Funding in peril
Federal lapses could hurt community health centers, Gillibrand says
Government shutdown could hurt community health centers.
U.S. Sen. Kirsten Gillibrand served up a grim prognosis this week for federally funded community health centers across New York if Congress fails to fund the government past its next deadline on Dec. 20.
“In New York, health centers provide high-quality, comprehensive and low-cost primary and preventative care services sites to more than 2.4 million New Yorkers,” Gillibrand wrote in a letter Tuesday to congressional leaders. “Community health centers … are ready and able to respond to the changing, pressing needs of the communities they serve and are the backbone of America’s health care safety net.”
Last month, Congress approved a stopgap spending measure to keep the government open through Dec. 20. The principal roadblock to fully funding the government through the remainder of the fiscal year is disagreement over President Donald J. Trump’s border wall, a staple pledge of his 2016 campaign.
Nationwide, community health centers often are a lifeline for lowincome families and individuals — particularly in sparsely populated rural areas like those of upstate New York, where medical services often are distant and unaffordable.
Over 29 million individuals, including over 385,000 veterans and almost 9 million children, get medical, dental, vision and behavioral care from a CHC, Gillibrand said.
In New York, 65 federally funded organizations run a total of 761 sites. Upstate, they include ones that serve primarily urban and immigrant populations such as the Whitney M. Young Jr. Health Center in Albany.
On a conference call with reporters Tuesday, Gillibrand recalled a visit to the Whitney Young site last year.
“This incredible community health center provides primary medical, dental, and behavioral health services to more than 20,000 people across the Capital Region,” she said. “More than one-third of their patients live at or below the federal poverty level, and the patients speak more than 40 different languages.”
The centers accept all patients who walk through the door, but base their rates on a person’s ability to pay. In all, 16 percent of New York patients are uninsured, and 53 percent are covered by Medicaid. Sixty-eight percent of patients are considered low-income. The federal government covers about 70 percent of the cost.
By keeping patients out of higher-cost emergency rooms, the centers save the health care system more than $24 billion per year, Gillibrand said.
Also, they are often the only available medical service for treatment of opioid addiction in rural areas.
Although the last-minute pyrotechnics of budget negotiations often go down to the wire, Gillibrand recalled that federal funding for community health centers lapsed in late 2017 and was not fully restored until early 2018.
The results were “devastating,” the senator said, adding: “We can’t afford to let that happen again.”
Though she voted to repeal Obamacare, which permitted the expansion of Medicaid in New York to cover an extra 3.5 million, U.S. Rep. Elise Stefanik, R-schuylerville, also has been a supporter of community health centers.
“People need access to quality health care,” Stefanik wrote in an op-ed in August. “Whether they have a minor ailment or chronic illness, a doctor should be within a reasonable travel distance and offer services that are easy to navigate on a regular basis and affordable for their family’s budget.”
In addition to treating illness, the centers “also reach beyond the conventional medical chart to address and prevent the underlying factors that can make people sick — lack of nutrition, stress, substance abuse and mentalhealth conditions,” she wrote. In the House, Stefanik’s CHIME Act would extend the funding lifespan for the centers.
Gillibrand on Tuesday noted her proposed Community Health Center and Primary Care Workforce Expansion Act would increase the centers’ funding by 10 percent a year for five years, and add $4.6 billion for capital projects to modernize facilities and expand the scope of services to better address the opioid epidemic.
“Her bill is useful, but it’s less generous,” Gillibrand said of Stefanik ’s proposal.