Community health centers — including many located in area schools and providing health, dental, and behavioral care to East Hartford, Manchester, and Vernon residents — soon could see a sudden reduction in services if federal funds aren’t restored, local and congressional officials warn.
Eugene Market, president and CEO of the nonprofit First Choice Health Centers, which provides care for newborn to elderly patients at freestanding sites and 57 area schools, says that by May he’ll be looking at staff reductions and a loss of some 2,000 patients should Congress fail to restore the nonprofit’s main funding source.
Bolstered by a fiscal mandate from the Affordable Care Act, community health centers serve more than 25 million patients in nearly 10,000 communities in each state and territory, receiving more than 70 percent of their funding through federal grants.
That financing ended with the close of the federal fiscal year Sept. 30, however, leaving the nonprofits scrambling to make ends meet.
Market believes he can continue services until spring, but without restoration of the grants, some sites might have to close.
While the Trump administration is focused on repealing the ACA, Market said he’s thankful the health centers have bipartisan champions in both chambers.
Along with four other members, U.S. Rep. Joseph D. Courtney, D-2nd District, is leading the charge, writing a letter last week to House Speaker Paul Ryan and Minority Leader Nancy Pelosi that was signed by 150 House members expressing their deep concern over the lapsed funds.
Last month 70 senators, including Democrats Richard Blumenthal and Christopher Murphy, also called for immediate action to extend the grants before clinics were forced over a “funding cliff.”
But the discussion “is getting crowded out by all the other drama surrounding health care,” Courtney said. “The ACA repeal cut really used up all the bandwidth.”
The clinics are “an incredible part of the safety net,” not just for the poor, but also for low-income working adults and veterans who need pediatric care for their children, he added.
In the Oct. 27 letter, Courtney along with U.S. Reps. Niki Tsongas, D-Mass., Elise Stefanik, R-N.Y., Tom O’Halleran, D-Ariz., and David Young, R-Iowa, claim the clinics provide a vital service for millions of Americans.
They are calling for a five-year reauthorization of the funds, with steady increases in each succeeding year, to ensure the clinics have the stability they need to continue their mission.
Five years of mandatory grant funding was initially created under the ACA and Congress extended that in 2015 for two more years. Previously, annual appropriations were discretionary, and often cut or “backfilled” by the mandatory grants.
In fiscal year 2017, community health care grants totaled some $3.6 billion nationwide. The clinics also received discretionary budget appropriations of $1.5 billion for that same time period.
Funding for the clinics, which have been able to expand their services in recent years, could revert to 2011 levels if the grants aren’t reinstated, Market said.
First Choice, which provided care to 19,000 patients who made 85,000 visits in 2015, was able to expand from five to 15 sites in six years, he said.
Under the mandate, the clinics are required to provide care to anyone who seeks it, and many patients pay a portion of the cost on a sliding fee scale based on their income.
Besides health and dental care, the nonprofit clinics also have become an “essential provider for behavioral health and opioid abuse medication that flows through those centers and can take on that population,” Courtney noted.
Courtney said he’s optimistic that Congress will extend the grant in the coming weeks, but fears the money might be redirected from preventive measures.
“Essentially, we’d be robbing Peter to pay Paul,” he said, and wind up spending more on health care in the end.
But until then, the clinics will have to tread water and hope for the best.
“It’s a real challenge, having to do the reauthorization every two years,” Market said, adding that a five-year mandated funding steam would, at least, take politics out of the equation.