In healthcare, CHC most commonly stands for Community Health Center, a federally supported clinic in the United States that provides primary care to anyone regardless of their ability to pay. In the UK, CHC refers to something entirely different: Continuing Healthcare, an NHS funding program for people with complex, ongoing medical needs. Both meanings come up frequently, so this article covers each one clearly.
Community Health Centers in the US
A Community Health Center is a nonprofit or public clinic that receives federal funding under Section 330 of the Public Health Service Act. These centers exist specifically to serve medically underserved communities, meaning areas where people face significant barriers to getting basic healthcare. In 2024, US health centers served over 32.3 million patients. Roughly 90% of those patients had household incomes at or below 200% of the federal poverty level, and about 18% had no insurance at all.
To qualify as a CHC, a facility must be a private nonprofit organization or a public agency. It must already be delivering primary care in its service area. It cannot be owned or controlled by another entity, and it must operate independently with its own leadership, including a dedicated project director or CEO who answers to the center’s own governing board.
What Services CHCs Provide
Federal law requires CHCs to offer a core set of primary health services. This includes general medical care, preventive screenings, immunizations, and lab work. Many centers also provide dental care, behavioral health services, and pharmacy access, either directly on-site or through formal contracts with outside providers. Centers that serve homeless populations are additionally required to offer substance use disorder services.
Beyond clinical care, CHCs often provide what are called “enabling services,” things like transportation assistance, translation, case management, and help signing up for insurance. The goal is to remove the practical obstacles that keep people from showing up to appointments in the first place.
How Patients Pay at a CHC
CHCs use a sliding fee discount scale tied to household income. If your income falls at or below 100% of the federal poverty guideline, you receive a full discount. Some centers charge a small flat fee at this level, but it must be nominal. If your income is between 100% and 200% of the poverty guideline, you pay a partial fee that increases gradually across at least three income tiers. Above 200%, you pay the standard charge. Insurance is accepted but never required. No one is turned away for inability to pay.
Patient-Led Governance
One feature that makes CHCs unusual in healthcare is a federal requirement that patients control the board of directors. At least 51% of board members must be current patients of the center. These patient board members have authority over meaningful decisions: choosing which services the center offers, setting hours of operation, defining budget priorities, and evaluating patient satisfaction. The requirement exists to ensure the clinic reflects the community it serves rather than outside institutional interests.
Federal Funding Streams
CHCs receive grants through several channels under Section 330. The general program funds centers serving broad medically underserved populations. Separate grant categories target specific groups: migratory and seasonal agricultural workers and their families, homeless individuals (including veterans and youth at risk of homelessness), and residents of public housing. Each of these special population grants can fund planning, operations, and programs aimed at reducing infant mortality. Centers also bill Medicaid, Medicare, and private insurance, so federal grants supplement rather than replace insurance revenue.
NHS Continuing Healthcare in the UK
In the UK, CHC stands for Continuing Healthcare, a program through the NHS that fully funds care for adults with significant, ongoing health needs. If you qualify, the NHS pays for all of your care, including nursing home fees or a package of support at home. This matters financially because social care in the UK is means-tested, meaning you normally pay based on your savings and assets. CHC funding removes that means test entirely.
How UK CHC Eligibility Works
Eligibility comes down to whether you have what the NHS calls a “primary health need.” A multidisciplinary team of healthcare professionals assesses your situation across 12 categories: breathing, nutrition, continence, skin integrity, mobility, communication, psychological and emotional needs, cognition, behavior, medication management, altered states of consciousness, and any other significant care needs. For each category, they evaluate how complex, intense, and unpredictable your needs are, including the risk to your health if the right care isn’t provided at the right time.
The assessment typically begins with an initial checklist screening. If the checklist suggests you may be eligible, you move to a full assessment by the multidisciplinary team. The team then makes a recommendation, and the local Integrated Care Board (ICB) makes the final funding decision.
Appealing a UK CHC Decision
If your application is denied, you can ask the ICB to review its decision through a local resolution process. If that doesn’t resolve the issue, you can apply to NHS England for an independent review. You have six weeks to submit that application. The independent review process typically takes three to six months. If the review sends your case back for a full reassessment and you disagree with the new outcome, you’re entitled to request a second independent review.