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Amid federal budget battle, Pa. health clinics develop contingency plans

Madasyn Czebiniak
| Sunday, Feb. 4, 2018, 12:24 a.m.
Community Health Clinic Executive Director Raji Jayakrishnan, shown on Wednesday, Jan. 31, 2018, in the New Kensington facility.
Louis B. Ruediger | Tribune-Review
Community Health Clinic Executive Director Raji Jayakrishnan, shown on Wednesday, Jan. 31, 2018, in the New Kensington facility.

What Congress does Thursday with the federal budget could have a major impact on New Kensington's Community Health Clinic and the roughly 1,400 free or low-cost health care centers like it across the United States.

If Congress doesn't pass a budget or stopgap measure that includes funding for the health center program, it could mean the end of many community health center sites and services across the country.

Officials at New Kensington's clinic aren't panicking just yet. They remain hopeful Congress will pass the funding the clinic needs.

If that doesn't happen, the clinic could continue to offer reduced services — but for how long remains to be seen.

“We're a small location and we could still sustain, but only to a certain point of time should these cuts happen,” Executive Director Raji Jayakrishnan said. “After that, we'll start collapsing under our own weight.

“We need that money in order to get us through.”

About 70 percent of Community Health Clinic's operating budget of just under $2 million comes from federal funding, administered as grants by the Health Resources and Services Administration, Jayakrishnan said. The remaining 30 percent comes from patient payments.

“The impact isn't good,” she said.

Community health centers have been worried about their funding since September, when the $5.1 billion that funded them for two years expired.

HRSA has been using $550 million appropriated from an earlier stopgap measure, as well as carryover funds, to keep the centers running, but that won't last long, HRSA spokesman Martin Kramer said.

“We have funding through April 30 — that's about it,” he said.

The uncertainty has forced some Pennsylvania health care centers to come up with contingency plans. Some are looking at closing sites, laying off employees and reducing hours and services, said Jim Willshier, director of policy and partnership for the Pennsylvania Association of Community Health Centers.

“All of them use this funding from the grant,” Willshier said. “If this does come to pass, there's going to be rural areas (where) there will be at least one health center site closing if not the entire organization. In those rural areas, it has a more devastating impact because there's fewer providers to go around.”

Community health centers often are the last line of defense for people in terms of health care because they see anyone regardless of their insurance or ability to pay.

In 2016, the health centers served nearly 26 million Americans, or 1 in 12 people. Those numbers included 1 in 10 children, 1 in 3 people living in poverty and more than 330,000 veterans.

“We're where the cracks fall,” said Bill Hall, New Ken­sington Community Health Clinic's board secretary. “There's no place after this.”

Jayakrishnan said the clinic is not looking at a contingency plan or cutbacks right now. She said its size puts it in a better position than larger centers.

“We don't see that urgency right now,” she said. “We are a small organization, and we're pretty agile. If we have to do something, we will make those decisions then, re-evaluate our priorities and restructure accordingly. Those decisions will happen if those cuts are there. Right now, we hope those cuts do not happen and we can continue to serve our patients.”

She said it's important to let patients know the clinic will continue to offer its medical, dental and behavioral health services. It has three locations, two in New Kensington and one in Vandergrift, which see almost 3,000 patients a year.

“We do not want to put the word out to the community that we are not going to be there,” she said. “Funding is also important. We want Congress and people deciding to fund us or not to know the urgency is there — you have to fund us.”

U.S. Rep. Mike Doyle, D-Forest Hills, said the reason for the delay in health center program funding has been a disagreement over where the money is coming from.

Republicans would like the money to come from programs such as Medicaid and Medicare, while Democrats want it funded through a separate appropriation.

He couldn't say with certainty whether that funding would be included in any budget agreement.

Doyle said community health centers play a big role in the lives of many Americans. There are 33 sites that serve more than 44,000 people in his district alone. Doyle represents Pennsylvania's 14th District, which includes New Kensington.

“They're a vital piece of the puzzle here,” he said. “If people don't have access to these community health centers, then a lot of people are going to lose their access to care.”

Madasyn Czebiniak is a Tribune-Review staff writer. Reach her at 724-226-4702, mczebiniak@tribweb.com or via Twitter @maddyczebstrib.

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