“To break it down to its most basic level, it allowed us to sleep,” says Dr. Lisa Green. “There’s peace of mind in knowing that regardless of external factors, we have the flexibility to make payroll, purchase supplies, pay vendors, and move forward with our larger plans for health care in the South Suburbs of Chicago.”
In a Nutshell
What: By refinancing its debt during the pandemic, FQHC Family Christian Health Center gained needed flexibility to pursue its strategic goals for quality health care in Chicago’s South Suburbs. The loan that enabled the organization to refinance was the continuation of a long-term relationship with IFF that has supported its growth since 2005.
Sector: Health Care
Location: Harvey, IL (South Suburbs of Chicago)
IFF Support: $3.5 million loan closed for FCHC in February 2021, IFF’s eighth loan to the organization since 2005
IFF Staff Lead: Brett Mueller, Senior Lender – Northern Illinois and Northwest Indiana
Impact: $100,000 in annual cost savings from recent refinancing
Dr. Green’s comments refer to the impact of a $3.5 million loan from IFF that refinanced a significant portion of debt at Family Christian Health Center (FCHC), the organization she co-founded and leads as CEO. Her comments are also indicative of the financial strain that Federally Qualified Health Centers (FQHCs) across the country have felt during the pandemic.
Despite providing high-quality health care to individuals in underserved communities at a time when access to care was critical, FQHCs have faced fundamental business model challenges as fewer patients were willing to visit physical health care centers for fear of being in close contact with others during the pandemic. In turn, revenue decreased as reimbursements from Medicaid and other government programs – determined by the number of patients served – also decreased.
That was the challenge facing FCHC in 2020, as the organization experienced a sharp decline in the number of patients visiting its four health care facilities in the South Suburbs for primary care, urgent care, behavioral and mental health services, obstetrics and gynecological care, prenatal care, dental care, and diabetes management. While telehealth visits helped make up some of the difference, reduced revenue limited FCHC’s ability to execute on an ambitious vision focused on the creation of a comprehensive medical district in the South Suburbs akin to the popular Illinois Medical District that serves the west side of Chicago.
In response, FCHC developed a three-pronged plan to increase liquidity by cutting operating costs, strengthening its billing practices, and reducing the cost of its long-term debt. Having worked with IFF multiple times since 2005, FCHC knew it had a partner willing to step up to support the organization as it executed its plan.
The mission and the vision for IFF aligns with the wellbeing of communities, which is what FQHCs generally and Family Christian Health Center specifically are all about. When you work with a partner that has a like-minded approach and recognizes the value of the work that you’re doing for the community, it’s not a matter of whether it can get done, but how it will get done.
“The mission and the vision for IFF aligns with the wellbeing of communities, which is what FQHCs generally and Family Christian Health Center specifically are all about,” explains Dr. Green. “When you work with a partner that has a like-minded approach and recognizes the value of the work that you’re doing for the community, it’s not a matter of whether it can get done, but how it will get done.”
That’s been true in the relationship between IFF and FCHC since early in its history. IFF helped finance the agency’s expansion to a second location in 2005, provided refinancing of some of FCHC’s commercial loans in 2017, and used $1 million from our New Markets Tax Credits Small Pool Loan Fund to help leverage a federal capital improvement grant in 2019. Altogether, IFF has provided eight loans to FCHC since 2005 – enabling the agency to save money, stabilize operations, open new facilities, renovate older facilities, and grow its impact in the South Suburbs.
'CDFI Plus' Support for HRSA Funding
Earlier this fall, the Health Resources and Services Administration (HRSA) released $1 billion in funding from the American Rescue Plan for Federally Qualified Health Centers (FQHCs) to complete construction and renovation projects – with award sizes ranging from $500,000 to $1 million. FQHCs that receive HRSA funding often need a partner to help implement facilities projects, and the nature of IFF’s work as a “CDFI Plus” means we’re tailor-made for this role.
By lending flexible capital to FQHCs, we ensure that HRSA funding can be leveraged for projects with costs that exceed HRSA award amounts. By providing a wide continuum of real estate services and bringing decades of experience working with FQHCs to the table, we ensure that FQHCs have the technical support needed to transform their spaces and operations as efficiently as possible.
