Providing chiropractic care to underserved populations through a Federally Qualified Health Center

The US census reports 50 million Americans as uninsured and 46 million in poverty. This is the highest number ever recorded. For many of these people the only option for health care is through a Federally Qualified Health Center (FQHC). These centers receive federal funding to provide healthcare to underserved and vulnerable populations. They provide primary care and support services such as translations, education and other services to improve access to care. Services are available to all with fees adjusted according to income. A major FQHC subset is the Community Health Center (CHC) that provides health services including family practice, internal medicine, pediatrics, obstetrics and gynecology, dentistry and education encompassing nutrition, smoking cessation and substance abuse programs. Limited options for musculoskeletal treatment are available in most CHCs. Some offer chiropractic care however this is relatively rare and the actual frequency is unknown. Chiropractic services have been offered at one CHC since February 2011 through a feasibility project known as ECHO (Evidence for Complementary and Alternative Medicine Healthcare Options). At the conclusion of this project an ongoing partnership was developed between the CHC and a chiropractic college. The CHCs unique patient population provides a rich learning environment for chiropractic students. Mechanisms to offer intern rotations have been developed consistent with facility operations and in light of Joint Commission accreditation standards. This talk will review the operational and clinical challenges and opportunities in integrating chiropractic care and intern education into a CHC.