The FQHC Funding Cliff:  Update Following Government Shutdown 2018

As I write this update about the status of the Federal FQHC funding cliff, Congress is in the process of voting to reopen the Government, with health centers still left in uncharted territory. has received numerous contacts regarding our last funding cliff update, and we have spoken to many of you about your concerns.

We’ve heard that many health centers have reduced hours for certain specialties, delayed rollouts of additional services, and put off hiring needed providers and staff.

Are there other ways to maneuver in these uncharted waters?

It is generally agreed that Federal funds will again flow in time, at near traditional levels. However, the way you manage these three key areas now may impact your level of success once Congress regains its direction:

1. Operational Considerations

Review your present clinical operations for opportunities. Are there light volume days or sessions that you can consolidate without significantly impacting patient care?  

This is also an opportunity to review your patient scheduling templates and appointment types. Could movement of appointment times and sessions increase efficiency and lower man-hours in your center?

These assessments may not be familiar to FQHC entities, as Mission and assisting needy populations are a priority. Consider a bit of private practice philosophy here: What is best for your entity short term? Some changes in philosophy now may affect how well you are able to return to traditional services at a later date.

Whatever you decide to do operationally, just make sure that you communicate the reasons for these changes with your providers, staffs and patients. This will prevent undue gossip and negative impressions of your center that may impact you later. 

2. Financial Considerations

A back-to-basics philosophy is in line here: Where can you cut cost and minimize patient and staff impacts?

Are there vendor contracts or agreements due for renewal? Have you shopped cost and renewal rates for these? Don’t be shy about discussing the funding cliff with vendors and communicating that you are looking for savings opportunities. Vendors want to retain your business, not lose it.  Alternate options, such as short-term/month-to-month agreements or delaying scheduled implementations/upgrades to systems and software may also warrant consideration.

Additionally, you may consider short term funding options. Regional banks and lending entities are generally open to entity needs in times such as this. If you think you might want to go this route, just be sure that your financial statements and budget projections are up to date.

Also, don’t overlook short-term funding opportunities from local charities and foundations. We have witnessed willingness from these sources to assist FQHC entities recently.  Grants and low interest loans are some of the options we have seen.

3. Political Considerations

Many of you are already active in this area. If not, now is the time to start! We recommend the following actions:

  • Be active in your State Primary Care Association (PCA) activities and participate in roundtable discussions.

  • Follow National Association of Community Health Center (NACHC) activities and web activities. If you haven’t already done so, subscribe to the NACHC Health Center Advocacy Network, which sends regular email updates on advocacy issues and recommends actions that health centers can take. It’s free, and signup just takes a minute on their home page.

  • Maintain outreach with your local Chamber of Commerce and business groups. This will expand knowledge of your cause and assist with networking for fundraising and loan/grant resources if needed.

  • Contact your Senator and House Representatives. They are generally willing to listen, and many representatives are open to visiting your health center and hearing your concerns directly. This can be a PR win for your center as well.

  • Share your story on social media. Get the word out on how your health center is doing and how you’re being affected.

The FQHC funding cliff is now more than a projection; HRSA funding will return at a yet to be determined time.  The actions you take now will likely influence the rebound you are able to make once funding is re-instated.

Stay tuned…

And, as always, if you have any additional questions or would like help with planning a strategy for your health center, the consultants at would be happy to assist.


Chuck Hutchings is the Director Healthcare Operations & Strategy at RDI.

To connect with Chuck on LinkedIn, click here.

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