Deadline Week for Community Health Center Funding: ‘Lip Service Really Isn’t Enough’

As Congress approaches the Thursday funding deadline to avoid a second government shutdown, community health centers urge action ahead of funding cliff.

Another impending government shutdown has Congress pressed with the challenge of funding overall expenses as well as potentially extending funding to community health centers (CHC), which cater to medically underserved communities.

Though CHCs enjoy widespread bipartisan support, funding lapsed in October. Temporary spending measures have kept CHCs operating since then, but stakeholders feel hamstrung by the lack of long-term solutions.

“People are pretty anxious, hopeful but anxious,” said Allison Coleman, CEO of Capital Link, a Boston-based nonprofit that assists CHCs with financing. “They’re taking the position that we need congressional action on this and lip service really isn’t enough.”

How did CHCs get into this position?

A creation of the Affordable Care Act, the Community Health Center Fund (CHCF) was authorized with funding for five years. After the original appropriation expired in 2015, the CHCF received a two-year funding extension alongside the Children’s Health Insurance Program (CHIP).

Unlike CHIP, which received a six-year funding extension in last month’s continuing resolution, the CHCF was appropriated enough funding to operate through March.

There are currently 1,367 CHCs operating at more than 10,400 sites across the country, providing care to 26 million patients, according to the Health Resources and Services Administration. If CHCs do not receive a funding extension by Thursday, an estimated 9 million people would lose access to nearby care options due to staff layoffs and site closures.

Stakeholders brace for impact, as CHCs feel effects already

CHCs experienced a financial pinch even before federal funding expired in October, according to Coleman.

Most capital projects for CHCs were put on hold in early summer and have not progressed due to congressional inaction, she said. Additionally, lenders are backing away due to long-term funding concerns, a situation Coleman said gets worse with each passing deadline.

Some CHCs have also instituted a hiring freeze, a situation mirrored by Capital Link.

Dan Hawkins, senior vice president of National Association of Community Health Centers (NACHC), said care sites have struggled to commit to facility leases without a clear long-term funding future. Hawkins said this has led not only to the closure of care sites but also to the loss of physicians and dentists who can’t secure long-term employment options from CHCs.

Expect ER use and hospitalization rates to rise if CHCs fold

The broader healthcare community is expected to share in the costs and medical challenges caused by potential CHC funding shortages.

“Patients don’t go away. They just go to other parts of the healthcare system,” Coleman said.

CHCs are legally mandated to operate in medically underserved communities, which include areas with high poverty rates, poor overall health, high uninsured populations, and a lack of available providers. If CHCs were to pull out of these areas, their absence would force patients to use the ER more frequently, Hawkins said.

“Health centers provide care to anyone, regardless of their ability to pay, and it’s these grant dollars that enable them to do that,” Hawkins said. “It’s ERs, if there are ERs nearby, or there’s nothing.”

Worrisome waiting game continues

CHCs enjoy bipartisan support but have received little media or political fanfare in the lead up to the funding cliff. While CHIP was used as a “political football,” Coleman said, Congress has not used such a technique for CHCs.

Leaders on Capitol Hill are expected to iron out the details on an extension this week, but nothing had been finalized as of Monday morning.

NACHC is holding a press conference with other state associations representing CHCs on Tuesday to highlight the need for a long-term funding extension. Hawkins remains optimistic the two sides will come together on a resolution, adding he expects a two-year funding extension to pass by Thursday.