Darcy Cusano, APRN, of the CommunityHealth & Wellness Center in Torrington, meets with a telehealth patient. Melanie Stengel / C-HIT.ORG

Federally qualified health centers across Connecticut are counting on a one-time boost of additional aid this year to help maintain staff and services.

But leaders of those facilities say the $32 million set aside for them in the Appropriations Committee budget is now under threat as legislative leaders try to reach a budget deal.

“It became common knowledge that because our request of $32 million is a large line item — even though it goes to 17 individual health centers divided equally — it looks to be looming large as a target in the Appropriations Budget,” said Kathy Yacavone, interim CEO of the Community Health Center Association of Connecticut.

About 61% of the 417,000 people who visit Connecticut’s federally qualified health centers each year are Medicaid recipients. The facilities also don’t turn away anyone who cannot pay.

But reimbursement for services has not kept up with cost increases over time, Yacavone said.

“The state Department of Social Services has not reimbursed the health centers as their costs have gone up,” she said. “They have not reimbursed the health centers at their actual costs. So right now, there’s a cumulative effect of a deficit for the Medicaid program. … Coupled with that, there’s been inflation, workforce challenges of recruiting and retaining, and operational costs going up.”

While facility leaders negotiate with the state on Medicaid reimbursement, Yacavone said the $32 million would help keep the health centers afloat in the upcoming fiscal year and delay cutting services.

“The governor’s office has not really supported this request, despite our meetings and attempts, but the Appropriations Committee and the legislators really want this money for us,” she said.

The administration continues to meet with legislative leaders on the upcoming budget, and ensuring an appropriate level of funding for our FQHCs is part of those conversations,” said Chris Collibee, a spokesman for the Office of Policy and Management. “It is important to note that unlike most other Medicaid providers FQHCs are guaranteed inflationary increases. As budget conversations are ongoing, it would be inappropriate to comment further at this time.”

Federally qualified health centers provide critical services to low-income residents and people without permanent legal status, who may not have access to health coverage.

More than 65% of patients visiting the health centers identify as Black or Hispanic, officials said, and the facilities treat many people who come from underserved communities.

Without the additional funding, health centers would look to trim staff and hours of operation, along with some important services, health officials said.

“I would probably look at, unfortunately, scaling back dental services,” said Joanne Borduas, CEO of Community Health and Wellness in Torrington. “We have seven operatories. Right now, staffing plays a role in us being able to sustain those, but we’d have to make cuts to those high-cost specialty areas. We have a podiatrist and we have a chiropractor, both of whom are very busy and really fit well with our model of delivering health care services in a convenient way for our patients.”

Several funding requests have run into trouble this year as lawmakers try to stay within the state’s spending cap as they negotiate a budget. Officials have said a budget deal is imminent.

Most segments of state spending are subject to the cap, which follows a formula to keep overall growth in line with increases in household income or inflation — whichever is larger. The Office of Policy and Management estimates the cap system, which permitted $906 million in growth this fiscal year, would allow $998 million in 2023-24.

Still, some legislative leaders say the health centers are a priority.

“They do a lot of wonderful work. They provide a lot of care in the community,” House Speaker Matthew Ritter said. “They’ve got to make ends meet; they’ve got to pay staff and cover their expenses. So it’s something that will be part of the final budget negotiations for sure.”

CT Mirror Reporter Keith M. Phaneuf contributed to this story

Jenna is CT Mirror’s Health Reporter, focusing on health access, affordability, quality, equity and disparities, social determinants of health, health system planning, infrastructure, processes, information systems, and other health policy. Before joining CT Mirror Jenna was a reporter at The Hartford Courant for 10 years, where she consistently won statewide and regional awards. Jenna has a Master of Science degree in Interactive Media from Quinnipiac University and a Bachelor or Arts degree in Journalism from Grand Valley State University.