Community health funds are running out
Without money by Saturday, 2,800 sites would close and eliminate access for about 9 million patients
health centers, which serve more than 27 million people, are at risk of losing 70% of their funding if Congress doesn’t act by Saturday to restore it.
Progress is being made as the deadline approaches.
Bipartisan legislation is pending in the House to address the funding cliff, but a solution also could be included with measures to extend the Children’s Health Insurance Program (CHIP) and other health care-related provisions known as “extenders” for which the money also runs out on Sept. 30. The bill is gaining House sponsors.
Bipartisan negotiators are working in both houses on a deal, says Dan Hawkins, senior vice president for policy and research at the National Association of Community Health Centers.
Without the new money, the Department of Health and Human Services estimates 2,800 health center sites would close and eliminate more than 50,000 jobs and access to care for about 9 million patients.
The House and Senate will be in session for 24 days between October and mid-November, and Mary Bufwack, CEO of Neighborhood Health, said “the focus will likely become getting a bill through Congress by Thanksgiving.”
It will be tough for the U.S. Health Resources and Services Administration (HRSA) to get money to clinics on the Jan. 1 cycle if legislation isn’t passed by mid-November, said Bufwack.
A continuing resolution signed by President Trump extended 30% of the funding temporarily. The HRSA could help with discretionary funds through March if another continuing resolution is passed.
There’s a bill in the House — the Community Health Investment, Modernization, and Excellence Act of 2017 — that could be discussed in the House Comward; mittee on Energy and Commerce next week.
The bill, sponsored by Rep. Elise Stefanik, R-N.Y., “already has over 150 bipartisan cosponsors and we’re working with more offices now who are interested in signing on,” said her spokesman, Tom Flanagin. “We’re looking at multiple legislative paths forCommunity Congresswoman Stefanik will continue to build support and hopes to have this legislation passed on its own or included in a broader health care package.”
Flanagin said that the law expires Saturday but that they hope if the deadline passes to have the money applied retroactively after Congress acts.
The National Association of Community Health Centers warned its members that they will “feel the direct impact of going over the cliff at the start of your next budget period,” as different centers have different fiscal years. Still, health centers already are feeling the pinch.
In Cumming, Ga., Georgia Highlands Medical Services won’t hire the extra primary care doctor it needs until it knows it will get the money, says CEO Todd Shifflet. Georgia Highlands’ centers’ fiscal years run from June through May.
“I’m so tired of being uncertain about the future,” he says.
Georgia Highlands charges a minimum payment of $35 for a visit for patients who earn under the federal poverty limit, which about 75% of patients do. Other charges are on a sliding scale based on income.
While some centers charge much less for a visit, Shifflet notes they never turn anyone away for monetary reasons.
“Our mission is to see people who have nowhere else to go,” says Shifflet. “We’re clearly saving the system money on emergency room visits and hospitalization.”
Some health centers have put hiring freezes in place, while others can’t secure loans, expand capacity or recruit or retain health care providers, the health center association says.
Health centers are run by a 51% patient majority. In Merced County, Calif., design/build company owner John Price has been a patient and board member at Golden Valley Centers for 31 years.
These California centers have about 450,000 patient visits a year and have $12 million in federal grant funding. Price has been lobbying his members of Congress on their behalf.
“Our representatives are fans because in our area there are so many people on assistance,” Price says. “We’re pretty efficient at seeing lots of people for lower amount of money.”