Across the street from SEPTA’s Germantown regional rail station, a few blocks from East Chelten Avenue’s bustling retail corridor, sits an unassuming, 1950s-era commercial building.

The two-story glass and faded brown brick structure is home to Philadelphia’s Health Care Center 9. It may be architecturally dated, but in a classic embodiment of “you can’t judge a book (or building) by its cover,” inside of 131 E. Chelten Ave. is one of America’s best health-care delivery systems.

Health Care Center 9, as well as the other seven Department of Public Health’s clinics spread throughout the city, is a Federally Qualified Health Center (FQHC).

FQHCs, more commonly known as Community Health Centers (CHCs), provide medical and behavioral care and social services to people living in low-income and medically underserved areas. Patients pay on a sliding scale and by law, no one can be turned away. Depending on the patient’s income, a full workup at the city’s eight CHCs (which receive federal money) and so-called “Look-Alikes” (LALs), which don’t receive federal funds, could cost as little as $5, said James Garrow, communications director for the department.

CHC services include pediatric and adult primary care, vaccinations, dental care, prenatal care, urgent care, behavioral health, and cancer screenings. There are onsite pharmacies, laboratories, X-rays, and at Health Care Center 9, HIV counseling and treatment. Social services are available to help with food insecurity, utility, insurance, and legal issues. And it’s all under one roof.

And the quality of care? A 2019 study published in the Journal of General Internal Medicine found that “on a number of high-value and low-value measures of care, CHCs performed similar to or better than private practices” and that “CHCs are well positioned to provide high-value healthcare.”

“A lot of folks see the local clinic as for those who may be a little less than,” says Eric Kiehl, director of policy and partnerships for the Pennsylvania Association of Community Health Centers. “We have amazing facilities that get a lot of financial support, not just from government but local foundations. We should be the backbone of [the health-care] conversation.”

Almost half of CHC revenue comes from Medicaid. But with the sizable cuts to the federal funding of Medicaid programs in the form of work requirements and stricter enrollment contained in the government’s One Big Beautiful Bill, supporters are concerned about the future. Some clinics may be forced to close and, according to the U.S. Centers for Disease Control and Prevention and the National Institutes of Health, “CHC site losses were associated with increases in mortality.”

CHCs were created by the 1964 Economic Opportunity Act that was part of President Lyndon B. Johnson’s War on Poverty. The Great Society law also created the Office of Economic Opportunity.

That’s where H. Jack Geiger, a Harvard-trained physician and civil rights activist, and Count Gibson Jr., who would later go on to lead Stanford’s Department of Community and Preventive Medicine, took their idea for creating neighborhood health centers.

They wanted to provide medical and behavioral care, along with social services, to people in low-income and medically underserved areas. A year later, the first two neighborhood health centers — one in Mississippi, the other in Boston — opened their doors.

In 1978, Congress amended Section 330 of the Public Health Services Act of 1944 to outline the requirements health centers needed to meet to receive federal grants. It also changed the name to Federally Qualified Health Centers. Today, the FQHC is slowly yielding to the friendlier, less bureaucratic CHC.

By law, 51% of each CHC/LAL board must be made up of patients served by the center. Those board members, the thinking goes, will be tuned into the community’s unique needs, which makes sense. Services needed in, say, rural South Dakota may not be needed in Philadelphia.

Nationwide, there are roughly 1,512 nonprofit community organizations overseeing 17,076 CHC and LAL sites in all 50 states, the District of Columbia and U.S. territories, according to the National Association of Community Health Centers (NACHC).

In 2024, CHCs and Look-Alikes cared for 33.9 million patients nationwide, almost triple the number of patients served in 2002, according a 2025 NACHC report. In other words, one in 10 Americans — and in some states, as many as one in three people — receive their health care from a CHC or an LAL.

Last year, the 53 nonprofit groups (including Philadelphia’s Department of Public Health) overseeing Pennsylvania’s 475 CHCs and LALs provided health care to one million residents, according to NACHC’s 2024 Pennsylvania Health Center Fact Sheet. Philadelphia’s 79 CHCs and LALs accounted for 291,314 of those patients (71,855 in city-run clinics), or roughly one in five Philadelphians.

Most of the funding for the city’s eight CHCs comes largely from its general fund, along with Medicaid reimbursements and other federal programs, Garrow said. Recognizing the city’s growing health care needs, the city is establishing two new health centers in the lower Northeast.

“Right now, our focus is on getting folks the health care they need,” Garrow said. “The two [new] health centers were approved as part of the city’s general fund and capital budget.”

On any given weekday, Health Care Center 9 is staffed by an array of providers, including a dentist, five medical doctors, nurses, and social workers. Many of the doctors come from the National Health Service Corps. Patients who need advanced treatments are referred to outside specialists.

“The health department has arrangements with the major group of city hospitals, such as the Hospital of the University of Pennsylvania, Thomas Jefferson, Einstein and Temple University Hospital,” said Chanel Conley-Bacon, director of operations for Health Care Center 9. “Most providing specialists are available, but not all.”

Health care is the main mission of CHCs. But the Community part of the name is equally important. Health Care Center 9, said Bethany Hill, its director, “is an oasis” for the neighborhood. Events are held year-round. In the fall, there is a back-to-school festival where children receive new backpacks. Food baskets are discreetly distributed to families in need at Thanksgiving, and Santa Claus drops by with toys around Christmas. There is also a winter coat drive.

For now, no one knows what the financial future holds for CHCs nationally and locally. But for the city’s CHCs, it’s business as usual.

“We will continue to provide services to those in the city of Philadelphia as long as we can,” Conley-Bacon said. “We are good at shifting and making things work and we will continue to do so in the communities that we serve.”