How to Start a Health Care for the Homeless Program
Primary audience: Non-HCH health centers and potential health centers
What does the HCH designation mean?
This month we address one of the most frequently asked questions in NHCHC technical assistance: how to start a Health Care for the Homeless program. Find a more formal and detailed version of this blog here.
First, Health Care for the Homeless (HCH) is a designation (among four) within the federal health center program through the Health Resources and Services Administration (HRSA). HCH programs are federally qualified health centers, a reimbursement term sometimes mistakenly used to describe Community Health Centers that do not have HCH funding.
From a compliance standpoint, HCH programs are nearly identical to all health centers. Of course, compliance is not the only consideration: HCH also represents a unique model of care grounded in social justice and human rights.
So, if you want to become a Health Care for the Homeless program, you must apply to become a HRSA health center.
If your organization is already a health center grantee, this means you are already almost entirely compliant with health center program expectations and are best positioned to add HCH funding. Note that you don’t need HCH funding to provide HCH-like care: learn more.
If your organization is not yet a health center, the application process is usually worthwhile, but a substantial undertaking.
HRSA has two doors to become a health center: the Service Area Competition (SAC) and the New Access Point (NAP).
With a SAC, you’re competing for an existing health center’s grant, so it can be challenging and potentially contentious depending on the local politics. A NAP is a more common method of becoming a new health center, which funds new clinic sites.
But here’s the catch: New Access Points are released on an irregular schedule and recent messaging from HRSA indicates they have no plans for NAPs anytime soon. The only way to know if a NAP opportunity is released is to closely monitor HRSA communications.
Pending availability of NAPs, though, these two resources are most helpful:
- So You Want to Start a Health Center?; National Association of Community Health Centers
- How to Become a Health Center; Health Resources and Services Administration
What to consider
You may not have time to wait for a NAP and, in fact, it may be the case that the HRSA health center program is not the best option for you. For example, most medical respite providers and street medicine programs are not health centers.
Consider what services you want to provide to inform your funding options, which may include:
- Community Benefit funding from nonprofit hospitals
- Health care-related philanthropic organizations
- Community foundations
- Partnerships with Managed Care Organizations
- Grants through the Substance Abuse and Mental Health Services Administration (SAMHSA) such as PATH, SOAR, and CABHI
- Grants or contracts from state and local governments
- Direct hospital investment/contracts