Community health centers serving underserved populations could dramatically expand access to personalized genetic medicine, yet fundamental operational barriers may prevent this transformation from reaching those who need it most. An Alabama community health center's preparation for genomic medicine implementation reveals how resource constraints create a complex web of challenges that extend beyond simple funding shortfalls. The assessment involved 13 healthcare staff members across multiple roles, from physicians to administrators, who participated in surveys, interviews, and strategic planning exercises to evaluate their facility's capacity for integrating genetic testing and counseling into routine care. Three primary obstacles emerged as dominant themes: inadequate staffing levels, financial limitations, and communication barriers particularly affecting non-English speaking patients. These findings highlight how genomic medicine's promise of early disease detection and personalized treatment plans faces practical implementation hurdles in safety-net healthcare settings. Despite these constraints, the evaluation uncovered significant organizational strengths including leadership commitment to quality improvement and strong alignment with the center's mission to serve vulnerable populations. Staff surveys revealed positive attitudes toward innovation culture and learning environments, though scores for available resources and change readiness hovered near neutral, suggesting cautious optimism tempered by practical concerns. The systematic approach using established implementation frameworks allowed the team to prioritize nine potential strategies based on feasibility and expected impact. This methodical assessment represents a crucial step toward understanding how genomic advances can be meaningfully translated into community-based healthcare settings that serve populations historically underrepresented in genetic research, though the pathway forward requires addressing fundamental capacity limitations before technological integration can succeed.