Healthy Futures Fund Goals
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PROVIDE NEW CAPITAL to Federally Qualified Health Centers (FQHCs) at a
time of significant patient growth
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ENCOURAGE COMMUNITY DEVELOPMENT ORGANIZATIONS &
COMMUNITY HEALTH CARE PROVIDERS to work together on mutually
beneficial programs that improve the health of low-income individuals and families
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EXPAND HEALTH CARE PROGRAMS & SERVICES available to tenants in
projects financed with Low Income Housing Tax Credits
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UTILIZE MORE EFFICIENT STRUCTURE for New Markets Tax Credit to
finance health centers, in an effort to reduce transaction costs & better leverage
capital from investors
Capital Sources
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$50 million in Low Income Tax Credit Equity for
affordable housing developments incorporating health
care programs and services
$43 million FQHC Financing Fund for health center
construction and permanent financing
$4 million in predevelopment financing for health
center and affordable housing projects
$800,000 in grants supporting Healthy Futures Fund
goals:
Expected Community Impacts
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6-7 affordable housing projects financing 500 new housing units
with incorporated health services
7-8 new health center sites expected to serve 75,000 individuals
and create 200 temporary and 1,200 permanent jobs
New partnerships between health centers, affordable housing
providers and other community stakeholders focused on
improving the social determinants of health and creating healthy
communities
New capital source for investment in health centers with a goal of
deeper understanding of the credit risks of health centers and
additional investment in the future
Healthy Futures Fund Partners
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Founding partners:
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The Kresge Foundation
LISC
Morgan Stanley
Fund manager:
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New Markets Support
Company (a LISC subsidiary)
Health Center Technical
Assistance Partner
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Capital Link
Current fund partners:
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National Development Council
NCB Capital Impact
Opportunity Finance Network
Other partners:
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Coastal Enterprises, Inc.
Primary Care Development
Corporation
Mercy Loan Fund
Community Health Center
Capital Fund
FQHC Financing – What is a FQHC
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Non-profit 501(c)(3) organizations that are community-based
FQHCs provide comprehensive community-based primary and
preventive health care services (medical, dental, behavioral health)
Governed by 51% community boards (registered patients of health
center);
Accessible to everyone, regardless of financial means, offering a slidingfee scale
Are located in a HRSA-designated Medically–Underserved Area or
serving a Medically Underserved Population
FQHC is eligible for cost-based reimbursement and operating support
from the federal government.
FQHC Financing - Eligibility
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Priority sites:
 First
priority to LISC markets: 31 program cities and Rural
LISC program areas
 Partner CDE markets

Eligibility based on FQHC location in qualified census
tract
 Call
with FQHC location or look up at:
http://www.newmarkets.org
FQHC Financing - Terms
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First mortgage loans from $2.5 million to $10 million
Total financing up to 80% LTV w/ 1.20 DSCR
7-year initial term, with first 30 months interest-only then
19-year amortization schedule
Renewal options for a 2nd 7-year term
Rate fixed at 7-year LIBOR swap + 200 to 250 basis points
for 7 years
At least 20% of the total loan to borrowers will have the
ability to be cancelled (through a put-call structure) upon
successful third-party refinance of the remaining principal
balance
FQHC Financing – Benefits Compared to
Standard NMTC Financing
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Committed Sources of Capital
Financing Product with Pre-Established Terms &
Documentation
Dramatically Reduce Borrower Need to Retain
Consultants and / or Develop Internal NMTC Expertise
Lower Transaction Costs
Shorter Closing Process
FQHC Financing - Examples
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New construction of a stand-alone health center to
consolidate sites and expand services for health center
serving rural area and migrant farm workers;
Renovation of ground floor commercial space in supportive
housing project for a satellite health center to deliver both
behavioral health and primary care services;
Renovation and expansion of ground floor commercial space
for primary care services, including updating of space to
accommodate more efficient flow and delivery of preventive
services.
New construction of mixed-use project, with affordable
housing and FQHC components.
LIHTC Fund Overview
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Purpose:
 to expand health care programs and services available to tenants in
LIHTC developments
 to encourage affordable housing developers to work with FQHCs
and other community-based health care providers to promote the
health of low-income tenants
Project requirements and priorities:
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Projects must be located in a LISC market
Project sponsor must partner with a local primary health care provider
LIHTC Fund – Health-related
requirements
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Projects must have clear links to a local FQHC or other
community-based health center or on-site health center
Potential links include:
 Health
screenings, physicals, check-ups, nutrition counseling
available at affordable housing site;
 Hire a part-time services coordinator to coordinate access to
services; or
 Transportation to a local health center in substitution for onsite services.
LIHTC Fund – Examples
 Michigan
- Lloyd House was closed into the Healthy
Futures Fund on April 26, 2013. The Bay Area Medical
Center will establish an outreach program that will connect
Lloyd House residents to primary care services.
 Minnesota - The next deal slated to close is the Rolling
Hills Apartments, a 108 unit apartment complex that will
provide affordable rents for workforce housing managed by
Lutheran Social Services of Minnesota (LSS). LSS will be
providing services to refugee families and making space
available to other community partners, including West Side
Community Health Services for tenant health care
screenings.
Grants for Project Sponsors
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$800,000 in pass-through grants for health centers and/or
housing sponsors
Average grant size of $25,000 - $50,000 per project
Anticipated uses:
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Health/housing linkages to connect tenants to health services and
promote health and wellness, including:
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Increasing resident access to health facilities
Facilitating provision of preventive health services in housing developments
Community outreach to increase awareness about the availability and
benefits of preventive health services, good nutrition and active living
Project planning, design and/or predevelopment
Contact Information
Emily Chen
Program Director, Health Center Financing
212-455-9882
echen@lisc.org