In 2019, IFF worked with Family Christian Health Center (FCHC) to leverage its $1 million capital improvement grant from HRSA with another $1 million loan from our New Markets Tax Credits Small Pool Loan Fund. These funds supported a major renovation of FCHC’s 14-year-old primary facility in Harvey to accommodate additional growth in patient visits and a wider range of services.
With the HRSA funding and financing from IFF, FCHC was able to move forward with the redesign of its space, which added 10 new exam rooms, two new procedure rooms, a new reception area for patients, and a new staff lounge, while also relocating its in-house pharmacy and behavioral health services within the facility to more efficient locations.
The most recent loan in February 2021 to refinance FCHC’s debt was no exception, helping FCHC achieve annual cost savings that will amount to close to $100,000 that are being redeployed to support the agency’s operations.
“There have been lots of moving parts for us during the pandemic, and refinancing our debt was about strengthening the foundation of our business model and becoming more sustainable,” explains Family Christian Health Center CFO Tiffany Robertson. “We have more flexibility now after consolidating multiple loans into one loan at a better rate and are able to reinvest those savings into our operations.”
That flexibility immediately paid dividends, clearing the way for FCHC to move forward in April 2021 with the opening of a maternal and child wellness center in Harvey that offers comprehensive care for mothers of color to help ensure they have successful pregnancies. In addition to providing care predominantly to Black women, who experience racial disparities in health care that result in unacceptable mortality rates, the center’s location in the South Suburbs means that women with high-risk pregnancies no longer must travel elsewhere in the Chicago metro area for quality, specialized care.
“We would not have been able to open the Maternal Child Health & Wellness Center if we hadn’t refinanced earlier in the year,” says Dr. Green. “It’s a really beautiful facility where we can offer care for women in one ecosystem, with prenatal and postnatal care, mammograms, an on-site pediatrician, and other services women need during their lifecycle. If you live on the far South Side of the city or in the South Suburbs, you don’t have to go to five appointments at five different locations all over Chicagoland anymore.”
And with the Center now open and the turbulence of the early days of the pandemic behind it, FCHC is poised to continue building out an ecosystem of equitable care in the South Suburbs that addresses multiple social determinants of health.
“Our core function is primary care, but the pandemic forced us to think more broadly about how we can best meet the needs of the communities we serve,” Dr. Green says. “The vision is to bring together quality, affordable medical care with amenities like a fitness facility on one campus to address patients’ underlying health issues. There’s no reason residents in the area we serve should have to travel outside of their community to find this level of care. We have an opportunity to build an ecosystem that serves as a model of care for underserved communities throughout Chicagoland and the State of Illinois.”
IFF and Community-Based Health Care
Lower Lights Christian Health Center
Lower Lights Christian Health Center (LLCHC) is a Federally Qualified Health Center (FQHC) based in Columbus, OH, that provides comprehensive health care services to more than 13,000 patients annually at seven locations in central Ohio. In March 2017, IFF closed two loans that enabled LLCHC to renovate a portion of an existing 40,000-square-foot health center on Columbus’ west side to open a grocery store, café, and commercial kitchen. Because of the renovation, LLCHC clients are able to take health recommendations from their providers straight to the on-site store, where they can meet with a dietitian and discuss incorporating healthy, affordable foods into their daily lives. LLCHC also offers pre-made healthy meals to clients through the commercial kitchen and café. Read more about the project in our 2017 story.
Jane Pauley Community Health Center
Based in Indianapolis, the Jane Pauley Community Health Center is a FQHC with 13 locations in Indiana that provide primary care, pediatrics, OB/GYN, behavioral health, and dental services to more than 23,000 people annually. In February 2018, IFF closed four loans as part of a New Markets Tax Credit deal that enabled the organization to renovate two facilities in Indiana.
Places for People
Places for People is a nonprofit headquartered in St. Louis, MO, that provides high-quality, recovery-based treatment for mental illness and substance use disorders to approximately 2,400 adults and youth annually, many of whom are chronically homeless, suffer from primary health disorders, and have experienced significant trauma. In 2020, IFF closed three loans that enabled the organization to begin renovations to a new headquarters facility in St. Louis’ Soulard neighborhood and to purchase and install HVAC equipment as part of the development project.