Uncertainty and instability.
Those are the words frequently used to describe what community health centers across Texas are feeling right now as they wait for Congress to pass long-term funding.
“We had hoped for five years,” Regina Rogoff said. “At this point, I think we would settle for two years.”
Rogoff is chief executive officer for People’s Community Clinic in Austin. The center provides a wide variety of services helping infants and adults, such as preventative health screenings, immunizations and cancer screenings.
“We are really meeting a basic human need for primary care,” Rogoff said.
Congress has only passed a short-term Continuing Resolution including $550 million for community health centers to last through March.
Rogoff said if there isn’t funding approved beyond that, health centers like People’s Community Clinic will have a tough time providing for their patients. “It would make a big dent and it would make it hard to continue delivering services at the level we currently do,” she said.
Texas Association of Community Health Centers says without the promise of long-term funding, health centers are putting what they would usually do on hold.
“They’re putting off decisions,” executive director Jose Camacho said. “They’re delaying the decision to hire. They’re delaying the decision to add more staff. They’re delaying decisions to expand buildings and services.”
Community health centers employ about 600 physicians statewide. Camacho said there are currently 66 vacancies. That’s not including other types of providers, such as physician’s assistants and nurse practitioners. They serve 1.3 million people across Texas and around 40 percent of them don’t have insurance, according to TACHC.
“It’s very hard to plan, hire and recruit those physicians with the uncertainty that part of your funding may be terminated,” he said.
Several capital projects slated to begin in January and February are also being delayed, Camacho said.
“Plans are already on the drawing board,” Camacho said. “But if you have an interruption in the revenue and you’re financing part of it through a bank, they may believe in the community service you’re providing but they have to be realistic in terms of the ability to pay off those loans.”
Camacho said issues like behavioral health needs and the opioid crisis have “been laid at the doorstep of health centers.” Expanding services for those two needs are also being placed on hold, Camacho said.
Alan Schalscha, chief medical officer for CommUnity Care, said their organization has slowed down recruitment for these specialty areas.
“Some of the best ways we can care for patients is utilizing expanded care teams,” he said. “Utilizing dieticians, pharmacists, behavioral health services and what we’re not going to be doing is expanding those team members.”
Schalscha said that’s a key area where quality of care for patients is getting affected.
Rogoff said the board of People’s Community Clinic has adopted a budget for 2018 while they actively monitor what happens in Congress. If no action is taken, their center has some savings as well as community donations, she said.
“They won’t last forever,” she said. “And you don’t want to use up all your cash reserves. It is your rainy day fund.”
In the Continuing Resolution, there was also $2.85 billion to keep the Children’s Health Insurance Program (CHIP) going through March. Patients on CHIP often seek services from community health centers. Sen. John Cornyn, R-Texas, said Tuesday CHIP remains on the top of the list of unfinished business lawmakers will tackle.