Health Center Funding Cliff's Local Impact, Interview with a Health Center CEO
10 days remain until the Health Center Funding Cliff becomes a reality. If Congress fails to act to fix the Health Center Funding Cliff - a 70% reduction to Program funding - 9 million patients will lose access to care, 2,800 Health Center sites may close, and more than 51,000 Health Center jobs could be lost.
Here in Mississippi, if Congress fails to act, the 20 health centers will lose $42,837,309 in Federal 330 Funding. This will mean over 77,000 patients will lose access to care. This is especially important given that Mississippi Community Health Centers provide access to care for approximately 300,000 patients with over 900,000 provider visits each year.
Given this potentially drastic cut, Mississippi health centers, their patients and communities are making their voices heard. In the last few weeks, they have made over 600 phone calls, delivered over 1500 hand written letters and made personal visits to our Congress members to express how important community health centers are to their communities.
As the deadline approaches for a fix, last week Rep. Elise Stefanik (R-NY) introduced the Community Health Improvement, Modernization & Excellence (CHIME) Act of 2017. Specifically, the bill would extend the Community Health Centers Fund for five years, with modestly increased levels each year to address emerging needs in communities nationwide. We are asking that our Representatives in the House join Rep. Stefanik as co-sponsors on this bill.
And in the Senate, both Sen. Wicker and Sen. Cochran signed the Blunt-Stabenow Health Center Cliff Letter that is working its way around the Senate.
While this is welcomed news, the fact remains that without a solution from Congress by September 30, 2017, Mississippi health centers will be severely impacted. To get a better idea of how this looks locally, MPHCA sat down with Dr. James Coleman, CEO at G.A. Carmichael Family Health Center and his Clinical Services Director, Dr. Teresa McKetney to hear first-hand how this would impact a community like theirs. G.A. Carmichael is a Canton, MS based health center with clinics in Canton, Yazoo City, and Belzoni.
We can all agree that a 70% health center funding cut would be devastating. But, can you speak directly on the impact at your center?
Dr, Coleman: One of the impacts at G.A. Carmichael is when you look at service in our community is it is already a desperate population that has access to care issues. If CHCs are not funding at the level we need, it is going to affect the community as a whole because there are few access points in this area. It will not only affect the economics, like staffing, but the small towns of Canton, Yazoo City and Belzoni. Especially in Belzoni, where they do not have a hospital or other providers. With no hospital services, the CHC is the only access point for care.
Dr. McKetney – Also, we’ve been impacted over the last few years by a population that either doesn’t have insurance or are not eligible to get insurance – especially our Hispanic population. Last year the Health Department stopped doing OB family planning services, so they have turned to our clinics for these services. This would be a whole group of people that wouldn’t have access to that type care if we do not fully fund our health centers.
Dr. Coleman – One of the programs we offer in Mississippi is WIC (Women, Infant and Children) as a part of the CHCs. Because we have WIC we have an opportunity to care for the babies and the mom’s. If the funding cliff impacts us, that is another population that we will have a cut to service.
According to the Health Center Funding Cliff Impact Estimator, G.A Carmichael stands to lose $2.6 million in funding, and almost 4,200 patients will lose access to care. Tell us more how this further affects the communities you serve?
Dr. Coleman – More specifically with the cut it greatly impacts our staff and their quality of life. When this happens, it is an economic impact on where we work, live and play – the social determinants of health. So, if $2.6 Million is cut, the staff will have no jobs. And given the economics of the area, there are no jobs to go to. When it impacts staff, it impacts the community. Reduced staff increases wait time, and impacts patients because there is no one to offer the care they need. This also reduces the opportunity for eligibility for health insurance. It is a cyclical effect as it relates to staff. When staff is affected it affects the economy of the area.
Dr. McKetney – I agree. And if we get a big cut in funding all the other initiatives aside from medical care will be impacted. Diabetes care, education, LBGTQ services, tobacco cessation – there is no way we do all those things for everybody without the funding. The Affordable Care Act helps, but there are too many people without insurance or Medicaid. In MS there is no health coverage for people who are not working. This is another group that will be impacted.
If action on the funding cliff is not taken by Sept. 30, 2017, do you anticipate cutting staff and services?
Dr Coleman – Not immediately. But we will. The current grant will support us for a particular amount of time. That gives us time to look at the staffing plan, to look at essential staff and ancillary staff. And that is even unfair because ancillary staff supports essential staff. And they are all connected with service delivery. It will be a huge impact on service delivery; but internally staff moral will be greatly impacted. And this leads to how do we, as health center leaders, must consider the tough employment decisions that will be taken. There are a whole lot of things that we will have to look at in these areas.
Have you discussed this with any patients, and if so, can you relay any concerns they have?
Dr Coleman – Our marketing person has reached out to our patients to speak with them about the possibilities. They are generating advocacy efforts to contact our Congress members in Washington, and locally, to let them know how important CHCs are and that the impact would be devastating. I’ve discussed it with our leadership team. But, as the CEO, I want to raise the alarm, but not project panic until we fully know what the outcome will be.
News out of Washington yesterday was that Rep. Elise Stefarik (R-NY) introduced the Community Health Improvement, Modernization and Excellence Act (CHIME), that will fix the cliff for 5 years and includes modest increase each of those years. Your thoughts?
Dr. Coleman – The CHIME Act would be an awesome thing to do. Because we have been at a disadvantage for years because there hasn’t been stability or an increase in funding in years. When there are any kinds of cuts we end up having to send patients out the door who need to see our providers. Stability and a steady increases further helps us to provide the health care and ancillary services that impact health outcomes in the community.
Dr. McKetney – Of course there is a big need for continued funding. What we don’t want is just a stop-gap for funding. On the other hand, community health centers are here to help and the thing we don’t want to do turn people around or default to just taking insurance which moves us away from access to care for all regardless of their ability to pay. This would be very welcomed if it passes.
Any messages for our Congress members as we work towards fixing the cliff?
Dr. Coleman - It is our hope that Congress will do things that will consider the most needy in our population – those that do not have a seat at the table that need access to healthcare. Because this issue – healthcare - impacts all tax payers at all levels because healthcare is an economic issue and a humanitarian one.