Nurse‐Midwives in Federally Funded Health Centers: Understanding Federal Program Requirements and Benefits

Abstract

Midwives are working in federally funded health centers in increasing numbers. Health centers provide primary and preventive health care to almost 20 million people and are located in every US state and territory. While health centers serve the entire community, they also serve as a safety net for low-income and uninsured individuals. In 2010, 93% of health center patients had incomes below 200% of the Federal Poverty Guidelines, and 38% were uninsured. Health centers, including community health centers, migrant health centers, health care for the homeless programs, and public housing primary care programs, receive grant funding and enjoy other benefits due to status as federal grantees and designation as federally qualified health centers. Clinicians working in health centers are also eligible for financial and professional benefits because of their willingness to serve vulnerable populations and work in underserved areas. Midwives, midwifery students, and faculty working in, or interacting with, health centers need to be aware of the regulations that health centers must comply with in order to qualify for and maintain federal funding. This article provides an overview of health center regulations and policies affecting midwives, including health center program requirements, scope of project policy, provider credentialing and privileging, Federal Tort Claims Act malpractice coverage, the 340B Drug Pricing Program, and National Health Service Corps scholarship and loan repayment programs.

Advancing quality and safety of perinatal services in India: opportunities for effective midwifery integration

“…The midwifery model of care approaches pregnancy and childbirth as physiologic processes that hold multiple forms of value and meaning (personal, physical, social, religious and cultural) for individuals, families, communities and societies ( Ginsburg and Rapp, 1995 ; Jordan, 1992 ; Oakley, 1980 ). With the ultimate goal of providing safe outcomes for the mother and infant ( Carter, 2012 ; Center for Health Workforce Studies, 2015 ; Raisler and Kennedy, 2005 ), midwifery care is based on development of open, trusting relationships; promotion of person-centred decision-making and encouragement of self-determination and bodily autonomy ( Sword et al. , 2012 ; Kennedy et al.…”

Concept Analysis and Proposed Definition ofCommunity Health Center

“…8,12,16,18,26,37,43,66,78,80 Funding schemes for CHCs were variable, including program financing, fee-for-service, capitation, dependence on insurance coverage, or a combination of these methods. 3,4,19,27,28,42,51,63 However, stability and consistency of funding was identified as a challenge for CHCs in some systems since budget cuts or lack of financial resources often negatively impacted service provision and in turn, negatively affected outputs such as client health outcomes. 19,25,40,63,78,80 A particular element of CHC services that has been identified as vulnerable to funding cuts is prevention and health promotion, since often a lack of funding means shifting focus to treatment.…”

“…3,9,38,46 The literature typically described primary care in CHCs as being delivered by a range of healthcare professionals, predominantly physicians, nurse practitioners, and nurses. 7,12,27,28,37,46,49,51,54,55 Depending on the mandate and scope of a CHC, other disciplines…”

“…1,23,25 Provision of immunizations, screening and tracking of illness or disease patterns, engagement in health services research, and proactive work in health policy were described as functions of CHCs. 1,10,25,40,51,54 Defined population. As noted by Albrecht, a CHC may be "community-defined as belonging to a geographic area or a specific group of people" 4 (p. vi) and the original mandate of CHCs aligned with the latter aspect of this definition goal through provision of care to underserved populations.…”

“…Other specific populations served by CHCs included women and children, older adults, the LGBTQ populations, and individuals residing in rural settings. 2,8,11,21,30,51,56,57,73 In some articles, the population was defined by geography or community, such as for persons in rural settings. 30,40,43,57,71,73 Geographical demarcation for CHCs seemed to generally fall along the lines of catchment areas for delivery of services, often representative of the healthcare agency responsible for delivery of services.…”