Meeting A Milestone for Care Rooted in Compassion
Written by Chen Chen
Edited by Adriana DiBenedetto
Published #79 | Winter 2025 Issue
Federally Qualified Health Center Look-Alikes under Tzu Chi Medical Foundation achieve high scores in passing the federal annual accreditation on September 11, 2025. Photo/Tzu Chi Medical Foundation
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On September 11, 2025, after a rigorous, three-day evaluation, the U.S. Health Resources and Services Administration (HRSA) once again affirmed Tzu Chi Medical Foundation’s (TCMF) status as a Federally Qualified Health Center Look-Alike (FQHC LAL), awarding high marks across nearly every category reviewed.
Their commendation arrived at a time when, across the nation, the rising cost of care has placed crucial medical services further out of reach for many families. Over the past three years, however, TCMF’s three FQHC LAL sites have steadily expanded their impact, increasing monthly patient visits from 2,000 to 3,500. “The review team strongly recognized our commitment to humanistic healthcare values,” said TCMF Chairman Tim Chang, Esq.
Indeed, behind these figures lies a sustained effort to ensure that Tzu Chi’s human-centered philosophy, delivered with compassion, dignity, and respect, remains grounded in the realities of the U.S. healthcare system. As the centers deepen their work in preventive medicine, patient care, and operational excellence, they continue to demonstrate that a model anchored in empathy can still flourish even amid the complexities of modern health care.
Constant Self-Surpassing
“This time, we did even better,” reflected TCMF CEO Dr. Stephen Denq, commending the medical team’s outstanding performance. During the three-day evaluation, HRSA officials assessed 98 areas, including clinical quality, patient record management, and financial and regulatory documentation. Of these, Tzu Chi met 96 fully, with only two requiring minor adjustment. “These two items were truly minor,” said Dr. Denq with a smile. “But we will still learn from them and keep improving.”
Denq additionally shared that there was a notable shift in tone from the review itself. “They weren’t just looking for faults; they acted like advisors helping us learn,” he said, crediting the change to Tzu Chi’s thorough preparation and sincere presentation before the review. “We began by showing footage of Tzu Chi USA’s earliest free clinic centers. And I shared with them our journey from the free clinic center days to the present. I did that by adopting the approach taught by Dharma Master Cheng Yen: ‘Say what you do, do what you say.’ The officials were deeply moved by hearing this part.”
For Chief Operating Officer Izabella Sahakian, who joined TCMF just four months before the review, it was an unexpected initiation. “On my very first day, we received an email from HRSA announcing the on-site review,” she recalled. Yet with over 25 years in nonprofit health care, Sahakian quickly became, in Dr. Denq’s words, “the one who brings everyone together and can handle any unexpected issue.”
I think the greatest significance is that we have successfully passed the review twice [after becoming an FQHC LAL in 2020]. This demonstrates that our management and operations are sustainable.
Change and Unchange
Since gaining Federally Qualified Health Center Look-Alike (FQHC LAL) status in 2020, three Tzu Chi Health Centers have received partial federal subsidies, consultation reimbursements, and access to discounted pharmaceuticals, easing the barriers many patients face to accessing care. Over the past five years, the number of patient visits has nearly doubled.
To Dr. Stephen Denq, this evolution reflects the balance between “change” and “unchange” — a guiding principle inspired by the Tzu Chi International Medical Association. “Change means adapting to community needs and complying with U.S. regulations,” he explained. From the free clinic centers founded in 1993 to today’s outpatient health centers, and FQHC LAL accreditation, each step has responded to some of the most urgent needs of our time. “After the Affordable Care Act, commonly known as Obamacare, was implemented, we found that many patients, despite having insurance, still couldn’t secure medical care. That’s why we decided to contract with insurance companies to become their primary healthcare providers,” continued Denq.
“What remains unchanged is our medical mission. Our target will always be to serve those who struggle most to access health care. Grounded in this mission, we position ourselves as a safety net,” he noted. That mission is evident in their data. While many FQHC LALs provide care to 5–8% of uninsured patients, Tzu Chi’s centers average 16%, nearly double that.
This figure shows that we are truly caring for patients whom others are less willing to serve.
“HRSA’s requirements are rigorous and legally binding; everything must be in compliance with the law,” added Tim Chang. “That said, their ultimate goal aligns with ours: serving underserved populations. This resonates deeply with Tzu Chi’s mission of Great Unconditional Benevolence and Kindness with Universal Compassion.”
Under HRSA guidelines, FQHCs and Look-Alikes primarily serve individuals below 200% of the federal poverty level — a population that closely aligns with Tzu Chi’s focus. “In California, this includes people who are eligible for Medi-Cal, the state’s Medicaid program,” said Chang.
