Background <p>Underserved communities face significant barriers to healthcare access, often resulting in reliance on emergency departments (EDs) for non-emergent conditions. Federally Qualified Health Centers (FQHCs) play a key role in addressing these disparities, though many lack integrated urgent care services tailored to the needs of specific populations.</p> Methods <p>This case study describes the implementation of an emergency medicine–directed urgent care department within an FQHC serving a predominantly Ultra-Orthodox Hasidic Jewish community in Kiryas Joel, New York. This report is intended as an implementation-focused description of how urgent care services can be integrated alongside primary care within an FQHC, rather than as a causal evaluation of ED use, clinical outcomes, or primary care utilization. A descriptive analysis of de-identified patient encounter data from 2020 to 2025 was conducted to characterize patient volume and utilization patterns.</p> Results <p>From 2020 to 2025, patient volume increased from 1,215 to 13,636 encounters, representing a 1022.3% increase. Pediatric patients accounted for 65.1% of visits, comprising the majority of encounters. The department provides extended hours, holiday accessibility, and integrated referral pathways, supporting high utilization in a community with significant cultural and linguistic barriers.</p> Conclusions <p>This case study suggests that an emergency medicine–directed urgent care model can be successfully implemented within an FQHC and achieve high utilization in an underserved population. While causal impacts on emergency department utilization, primary care utilization, continuity of care, and clinical outcomes were not evaluated, this model offers a practical framework for health centers seeking to expand same-day urgent care access within an integrated FQHC setting.</p>