Community health centers are in federal funding crisis; care in Mass. facing $200m shortfall

To the Editor:

Public health is more vulnerable than ever today because community health centers like those serving Dorchester, Mattapan, Roxbury, and the South End are running out of time and money in the midst of a virulent flu season and an ever-climbing number of opioid overdoses.

Critical federal funding for our programs expired the first of last October, and since then, all community health centers have been operating under a “funding cliff.” This phrase alone would lead a person to think that this is an issue solely about money, but it’s about much more. It’s about people, and about how decisions made – or left unmade – can have a ripple effect.

When people are sick, they need an accessible place to go for affordable care. Few areas of the country are as dependent on community health centers to provide such care than Dorchester, Mattapan, Roxbury and the South End.

Collectively, the Bowdoin Street, Codman Square, Dimock, DotHouse Health, Geiger Gibson, Harvard Street, Mattapan, Neponset, Uphams Corner, Whittier Street, and South End health centers serve more than 148,000 patients, or one in six Boston residents. We are committed to maintaining our full range of high-quality services for all patients – but doing so isn’t easy, and we’re worried we will soon have to take the same drastic measures we are seeing put in place in other areas of the nation.

Community health centers across the country are being forced to make tough decisions. They are laying off staff, cutting back services like treatment for opioid addiction or onsite ultrasounds for pregnant mothers, and planning for site closures. Health care for more than 27 million people nationwide is being managed on a month-to-month basis because Congress has not extended funding for community health centers. So vendors cannot be paid, nor can doctors be recruited or persuaded to remain in some of the most medically underserved areas. Mobile health vans may not have the gas money to drive to the hardest-to-reach populations. Medicines and other supplies may not be purchased beyond next month.

The US Department of Health and Human Services has projected that the “funding cliff” could result in the closure of 2,800 health center sites throughout the US and the loss of health care access for up to nine million patients. In Massachusetts, funding losses could approach $200 million with 140,000 patients losing access to care. For Dorchester, Mattapan, Roxbury and the South End, a loss of close to $13.1 million in funding puts more than 10,721 patients at risk.

This is not how a health system should be operated – particularly a community health center system that has served the nation so well both in terms of saving lives and dollars. Health centers like ours have been providing care for more than 50 years, opening access to quality services and providing a more affordable option for preventive care than a hospital emergency room. Not only do we generate $24 billion in health care cost savings, but we are also innovators who work with community partners to respond to public health crises, such as trauma and violence, the opioid epidemic and the recent disasters that struck Texas, Florida, California, and Puerto Rico.

There is little doubt that health centers have contributed significantly to cost savings for the American taxpayer. Our record of success is why community health centers have earned bipartisan support from presidents and lawmakers. Yet there’s a bitter irony behind the health center “funding cliff”: Most everyone agrees that Congress should act now to extend funding. Lawmakers must move beyond the political debate and put their focus on public health.

Our Massachusetts congressional delegation and state leaders have a long history of advocating on our behalf, but they need your help now in spurring national bipartisan action. Sign up as a health center advocate today at www.hcaadvocacy.org/takeaction to let elected officials know what your health center means to you and your community.

Sincerely,

Phillomin Laptiste, Bowdoin Street Health Center
Sandra Cotterell, Codman Square Health Center
Myechia Minter-Jordan, MD, Dimock Community Health Center
Michelle Nadow, DotHouse Health
Chuck Jones, Geiger Gibson & Daniel Driscoll-Neponset Health Centers
Stan A. McLaren, Harvard Street Neighborhood Health Center
James W. Hunt, Jr., Massachusetts League of Community Health Centers
Guale Valdez, Mattapan Community Health Center
Bill Walczak, South End Community Health Center
Jay Trivedi, Uphams Corner Health Center
Frederica Williams, Whittier Street Health Center