By Rose Hoban
Even as health care advocates worry about whether the most recent Obamacare “repeal and replace” legislation moving through Congress has a chance at passage, leaders at the state’s community and rural health centers are worried about the absence of bills that could seal their fates.
Kim Schwartz, CEO of the Roanoke Chowan Community Health Center based in Ahoskie, said she’s concerned by other big deadlines looming on the 30th when the federal fiscal year ends.
One of the big bills that needs to get done re-authorizes federal dollars for all of the community and rural health centers around the country.
For Schwartz, that comes to about $1.1 million, or 13 percent of her annual $14 million budget.
“So, losing 1.1 million equates to us not being able to see about 1,000 patients a year,” Schwartz said. “I’m immediately on a hiring freeze, won’t be able to replace or likely may have to reduce staffing.”
“We try to get our federal funding down, but there are many health centers… that are truly seeing 60, 70, 80 percent sliding fee patients,” she said, noting for many of those centers, the grant funding represents as much as 50 percent of their annual revenue.
Deadline looms
Schwartz was in Raleigh meeting with state officials last week, even as others from the North Carolina Community Health Center Association drove to Washington, DC to advocate for movement on a bill to reauthorize the grants, along with funds to service loan repayment for health care providers who choose to practice in underserved areas.
“We need [Congress’] commitment to act by September 30th to extend the Health Center and National Health Service Corps funding so as not to impede the Health Centers’ ability to serve the 27 million patients that depend on access to affordable primary care in North Carolina,” says a statement from the organization.
Schwartz said the federal Health Resources and Services Administration has already created an action plan in case the bill doesn’t get done in time.
“They’ve told us, ‘OK, if your grant starts at this time, we’ll start reducing you,’” she said, noting that her funding stream starts in November. “We’ll be reduced right away.”
Schwartz said there’s a bill in the Senate that’s co-sponsored by Sen. Thom Tillis and supported by Sen. Richard Burr, who sits on the committee hearing the bill.
But Schwartz said in her conversations with health center lobbyists and advocates on Capitol Hill, that the clinics’ funding cliff is “barely on the radar.”
“The issue right now is that there’s so much competing noise now in DC that they don’t realize the risk we’re at,” she said.
The statement from the NCCHCA also asked Congress to “focus.”
Pamela Tripp’s rural health center organization, CommWell, serves patients in five eastern counties, at 13 sites. She said her annual budget is $22 million, the organization is slated to lose about $8 million if Congress doesn’t reallocate the funds by Saturday.
“That would put us back to where we were with grants in 2002,” Tripp said.
Honey, don’t forget the kids
Another budget reauthorization that needs to be completed by midnight Saturday reauthorizes spending on the State Children’s Health Insurance Program, which was a bipartisan effort first created during the Clinton administration.
North Carolina Medicaid head Dave Richard explained on Friday that SCHIP, which is called Health Choice in North Carolina, is essentially a federal program where states put in a much smaller percentage of the money to match federal dollars.
“That’s one of the drivers for Congress to really reevaluate the funding of SCHIP and make it more of a state-federal partnership rather than a partnership of feds, with a little bit of state contribution,” he said.
Last year, North Carolina spent $43 million on SCHIP, down quite a bit from prior years, because under the Affordable Care Act, many eligible children were funded by Medicaid, which saved the state money.
Richard said that staffers from the Department of Health and Human Services are participating in conference calls on Capitol Hill almost daily to keep abreast of developments around SCHIP and community health centers.
“The consensus from the Hill is that funding will go forward,” he said. “No one wants to cut the SCHIP program for children in this country, it’s now going to get down to what does that mean.
“We’ve heard there’s a lot of rumors out on the street that the impact would change.”
Both women and Richard said that time is getting short on all of the bills. Schwartz said she spends a significant amount of time on the phone and emailing legislators to keep the issue in front of them.
“It’s hard enough as it is doing what you’re doing out there, trying to address the mortality rates in our part of the state,” Schwartz said. “We’re a hot spot for colorectal cancer and breast cancer and the highest death rate due to diabetes complications and cardiovascular health.
“We’re really a risk area out there, and we’re just trying to keep focused on addressing those things, in the meantime,” she said.
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