application is similar to the initial designation application. Refer to Section III.1., Application Submission Requirements, for additional information on the types of applications.

· New Application Forms and Tables: The FQHC Look-Alike application now includes all Forms and Tables that are used for grants under the Health Center Program. The Forms previously used in PIN 2003-21 are no longer a part of the application requirements. In addition, FQHC Look-Alikes must report patient data based on the calendar year (i.e., January 1 – December 31). Refer to Appendix I, Form and Table Instructions, for a listing of all the new Forms and Tables.

· Organizations Serving Special Populations: Organizations that are requesting designation to serve a special population authorized under section 330 of the PHS Act (i.e., migratory and seasonal agricultural workers, homeless populations, and residents of public housing) are now eligible to apply for FQHC Look-Alike designation. Upon showing good cause, the following types of organizations are eligible to request a waiver of the 51 percent consumer/patient majority and monthly meeting governance requirements in accordance with section 330(k)(3)(H)(iii) of the PHS Act: (1) any organization serving a sparsely populated rural area (section 330(p) of the PHS Act); and (2) organizations that receive FQHC Look-Alike designation to serve section 330(g), Migratory and Seasonal Agricultural Workers, section 330(h), Homeless Populations, or section 330(i), Residents of Public Housing, only but do not serve the general community (section 330(e)). Refer to Section II.2.B., Program Requirements for Special Populations, for additional information regarding organizations that serve special populations authorized under section 330 of the PHS Act.

· Health Care Plan and Business Plan: Organizations are now required to prepare and submit a Health Care Plan and Business Plan that outlines time-framed and realistic goals with baselines that are responsive to the health care needs of the community served and the strategic needs of the organization. The Plans will be used as an ongoing monitoring tool by HRSA and organizations to measure progress in meeting clinical and financial goals. Organizations are expected to adopt the clinical and financial performance measures as identified in Appendix E when preparing the Plans.

· Letter of Interest (LOI): HRSA has eliminated the LOI process for the FQHC Look-Alike Program. In lieu of submitting an LOI, organizations that seek technical assistance in preparing an application for initial FQHC Look-Alike designation may submit questions in writing to HRSA’s Bureau of Primary Health Care, Office of Policy and Program Development (OPPD) at OPPDGeneral@hrsa.gov. Please indicate “FQHC Look-Alike Program” in the subject line of the email. Organizations may also contact OPPD at 301-594-4300 and their State Primary Care Association (PCA) and/or Primary Care Office (PCO) for assistance in developing an application. Contact information for the State PCAs and PCOs are available on HRSA’s web site at http://bphc.hrsa.gov/technicalassistance/.

· Effective Date of an Approved Change in Scope: The effective date of an approved change in scope will be no earlier than the date of receipt of a complete request for prior approval, and will extend to the end of the FQHC Look-Alike’s current designation period. The approved site/service should be included the FQHC Look-Alike’s subsequent annual recertification or renewal of designation application.

The effective date for this PIN will be six months beyond the issuance date. All organizations, potential and existing FQHC Look-Alikes, are strongly encouraged to use this application guidance upon the effective date. Organizations will be required to meet the new FQHC Look-Alike application guidance requirements twelve months beyond the issuance date. Organizations that are newly designated after issuance of this application guidance will be expected to submit a renewal of designation application five years from the designation date. Existing FQHC Look-Alikes are required to submit a renewal of designation application based on the following designation year:

Questions regarding the FQHC Look-Alike Program should be directed to OPPD at 301-594-4300 or OPPDGeneral@hrsa.gov.

James Macrae
Associate Administrator

Attachments

issued September 22, 2009