Think you want to become an FQHC or FQHC Look-Alike? Make sure you read this first!

Want to become an FQHC or FQHC Look-Alike? You’re in good company!

As FQHC consultants, 95% of the inquires we get are from organizations and individuals who want to become or start an FQHC (Federally Qualified Health Center) or an FQHC Look-Alike. Nine times out of ten, after we explain to them everything that is involved in the application process and all of the requirements they will need to meet, they decide not to pursue the designation.

Does this mean that becoming or starting an FQHC or FQHC Look-Alike is not worth the trouble? Absolutely not! But it does mean that you need to have a very good understanding of what it means to be an FQHC or a Look-Alike, and you need to want it for the right reasons (HINT: Making a quick buck is NOT the right reason!).

Here are some of the most common questions we are asked by prospective clients who are interested in obtaining these designations, as well as the advice we give them. This is valuable information that we generally charge for, so you’re going to want to pay attention!

P.S. If you would like some more basic information about FQHCs/Look-Alikes and whether pursuing these designations might be worth looking into, check out our post Becoming an FQHC – Is it right for your organization?.


Frequently Asked Questions About Becoming an FQHC or FQHC Look-Alike

Who is the best candidate to apply to become an FQHC or Look-Alike?

In general, the ideal candidate would be an established non-profit that is already serving the population in need in their community. Forming a clinic from the ground-up was more common in the past, but nowadays people wanting to go that route are better off applying as an FQHC Look-Alike first. Although a Look-Alike does not receive grant funding, there are many advantages to going this route before applying to become an FQHC.

The advantages of becoming an FQHC Look-Alike prior to submitting an FQHC application are:

  1. Look-Alikes have to meet all of the same requirements as FQHCs so, if you are operating as a Look-Alike, you will already have climbed one of the biggest hurdles to becoming an FQHC: Making sure you are in compliance.

  2. You can only apply to become an FQHC if there is an active funding opportunity. Once a funding opportunity is announced, there is limited time to get your application together, so a Look-Alike will not have to waste time setting up a clinic or becoming compliant.

  3. The FQHC and FQHC Look-Alike applications are similar, so you can re-purpose your Look-Alike application efforts into the FQHC application.

What’s one challenge in the application process that most people are unaware of?

There are actually two big ones:

  1. Complexity - Most people are unaware of the complexity of completing an FQHC or FQHC Look-Alike application. A lot of our clients are people who originally thought they could do it alone, but later realized that they couldn’t just do it based on the guidance from HRSA.

  2. Timing Challenges - Applicants often underestimate the amount of time it takes to be ready to submit your application and/or become operational. For example, with a Look-Alike, you have to be operational and compliant 6 months before you can submit the application. For an FQHC, you have 120 days to become operational once you receive the designation. Additionally, you don’t get all of your benefits right away after receiving the designation. There are a lot of moving pieces and advanced planning that needs to take place, and many things have to happen in a certain order. Often, applicants fail to take all of this into account in their planning and suffer delays and/or financial issues as a result.

What important piece of advice would you give those considering becoming an FQHC or FQHC Look-Alike?

  1. Make sure you’re doing it for the right reasons. You and your organization need to have a strong desire to provide services to the uninsured. Yes, there are financial benefits to becoming an FQHC or a Look-Alike, but we would not advise going these routes if your sole motivation is to become more profitable.

  2. Have a plan to attract a core of competent people who will be able to run your FQHC or Look-Alike correctly.

  3. Entertain other options, like partnering with another FQHC first, and realize that service area overlaps are becoming more of a concern, so analysis is necessary to defend your application.

How can candidates give themselves the best chance of a successful application?

Read and follow the advice above! Also, make sure you are using the most up-to-date guidance - For example, the FQHC Look-Alike guidance was recently updated in August of this year. And, if you are going to seek professional assistance, make sure you properly vet them to ensure they have experience. Check references and educate yourself as much as possible so you know what types of questions to ask them.


Final Thoughts

Armed with the above knowledge, you are now much better equipped to determine whether you should venture into the FQHC world. If you would like more advice or help with your application, don’t hesitate to contact the FQHC.org consultants – We offer a full range of services to FQHCs and FQHC applicants.


Running a successful FQHC is hard work (we know because we’ve done it!)

Health centers present their own unique challenges, which often require expertise in many different areas. Our consultants use their specialized knowledge and network of relationships to help you solve your biggest operational and financial challenges so your health center can thrive.

If you have a problem, chances are we have dealt with something similar or know someone else who has. Our consultants are experienced in all facets of establishing and running a health center, and our clients include established FQHCs, Primary Care Associations (PCAs), and organizations wishing to establish, become or partner with FQHCs.

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