1. Contact the LPCA , the Bureau of Primary Care and Rural Health (DHH), National Association of Community Health Center, and the Bureau of Primary Health Care to establish a communication link. These organizations are able to:  
   • assist with planning and implementation during the community development process;
   • provide training (How to Start a FQHC, 330 Proposal Writing, Board Governance (LPCA-Louisiana Governance Academy, LPCA/BPCRH Orientation);
   • facilitate meetings with FQHCs;
   • direct you to planning funds; and
   • provide other technical assistance as appropriate.
2. Obtain and read the following reference documents to become familiar with the necessary criteria to qualify and apply for a Federally Qualified Health Center (FQHC or FQHC Look-Alike), the necessary steps to start a FQHC, and compliance expectations of an FQHC.
   • Health Care Safety Net Amendments of 2002, Public Law 107-251 (section 330 of the Public Health Service (PHS) Act as amended)
   • Policy Information Notice (PIN) 98-12, “Implementation of the Section 330 Governance requirements” (signed April 28, 1998)
   • PIN 98-23 “Health Center Program Expectations”(signed August 17, 1998)
   • PIN 98-24, “Amendment to PIN 97-27 Regarding Affiliation Agreements of Community and Migrant Health Centers” (Signed August 17, 1998)
   • PIN 97-27, “Affiliation Agreements of Community and Migrant Health Centers” (signed July 22, 1997)
   • PIN 2001-13, “Clarification of Program Requirements and Benefits for Bureau of Primary Health Care Supported School-base Health Centers” (signed June 6, 2001)
   • Program Assistance Letters (PAL) 2002-19 “President’s Initiative to Expand Health Centers” (signed May 16, 2002)
   • PIN 2003-21 “FQHC Look – Alike Guidance”
   • PIN 2005-01 “New Access Points (NAP) in Programs Funded under the Health Centers Consolidation Act of 1996    Note:  Competition to be re-opened/date to be determined
   • "Healthy People 2010” 
3. Solicit a representative sample of community support from health professionals (physical dental, mental, substance abuse, pharmacy), and health related organizations, politicians, city government officials, social and civic representatives (community based organizations, churches, civic groups and lodges) to discuss the health needs of the community. 
4. Establish a Steering Committee and Chair.
5. Define your community. Perform a Community Assessment of the proposed service area to identify healthcare indicators and other related needs that will strengthen your case in proposing the idea to execute a community health center to the leaders and the community. Develop a brief description of the target or service area.  Include unique characteristics of the community/target population and health indicators (e.g., employment status, immigrants, elderly, homeless persons, public housing residents, farm workers, and/or low-income school children).  Identify major issues or barriers to care faced by the target population(s).
6. Assess health care resources that are currently available for the target population; estimate the unmet need for services and community priorities for the target population.
7. Determine if the area is a Medically Underserved Area (MUA)/Health Professional Shortage Area (HPSA) area or apply for HPSA designation (primary care, dental or mental). BPCRH can provide statistical data to determine healthcare needs of the target or service area, and determine if the targeted area or service area has been designated as a HPSA, MUA, High Impact Area and/or Medically Underserved Population (MUP).
8. Develop annual training schedule and provide initial trainings for a community-based   governance board (Louisiana Governance Academy from LPCA) of 51% consumers.
9. Apply for 501 © 3 status (or convert an existing nonprofit organization) from the IRS.
10. Develop a strategic plan for the organization.
11. After a careful needs assessment has been performed, identify if the center will be a New Start, Expansion Site, or FQHC Look-Alike may be more  appropriate.  Decide what type health center (or combination) to apply for based on the needs of the community.  The models of health centers include:
    • Community Health Center (CHC) -330 (e)
    • Migrant Health Center (MHC) – 330 (g)
    • Healthcare for the Homeless (HCH) – 330 (h)
    • Public Housing Primary Care (PHPC) – 330 (i)
    • School Based Health Centers (SBHC) – 330(e)   
12. Coordinate additional meetings and forums with Community Leaders (Representatives, Senators, City Council, Police Jury, Chamber, etc.), Churches, Civic Lodges, Hospitals, Businesses, Hospitals, Residents, etc. to discuss community issues, gauge support and identify pertinent resources that can ensure program viability and a seamless stream of services to the target or service area.  Obtain Memoranda of Understanding/Agreements from various businesses, organizations, and health-related agencies that have committed services to the CHC (i.e. facility use, in-kind, contracted services, referrals, etc.) that can be contributed as start up.
13. Identify a service package (RESPONSE to the stated need, Health Care Plan and Business Plan).
14. Identify possible center location(s).
15. Assess staffing needs (develop recruiting and retention plan).
    • Identify who will write the 330 proposal, (LPCA and BPCRH can assist with a list of grant writers, if needed) develop a strong Letter of Intent (LOI), and a proposal packet.  If a grant writer is employed: 
      • ask for credentials; 
      • determine their knowledge of FQHC operations, grant proposal submission and approval rates, number of FQHC proposals written and approved; and 
      • request and check references. 
    • Submit your LOI to the BPHC office, with a copy to LPCA and BPCRH, to acknowledge your intent at least 60 days prior to the submission of the final application (BPHC will provide feedback within 30-days of receipt of the LOI). 
    • Draft your proposal and submit your 330 proposal packet on the appropriate application date with plans to be operational and providing services 120-days of a grant award.

Helpful Websites:

The Pew Charitable Trusts - Grants Information

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