As community health centers across the country navigate how to best serve their communities as well as adapt and maintain operations during this devastating pandemic, they are facing unprecedented financial challenges. Capital Link has been listening and responding to health center’s concerns. This article contains some of the suggestions and insight we’ve been sharing to support health centers’ efforts to balance financial and operational sustainability with patient and staff care.

With the election now behind us, health centers have ongoing concerns regarding future policy, value-based care, 340B, telehealth, patient engagement, public expectations, and staff and community safety. For the foreseeable future, there is a significant number of unknowns.

Although the road we are on at times seems daunting, there are many useful resources available to assist health centers in finding the best funding sources for their organizations. Similar to a natural disaster, COVID-19 presents opportunities for action and ways of supporting our communities and one another. In order to move forward, keeping each health center’s individual needs in mind, organizations should plan for different scenarios, changing business models, and capital needs in the midst of the continued uncertainty of this crisis.

Health centers should evaluate: What is the obvious need? What do our patients and communities require? What information or resources are available? Maintaining resources, relationships, and reserves allows one to manage through the crisis and often come out stronger. It’s critical that health centers evaluate multiple possible scenarios and maintain awareness of your organization’s capacity—including strategic agility, emergency preparedness, and the availability of relevant data for decision-making.

Developing Your Priorities and Requirements for the Short and Long Terms

There are currently many lenders offering flexible terms for loans and repayment, which health centers may want to consider in order to assure adequate access to cash in an uncertain operating environment. Begin analyzing your needs by conducting a cash flow analysis, asking, “How long can we operate in our current position?” Determine the best and worst case scenarios—start small with what you know, and add on as appropriate. Use ranges rather than specific numbers and examine your environment—what might recover, and what might not?

Capital Renovations to Ensure Safety and Meet Staff and Patient Needs and Expectations

Consider how you might incorporate what you have learned during the pandemic into your center’s physical space and operational processes. What have you learned so far? What do you know now that you didn’t before? What do your patients and staff want and need in terms of your physical and/or virtual footprint? What has worked well, and what not so well? What creativity has expressed itself in the form of more efficient processes? How can you make these changes permanent? What spaces or equipment were you lacking that you wish you had? Did you work with new partners and did that change your space requirements? Which impromptu changes in your physical space do you want to make permanent?

Capital planning remains an important part of your strategic plan. This doesn’t always mean a new facility but rather using your current space more effectively: phasing, renovations, and having a “Plan A” and “Plan B” ready for when capital dollars make themselves available. For example, many centers are considering renovations to existing facilities to accommodate increased use of telehealth, reduce infection risk in common areas and dental suites, and adding negative-pressure rooms to care for contagious patients more safely.

Though we can’t predict the future, we can at least help shape it by sharing our experiences and resources with one another and provide ongoing support, collaboration and guidance. By combining our knowledge of what has worked in the past with what we have learned today, we can help provide a more promising tomorrow.

Keep an eye out for our new learning collaboratives beginning in early 2021, with official dates and application information to be announced soon. All three collaboratives are offered free of charge with support from the Health Resources and Services Administration.

Sustaining and Increasing Access to Care in Rural Communities Learning Collaborative – Offered in collaboration with NACHC, through a series of four interactive webinars between February and April 2021, this Learning Collaborative will explore community needs, growth planning, and financing options for health centers serving rural communities. It will address challenges and opportunities facing FQHCs in communities experiencing hospital distress and closure; examine the impact of telehealth on care delivery; and address financial capacity, sustainability, facility planning and financing options for FQHCs seeking to expand their impact in rural America.

Planning and Financing a Capital Project to Accommodate Integrated Care Learning Collaborative - Capital Link is launching a fourth year of this collaborative, which provides practical direction and tools for capital project planning, financing, and completing for health centers that anticipate the need for a project in the next one-to-five years. This year we will also be highlighting key planning considerations related to the Patient-Centered Medical Home model of team-based, integrated care. Through a series of six monthly interactive learning sessions conducted between February and May 2021, this learning collaborative provides health center participants with guidance to successfully navigate the process of building or renovating facilities that will better serve their communities.

HRSA Loan Guarantee Program (LGP) Learning Collaborative –  Through a series of four interactive learning sessions, the second offering of our newly developed LGP learning collaborative will provide health center participants with guidance and tips on all key elements and requirements for submitting a HRSA Loan Guarantee Program application. The application review, approval, and loan closing process will be also be addressed. Resources developed by HRSA and by Capital Link will be provided throughout the collaborative. 

Developed by Capital Link with support from the California Health Care Foundation, the new California Federally Qualified Health Center Financial and Operational Performance Analysis 2016-2019 report provides an analysis of statewide, multi-year financial and operational trends and median outcomes from 2016 to 2019. It offers health centers a structure for recognizing the financial strengths, challenges, and benchmarks that support opportunities for performance improvement. 

Pages from California Financial and Operational Trends Report
View Report Here >

As a companion to this report, we have also updated our Performance Benchmarking Toolkit for California Health Centers to reflect this most recent data analysis.

CA Toolkit Redesign 11 5

View Toolkit Here >


Access all of our California health center publications here.


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