HRSA doesn’t set a specific number of collaborative relationships that every health center must have. Instead, the requirement is that all HRSA-funded health centers (FQHCs and Look-Alikes) must demonstrate ongoing collaboration with other community organizations, providers, and local stakeholders. Per Chapter 14: Collaborative Relationships, health centers document their efforts to collaborate with other providers or programs in the service area, including local hospitals, specialty providers, and social organizations (including those that serve special populations), to provide access to services not available through the health center to support the following:

• Reductions in the non-urgent use of hospital emergency departments;
• Continuity of care across community providers; and,
• Access to other health or community services that impact the patient population.

Health centers should document their collaborative efforts through written agreements (MOUs, contracts, referral agreements, etc.). Documented participation in local health improvement coalitions, hospital community benefit initiatives, or regional care coordination networks are all excellent examples. Lastly, health centers should consider relationships with partners aligned with their mission and vision, which may include schools, homeless shelters, correctional facilities, behavioral health providers, or academic institutions. HRSA’s standard is quality and relevance of collaborations, not quantity. Each health center should be able to show it has established, maintained, and can document active collaborations that meet the needs of its community.