Tzu Chi also embodies this care philosophy through its policy on patient copayments. “Two months ago, we decided to maintain the $20 copay, which is the lowest among all FQHCs,” Chang added. “If someone cannot afford $20, we classify them as a charitable case when they see the doctor. This has always been Tzu Chi’s practice.”
Izabella Sahakian, too, found Tzu Chi’s values resonant, discovering parallels between her heritage and Tzu Chi’s principles. “Kindness, respect, volunteerism, giving; these are all deeply rooted in Armenian culture, so I resonate with them.”
I am deeply impressed by Tzu Chi's culture and its volunteers. I am moved by how everyone upholds Tzu Chi's principles, honors Master Cheng Yen, and speaks with such passion about their mission.
Comprehensive Enhancement
The accreditation also recognizes years of operational and clinical improvements, with a special focus on preventative care. “Quitting smoking is one of the most challenging programs. A 30% success rate is a plausible result for many institutions, but we’ve reached 45%,” said Dr. Stephen Denq, explaining that such an achievement is gained by building strong doctor-patient relationships. In Tzu Chi’s model, healing begins with trust. “We took the initiative to invite patients back for regular check-ups. Once that relationship is built, promoting preventive medicine becomes much easier.”
Transparency and accountability have also been key priorities. Under Tim Chang’s leadership, TCMF earned Candid’s Platinum Seal of Transparency in 2024 — the highest certification in this category from Candid, and one of the most trusted sources for nonprofit data and analysis. “This also signifies our commitment to public accountability. As a nonprofit receiving external grants, transparency is essential to building trust.”
Izabella Sahakian has additionally spearheaded major upgrades to the electronic medical record (EMR) system, enabling better coordination and follow-up care. “We have an excellent EMR system. We use it to track patients’ physical condition. We also interface with labs to collect patient data, and this interface works very well. We are actively building closer relationships with patients to help them understand the services we offer,” she said, explaining how Tzu Chi Health Centers send regular text reminders for follow-up appointments and use email to track patients’ treatment progress. “Our Google rating is over four stars; that’s perfect.”
Healing the Person, the Illness, and the Heart
At TCMF, members are confident that there’s always room for improvement. “We will recruit five Western medicine physicians within five years.” Dr. Stephen Denq spoke confidently about future plans. “With five full-time Western physicians, our regular patients could reach 10,000. Once this figure becomes a stable one, we can invite specialists.” Dr. Denq also noted that the second Western physician has already joined and passed screening, while the third has been identified and is starting work part-time.
Izabella Sahakian likewise expressed confidence in this goal, stating, “I believe by the middle of next month, all three of our medical centers will reach their maximum patient capacity.” Regarding Dr. Denq’s vision of 10,000 regular patients, she said, “To achieve 10,000 patient visits per month, we will need additional medical centers. If we continue developing and expanding at our current pace, we will certainly reach the number Dr. Denq envisions.”
Tim Chang has furthermore put forth a detailed roadmap for TCMF’s future development. “We focused on strengthening our operational foundation for the past three years. For the next three years, we will enhance our services and scale. We aim to build our women’s health service capacity and have already identified a physician for this initiative,” said Chang, as over half of Tzu Chi’s volunteers are women. “It is also part of our responsibility to take care of our Dharma families in addition to treating the general public.”
Master Cheng Yen expects our medical services to go beyond merely saving lives. We must measure our actions with compassion and wisdom, ensuring patients live with dignity, healing the person, the illness, and the heart.
Developing a mental health department is another long-term goal. “This is something we’ve wanted to do for a long time,” said Chang. “Currently, we have to refer all mental health patients to other specialized institutions. But I believe mental health will be one of the greatest future healthcare needs. We tend not to talk about our stress and difficulties, so establishing a mental health department should help many people.”
Despite its progress, TCMF faces an uncertain healthcare landscape. In July 2025, federal legislation announced approximately $1.1 trillion in healthcare spending cuts over the next decade, which, according to the Congressional Budget Office, could leave over ten million Americans without insurance. Chang, however, remains cautiously optimistic. “We are diligently focusing on our fundamentals and hope to minimize any significant impact,” he assured. With a new wave of challenges surging into play, Tzu Chi aims to navigate them as steadfastly as all others since its founding.
As long as we are on the right track, there is nothing to worry about. We just need to focus on how to do better.
Strengthened by expertise, grounded in transparent governance, and supported by the selfless dedication of Tzu Chi medical volunteers, the Tzu Chi Medical Foundation continues to uphold its mission of humanistic care and sustainable development. While the review’s success marks another milestone, the deeper accomplishment lies in what happens every day: when someone in need finds not just a doctor, but a shoulder to lean on, and a friend to help light the path onward.
Together, we can do more.
