Health centers, with slim margins, ask state for funding help

Some Massachusetts community health centers are “essentially one snowstorm away from having challenges making payroll,” an expert on the industry’s finances said during a State House hearing last Wednesday.

Leaders from community health centers seeking more financial support from lawmakers converged on the State House, where Capital Link CEO Allison Coleman told them Massachusetts community health centers had enough cash on hand to last a median 34 days, while those at or below the 25th percentile had 18 days of cash or less.

Coleman said her organization, a nonprofit that helps community health centers plan for growth, recommends a minimum of 45 days cash on hand, and the national median is 65 days. She said Massachusetts health centers also lag nationally on operating margins. While the national median is a 3.3 percent margin, in Massachusetts it is negative 0.9 percent.

Coleman called the community health center system an “incredible asset” to the state and told the center staff who attended the lobbying event that they “urgently need the support of the Legislature.”

“Really, many of you can’t afford to wait,” she said. “I know we’ve been told to be patient, but there’s some real need out there.”

Coleman spoke at a briefing hosted by the Massachusetts League of Community Health Centers, which is advocating for bills that would create a new fund to spend up to $15 million annually on centers demonstrating “financial need,” including negative operating margins, insufficient cash flow, potential loss or reduction of critical services, inability to meet staffing needs, or uncertain ability to cover long-term obligations.

The bills (H 1165, S 675), filed by Rep. Kevin Honan of Boston and Sen. Julian Cyr of Truro, were scheduled for a hearing on Tuesday before the Health Care Financing Committee.

Sweeping health care legislation that the House passed last year included the $15 million fund. James Hunt, president and CEO of the health centers league, said a Senate version of the bill included language creating the fund but with “no resources identified” to seed it.

Lawmakers were unable to reconcile the House and Senate bills, which included provisions aimed at shoring up financially strapped community hospitals among various health reform efforts. Legislative leaders say they are interested in another run at addressing health care cost and access, but the issue is not on the front burner.

Hunt said his group hopes community health centers will be included in any future effort.

“We continue to feel extremely optimistic that both the speaker and the Senate president support community health centers and their vitality going forward, and also community hospitals,” he told the News Service. “What the sources of those resources are — we’re not speaking to resources, we’re speaking to need. There may be something later rather than sooner, but we’re hoping that it’s this year.”

Hunt said community health centers are a “big deal” in Massachusetts, serving one out of seven residents and offering medical, behavioral health, and dental care in underserved rural and urban areas. Without adequate financial support, the centers would lose capacity to serve the people who rely on them, he said.

“We’ve got health centers that basically struggle because of cash flow, we’ve got health centers that would like to expand but they’re reluctant to expand because they don’t want to put themselves in a deficit position,” Hunt said. “We have a need for further expansion.”


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