Guide to Understanding Florida's FQHCs and 330 Expansion ...

Where Are The Greatest Needs For Healthcare Services
In 2004, FACHC and the Florida DOH Office of Health Professional Recruitment (HPR) worked
on an assessment of the need for primary healthcare in Florida’s 67 counties. As a framework, we
used the criteria on the 330 Need for Assistance Worksheet (NFA) that is required of all applicants
for 330 New Access Point (NAP) funding. The results of Florida’s needs assessment projected an
NFA score for each of Florida’s counties. The needs document is available on HPR’s web site at
http://www.doh.state.fl.us/workforce/recruit1/index.html. In 2005, HRSA changed the NFA
format, criteria and scoring mechanism seeking public comment on the proposed new NFA in the
February 4th issue of the Federal Register (Vol. 70. No.23). HRSA's web site has since posted a
new version of the NFA worksheet at http://bphc.hrsa.gov/chc/needforassistance.htm.
While useful in providing a snapshot of need, county level data has limitations when trying to
pinpoint and establish priority areas in the state that lack adequate access to primary health care. Zip
code or census level information is more useful. In 2004, FACHC in conjunction with the Florida
DOH conducted an analysis of primary care needs in Florida using two of the three required major
access barriers on the proposed new NFA worksheet. These factors were the population to
physician ratio and the percent of the population living at or below 200% of the FPL. Each
community on the resulting List of Florida Communities in Need of Primary Health Care met the
following criteria: they were (1) within 15 miles of a population of at least 5,000 individuals that (2)
has a population to physician ration of 3000:1 or greater and (3) where at least 44% of the
population lives at or below 200% of the FPL and (4) are not currently served by an existing FQHC
or actively working with an FQHC on the creation of a New Access Point. The List of Florida
Communities in Need of Primary Health Care can be found at
www.fachc.org/cd_community%20development%20.htm and is used to help guide FACHC’s
community development (CD) efforts.
“Community Development” is the process of helping communities and their stakeholders
objectively assess their need for healthcare services and develop strategies to address their identified
needs. FACHC’s priorities are focused on areas with the highest level of need in terms of the
number of unserved or underserved people, the level of poverty, relative health outcomes, and the
degree of health disparities. We understand that communities have competing priorities and are in
different places in terms of their readiness to focus on healthcare access and the challenges
associated with becoming an FQHC. It is relatively easy to initiate community development
activities with some communities if there are leaders committed to addressing healthcare access
issues while efforts to initiate community development activities elsewhere can be more difficult.
To be successful there needs to be an infrastructure with resources, people and networks to sustain
long term community work. It is important that leaders are enthusiastic and supportive, and that the
community as a whole perceives the need to increase health care access and reduce health
disparities. FACHC considers all of these factors when determining where to focus our community
development efforts.
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