The Health Care for the Homeless (HCH) Program started in 1985 through 19 demonstration projects funded by the Robert Wood Johnson Foundation and the Pew Memorial Trust. The intention of these initial projects was to determine if a specialized model of delivering services could improve the health of individuals experiencing homelessness. Federal funding for more projects began in 1987 through the Stewart B. McKinney Homeless Assistance Act. In 1996, HCH projects were consolidated with community health centers and other primary care projects administered by HRSA’s Bureau of Primary Health Care. By law, HCH projects receive 8.7% of appropriated health center funds. There are now 208 HCH projects nationally—at least one in every state, the District of Columbia, and Puerto Rico.
Like other health centers, HCH projects are community-based and patient-directed organizations that serve low-income populations with limited access to health care. Each is located in a medically underserved community, is a nonprofit organization or public entity governed by a community board, and provides comprehensive primary care as well as supportive services (education, translation, transportation, etc.) that promote access to health care. All services are provided on a sliding scale with fees adjusted based on income and the ability to pay, and no patient may be turned away due to inability to pay. Unlike other health centers, HCH projects are required to provide substance abuse treatment services.