Clinics frustrated over failure to renew funding
While families and advocates are celebrating renewal of the Children's Health Insurance Program, community health centers were largely left out of the legislation that reopened the federal government this week.
The continuing resolution rushed through Congress on Monday included a 6-year renewal for CHIP, whose funding had first expired in September and had since been strung along by temporary measures.
Alongside CHIP for much of that journey was the Community Health Center Fund, a federal program providing funding to licensed community health centers serving low-income and uninsured patients. Community health centers, which serve 140,000 patients and employ 1,000 people across Adams, Cumberland, Dauphin, Franklin, Lancaster and York counties, count on the fund for 70 percent of their grant funding.
In 2016, Pennsylvania received $67.4 million in grants from the fund, which issued $3.6 billion nationwide last year.
But like other legislative priorities, Congress pushed renewal of the fund back to Feb. 8 - less than two months before the fund runs out on March 31.
"To be honest, we had not heard that much of a serious conversation on the health center fund," said Jim Willshier, director of policy and and partnership for the Pennsylvania Association of Community Health Centers.
Willshier said he received assurances from lawmakers the fund would be brought back into the discussion and refilled.
"What we have heardis from Sen. [Pat] Toomey [R] is they recognize our current situation is not ideal, but we have until March and Sen. Toomey’s office believes health center funding will be brought up" at those February discussions, said Willshier.
In a statement, Toomey press secretary Steve Kelly blamed Democrats and the Affordable Care Act for the tenuous status of the funds while offering assurances for the security of other funding sources. Pointing out the fund was given a Sept. 30 renewal deadline by the ACA, Kelly said: "Our office is optimistic that a long-term re-authorization will be enacted so that there is not an interruption in the funding."
Community health centers, like most other providers, also receive funding from insurance payments, which "reimburse community health centers for their services when an enrollee receives care there. These payments continue regardless [of] the status of government appropriations," said Kelly.
But the loss of the fund would still have a lasting impact on clinics, said Jenny Englerth, CEO and president of Family First Health in York County, who took issue with Kelly's assurances.
"I think that’s easier for Sen. Toomey’s office to say than to write on a daily operational basis for a health center. I have 220 employees that count on me to make sure that their employment is stable. We have 25,000 patients that count on us to keep their doors open. And there’s no way to replace that kind of shortfall without cutting services or employees,” said Englerth.
Democratic Sen. Bob Casey was one of few senators to raise the issue of community health centers, mentioning them in a Twitter spat with the White House
Can someone tell the White House their party controls the House and Senate? If they need our support, @realDonaldTrump should work in a bipartisan way to help PA families- let’s fund community health centers & fight the opioid crisis. No more short term CRs, let’s pass a budget. https://t.co/i129SJuiNI— Senator Bob Casey (@SenBobCasey) January 20, 2018
Casey also mentioned the clinics in a statement released after the government was shut down, calling for "a funding agreement that protects the middle class, retiree pensioners and 800,000 people who receive health care through community health centers."
According to Englerth, lawmakers frequently lend vocal support to community health centers but fall short when it comes time to vote.
"I continue to be puzzled by the fact that our representatives voice support for what we do locally in the communities that we serve and for their constituents, yet there hasn’t been action taken on this item," said Englerth.
Health centers like Family First are already looking into alternative funding plans, including reaching out to charitable foundations and local partners. But the threat of losing funding in April is already forcing some cutbacks.
"At this point, while we’re looking at those contingencies to maintain operations, we’re also putting on hold plans for expansion of services and geography that we’ve been working on for the last year and ready to take action on in 2018," said Englerth. Family First Health provides over $1 million in charity care at its locations in York County.
"Not only could it prevent us from expanding into communities where there is an unmet need, it also creates job and activity and fuels our economy. We hire people. We work with folks to maintain our properties and expand our services and all of that is on hold. We can’t have those discussions when we don’t have a stable funding source," said Englerth.