What Matters for Health Centers

Health centers need public policies that contribute to a robust, culturally competent, primary care workforce that is ready and willing to fill current staffing needs at health centers, as well as serve that role into the future. Part of NACHC’s agenda in this space is advocating for two essential programs, the National Health Service Corps (NHSC) and the Teaching Health Centers Graduate Medical Education (THCGME) program, which supply health centers with dedicated and hardworking health care workers, and train the next generation of health center doctors and dentists. These policies work in tandem to not only address the primary care shortage, but also help in increasing access to health care services for medically underserved communities.

Quick References

2019 NACHC Policy Paper: Workforce
NACHC Infographic: The Nuts and Bolts of Health Center Workforce
NACHC Issue Brief: Staffing the Safety Net, Building the Primary Care Workforce at America’s Health Centers
NACHC Fact Sheet: Expanding Access to Primary Care: The Role of NPs, PAs, and CNMs in the Health Center Workforce
NACHC Outreach and Enrollment Issue Brief: Expanding the Role of the Enrollment Assister at Community Health Centers

Federal Legislation to Extend Funding for NHSC and THCGME Programs

S. 1191, Training the Next Generation of Primary Care Doctors Act
S. 106/H.R. 2328, Community Health Investment, Modernization, and Excellence (CHIME) Act of 2019
S. 192, Community and Public Health Programs Extension Act
S. 962/H.R. 1943, Community Health Center and Primary Care Workforce Expansion Act of 2019

National Health Service Corps

The National Health Service Corps’ (NHSC’s) mission is to build healthy communities by supporting health care providers dedicated to working in areas with limited provider access through loan repayment and scholarships. The NHSC collaborates with community health centers to provide financial, professional and education resources to medical, dental, mental, and behavioral health care providers.

Teaching Health Centers

The Teaching Health Centers Graduate Medical Education (THCGME) program, first authorized in 2010 and extended with bipartisan votes in 2015 and 2018, is an initiative designed to increase the number of primary care medical and dental residents trained in community-based settings. Medical residents are able to provide care in various health center and primary care settings including FQHCs, FQHC Look-Alikes, Community Mental Health Centers, and rural health clinics. THCGME pays for the training resident’s medical education expenses or for the expansion of health centers residency programs.

Shortage Designations

Throughout the country, there are geographic areas, populations, and facilities with too few primary care, dental, and mental health providers and services. In conjunction with State Primary Care offices, HRSA determines which of these should receive “shortage designations,” and therefore be eligible to receive certain federal resources. Federally Qualified Health Centers all received automatic designation as HPSAs.  

Helpful Resources

NACHC Maps: Primary Care Shortage State Maps
NACHC Comments: HRSA’s Proposed Changes to Automatic Facility HPSA Score Calculations (2016)

Malpractice Liability Protection for Health Centers – FTCA

The Federally Supported Health Centers Assistance Act of 1992 and 1995 granted medical malpractice liability protection through the Federal Tort Claims Act (FTCA) to HRSA-supported health centers. Under the Act, health centers are considered Federal employees, with the Federal government acting as their primary liability insurer. Information and resources regarding FTCA are below.

Quick References

NACHC FAQs

In response to HRSA’s policy on FTCA coverage for volunteers, NACHC produced a Frequently Asked Questions (FAQ) document to provide comprehensive guidance to the field regarding the operational implementation of this new policy. The document is available in English and Spanish.

NACHC Letter of Support: FTCA Coverage for Volunteers

Important Links

BPHC’s FTCA website
BPHC FTCA Manual
BPHC Toolkit – list of tools to help health centers get coverage
PAL Instructions to apply for coverage – HRSA has extended FTCA coverage to volunteers working at health centers. The Program assistance letter (PAL) is to help health centers apply for FTCA coverage for their volunteers.
ECRI Institute Risk Management and Patient Safety Guidance – ECRI is a nonprofit organization dedicated to improving patient care. HRSA has worked with ECRI to create helpful risk management and patient safety resources.
Feldesman Tucker Leifer Fidell LLP Compliance & FTCA Support Services – provides services for health centers available with subscription.

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