Once bipartisan favorites, community health centers facing cuts from both parties

NEW HAVEN–Not long ago, leaders of the state’s community health centers were busy renovating facilities, hiring staff and expanding hours to treat more patients, bolstered by millions of dollars in government funding and the likelihood of getting millions more.

Now they’re bracing for potential cuts in federal and state aid and adjusting to a new political reality.

The package of federal spending cuts that passed the House Saturday would eliminate funding for new health centers in Danbury, Norwalk, Putnam and Torrington, and money that helped all health centers cover increased demand, health center leaders said.

And Gov. Dannel P. Malloy’s proposed budget calls for health centers to lose more than $3.8 million a year in state funding.

“Nobody really thought that the health center system was going to be on the chopping block,” said Evelyn Barnum, CEO of the Community Health Center Association of Connecticut.

Health centers have historically enjoyed bipartisan support, counting President George W. Bush and President Obama as boosters. Former Republican Gov. M. Jodi Rell authorized more than $25 million in bonding funds for the facilities, and Malloy, a Democrat, has spoken about wanting to expand the health centers’ model.

Because community health centers treat mostly poor patients with Medicaid or no insurance and charge on a sliding scale, their patient volume has grown since the recession began and they are expected to absorb much of the increased demand for care when health reform rolls out. Connecticut health centers received millions of dollars in stimulus money and were expecting to capture some of the $11 billion in new funding for health centers nationwide included in the health reform law.

Just last month, Barnum predicted the next few years would be a “golden age” for health centers.

Instead, on Monday, Barnum joined the leaders of eight health centers in describing a far different scenario as they made their case against the federal cuts to U.S. Sen. Richard Blumenthal at New Haven’s Cornell Scott Hill Health Center. Blumenthal pledged to fight the cuts.

Blumenthal 2-21 health centers

Sen. Richard Blumenthal pledges to fight for community health centers

The federal cuts are far from final. It’s not clear which cuts in the House bill would survive the Senate and win approval from President Obama.

The National Association of Community Health Centers projected that Connecticut health centers would lose $3.75 million and 88 jobs, and that 61,150 patients would lose access to care if the cuts in the House bill are enacted.

On Monday, several CEOs said patients who can’t get care at health centers will likely end up going to emergency rooms, ultimately costing the health care system more money.

“It’s the patients, ultimately, who will suffer,” said Alfreda Turner, CEO of Charter Oak Health Center in Hartford. The health center is open 62.5 hours a week, but still gets close to 400 patients a week it can’t accommodate, she said. Charter Oak is in the midst of a $15 million renovation aimed at expanding its capacity to serve patients, including by adding 60 employees, but she said funding cuts could make it harder to treat more patients.

Marge Berry, CEO of East Hartford Community HealthCare, said the cuts would most likely mean decreasing hours and laying off staff. “We’ll still see them,” she said of the patients. “I don’t know how we’re going to do it.”

Officials at Hartford’s Community Health Services are meeting Tuesday to develop contingency plans to determine what to cut, CEO Kenneth Green said. Expanded hours and a program that helps drug addicts stay clean are likely to be on the list. He said the prospect of budget cuts will make it even harder for health centers to recruit in-demand primary care clinicians.

One lawmaker who didn’t need to be convinced is Appropriations Committee co-chairwoman Sen. Toni N. Harp, D-New Haven, who works at the Cornell Scott Hill Health Center and sat in the audience during Blumenthal’s visit. When Blumenthal asked her to weigh in, Harp said health centers help keep people out of emergency rooms, get patients involved in wellness programs and address racial and ethnic health disparities.

“It’s really important that we don’t dismantle the system,” she said.

To argue against the proposed state cuts, the CEOs of two Bridgeport-based health centers planned to attend a Town Hall-style meeting with Malloy Monday night.

In the governor’s budget proposal, grants paid to the health centers would be cut by $3.8 million a year. Like hospitals, they would also lose state funding meant to help cover the cost of uncompensated care.

Office of Policy and Management Secretary Benjamin Barnes, Malloy’s budget director, called health centers “a big part of our health care landscape, especially for Medicaid recipients.” But he said the state must restrain health care costs, and said the way to do so is to pay health care providers less.

“We’ve elected to do that in the areas where we thought the providers would be best able to continue to provide care,” he said.

Barnes noted that health centers–known as federally qualified health centers, or FQHCs–receive higher rates for treating Medicaid patients than other providers. Like hospitals, they have also benefited from an increase in reimbursement rates from treating patients in a new Medicaid program for low-income adults, known as Medicaid LIA, that replaced a lower-paying state program.

“I’m not going to hide what we did to the hospitals and FQHCs,” he said. “We took money from them and we did it in those cases because we thought that those were the parts of the health care system that could afford that given what’s happened with LIA and what we need to do.”

Cuts in federal funding to health centers would change the environment, Barnes said. But he said the state must be selective in any efforts to make up lost federal funds.

“That same bill is taking hundreds of millions of dollars away from all kinds of other state programs,” he said. “I frankly don’t believe that the state of Connecticut is in a position to bail all those out.”