Around $601 million in primary health care grants was distributed to Texas entities as a result of the COVID-19 pandemic, however, TOMAGWA Healthcare Ministries did not receive any funding.

That’s because TOMAGWA, a nonprofit clinic whose service area includes Tomball, Magnolia and Waller, is not a federally qualified health center, or FQHC, CEO Timika Simmons said.

“Our patients matter too,” Simmons said. “And we couldn’t get a dollar. And there were entities who could just guess what their losses would be and they were getting millions of dollars to take care of their ... [patients].”

With that in mind, TOMAGWA—which primarily serves low-income and uninsured patients—spent several years and over $3 million to meet the qualifications to be an FQHC eligible for grants, a status it should achieve by year-end.

Two-minute impact

After several years of work, TOMAGWA earned its FQHC Look-Alike designation on Feb. 1, putting the clinic one step closer to its goal of becoming an FQHC and eligible for various grants.

“Even before this, our greatest pain was not [the] budget. The pain was having to say, ‘We can’t,’” Simmons said. “This will help us become ... a culture of ‘Yes.’ ... Over time, as we scale this FQHC program, we’ll be able to say yes more to our patients.”

To meet the requirements and achieve its FQHC Look-Alike designation, TOMAGWA underwent an organizational overhaul starting in 2020, Simmons said. The nonprofit restructured its leadership team; its bylaws were updated; the clinic received major upgrades to its clinical systems and technology; and hundreds of new policies and procedures were written.

“It gets extremely detailed ... one thing could take seven months, one thing could take a few weeks,” Simmons said. “Some things require an employee with a special skill set, so now you have to hire someone and then get a grant for that. So the timing wasn’t necessarily us trying to figure out what to do, it’s just pulling all the pieces together.”

Simmons said TOMAGWA is also undergoing various service expansions, which includes coverage for emergencies after hours; expansions of the clinic’s gynecology and obstetrics and pediatrics programs; transportation and translation services; expanded screening services; and expanded outreach programs.

Altogether, using private funding, it cost TOMAGWA over $3 million to achieve its FQHC Look-Alike designation, and the nonprofit expects to spend around another $2 million to achieve full FQHC status, Simmons said.

The details

“What the designation does is it says, ‘This is the standard that everyone follows. But you’re going to follow this standard at a higher level because you’re taking care of vulnerable people,” Simmons said.

Simmons also said the designation will allow the nonprofit to apply for grants for needs such as hiring mental health professionals; building upgrades; or expanding services.

“One of the gratifying things is we really have a plan ... to make us much more sustainable,” TOMAGWA board President Kevin Rudolph said.

Simmons said the plan is to scale up TOMAGWA’s Tomball and Magnolia clinics before attention is directed toward its Waller clinic, which is open by appointment only.

“Waller is extremely special,” Simmons said. “That community has state and federal designations in multiple areas ... and I think what we do there will have to be very unique and even more mission-structured than what we do here in Harris and Montgomery counties.”

Simmons said partnerships will be more significant in the delivery of care to patients in Waller.

Quote of note

"When you do this type of work, you come every day because you want to make a difference in someone’s life." —Timika Simmons, TOMAGWA CEO

Zooming out

There are 74 FQHCs in Texas that operate over 650 sites in 127 counties, said Jana Eubank, CEO of the Texas Association of Community Health Centers, which represents and works with Texas FQHCs. FQHCs:

  • Are located in areas of high need
  • Offer a comprehensive set of services, including medical, dental, pharmacy and other services
  • Are open to everyone regardless of insurance status or ability to pay
  • Provide consumer-driven health care, with at least 51% of every health center’s baord required to be made up of patients
  • Provide primary care to 1 in 17 Texans

“Health centers are really critical in terms of the state’s ability to serve those who are most in need and communities that are lacking access to really comprehensive primary and preventative health care services,” Eubank said.

In 2022, FQHCs served 1.8 million patients, according to the TACHC. Between 2013 and 2022, patients served at Texas FQHCs increased by 56%—rising from 1.13 million patients to 1.77 million patients.

“If an individual goes to a community health center and has access to FQHC services, that means they have access to ... comprehensive preventative and primary care,” Eubank said.

Eubank also said patients would likely go to the emergency room for primary care without FQHCs.

“[That’s] obviously not ideal in terms of comprehensive care and continuity of care, but it’s also the most expensive way to access services at a primary care level,” Eubank said.

What’s next

On May 30, the Health Resources and Services Administration opened the application period for New Access Points funding under the Health Center Program, which provides funding to support new health center sites, according to the grant application. TOMAGWA will now apply using its Look-Alike application, and Simmons said the FQHC designation comes from applying for those funds.

Simmons said it will take until August to get everything uploaded, and then award announcements would be made around November—meaning TOMAGWA could earn full FQHC status by the end of this year.

“If it was easy, you’ll have FQHCs everywhere. But it’s very difficult, and we were still doing it on private dollars,” Simmons said. “Our fuel was our passion for the mission.”