Health center program - established in 2008, intercambios was founded to improve the social integration of the most marginalized groups in puerto rico

The Department of Health and Human Services Health Resources and Services Administration awarded Intercambios Puerto Rico, Inc. $650,000 on August 1, 2026, under the Health Center Program (CFDA 93.224), a Section 330(e) Project Grant to establish a new access point for primary health care services in eastern Puerto Rico.

Intercambios will operate a fixed clinic site in Fajardo and a mobile program to deliver comprehensive harm reduction, medical care, mental health services, overdose prevention, substance use treatment linkage, HIV and hepatitis C navigation, and housing support services to over 650 individuals annually across 21 communities in Fajardo, Ceiba, and Luquillo. The organization also conducts public education, media outreach, and community mobilization to address societal inequities and trains participants in policy advocacy. The award period runs through July 31, 2027, with place of performance in the United States (Puerto Rico).

Intercambios, a non-profit established in 2008 to improve social integration of marginalized groups in Puerto Rico, operates independently with its own board of directors, though it benefits from the operational experience of Housing Works, Inc., an affiliate that operates multiple Federally Qualified Health Center sites in New York City. The new health center will serve medically underserved populations, including people who use drugs with co-occurring mental health and chronic health conditions such as HIV/AIDS in an under-resourced region with few social service providers.

Intercambios occupies a unique niche in puerto rico's health landscape, delivering comprehensive support for latinx people who use drugs (PWUD), particularly those marginalized by traditional providers, and who have CO-occurring mental health and chronic health conditions such as HIV/aids. Based in fajardo, intercambios reaches 21 communities in eastern puerto rico, an under-resourced region with few social service providers and even fewer willing to work with these populations, through its fixed clinic site and its mobile program, LA móvil. The agency provides comprehensive harm reduction, medical care, mental health services, overdose prevention, substance use treatment linkage, HIV/HEP-C navigation, and housing support services to over 650 individuals annually; conducts public education, media outreach, and community mobilization to amplify participants' voices to diminish societal inequities; and regularly trains participants to advocate for fairer policies. In 2008, intercambios became an affiliate of housing works, INC., the U.S.'S largest community-based and minority-controlled aids service organization. In NYC, housing works, INC., through its healthcare subsidiary, offers fully integrated primary, dental, mental health, and substance use treatment along with wraparound supportive services; and in 1998, was designated as an fqhc, receiving funding for both 330(E) and 330(H) programs. Intercambios will operate the proposed health center independent from housing works, INC. And with its own board of directors, but will benefit from the agency's two decades of experience operating several fqhc sites in NYC. Intercambios proposes to serve three municipalities-fajardo, ceiba, and luquillo-through the proposed new access point (section 330(E) program) located at 14 calle antonio R. Barcelo in fajardo, a short two-minute drive from the agency's administrative site (165 calle diego zalduondo). The service area's total population is 71,345 residents; with only 3.58% of the low-income population penetrated by the health center program. Many service area residents face economic hardship: 30% experience housing stress, 25% in fajardo and luquillo are unemployed and 10% in ceiba are unemployed, and 22% of those over age 25 do not have a high school diploma. In addition, 15% of residents do not have access to a vehicle, and with no public transportation, access to healthcare can be challenging. Roughly 15% of the population have poor physical health; 16.5% have diabetes, 12% have asthma, and just over one-third (37%) are obese; and roughly 15% of puerto ricans do not have a regular healthcare provider. Complex health conditions are compounded by behavioral health issues, which are highly stigmatized in puerto rico, creating systems of inadequate care. Overall, 12% of service area residents have poor mental health. Further, hurricane maria devastated the healthcare infrastructure (e.g. loss of facilities and out-migration of providers); and created a mental health crisis as evidenced by a 29% increase in suicides since the hurricane. Intercambios will draw upon its experience serving the most marginalized individuals through its fixed site and mobile outreach program, LA movíl, to implement a community-based "one-stop shop" for comprehensive primary care, and behavioral health, and supportive services to service area residents. Intercambios will also implement a robust and coordinated transportation support program, leveraging its robust mobile outreach program, to minimize geographic-related access barriers. Specifically, intercambios will provide primary care, including women's healthcare, substance use, mental health, case management, and enabling services to 650 clients through 6.3 FTE clinical staff.