Wars not health

“Community health centers hit hard by Washington deficit cuts

By Phil Galewitz, Thursday, October 6, 1:18 AM

The applications poured in, spurred by millions of dollars in new funding included in the health law to expand primary care to the poor. A record 810 groups sought federal grants to staff and equip hundreds of new and existing community health centers.

But in August, most were rejected, leaving advocates frustrated that they would not be able to serve the growing numbers of uninsured and poor people or be ready for an influx of patients under the health law.

Rather than handing out $250 million to establish new patient-care sites to serve more than 2 million additional people, as originally expected, the Obama administration gave $29 million to 67 nonprofit organizations that will serve an additional 286,000 patients.

The funding cut was a result of a federal budget compromise in March to keep the government running. That agreement reduced federal spending by nearly $80 billion, including a $600 million trim in funding for ongoing operations at existing health centers.

To make sure existing centers did not have to reduce services, the Obama administration diverted some of the $11 billion set aside in the health overhaul law for health-center expansion initiatives and instead used it to keep the centers operating at current levels.

But a casualty of this strategy was that some of the health-center expansion plans were either eliminated or drastically cut back.

In addition, to free up money to help with existing operations, the administration scrapped plans to distribute $335 million to health centers to boost medical, dental, pharmacy and vision services.

Advocates are concerned that Congress could again target operating funds and say the funding delay will slow efforts to build capacity by 2014, when the health law begins expanding coverage to 32 million uninsured people. “Now the whole process has been set back,” said Dan Hawkins, senior vice president at the National Association of Community Health Centers.

The situation highlights the trickle-down effect of Washington’s deficit cutting on local communities. Those efforts are being revved up this fall as the congressional “super committee” looks for ways to cut the federal budget by more than $1.2 trillion in the next decade.

At the local level, the lack of funding means:

●A dental exam room at FoundCare Health Center in West Palm Beach, Fla., will remain unused four days a week because there’s no money to hire a dentist.

● Triad Adult and Pediatric Medicine in Greensboro, N.C., might face a repeat of last winter when more than 700 adult patients were put on a months-long waiting list for care, and the center had to stop taking new pediatric patients because of a lack of doctors.

● Heartland Community Health Center in Lawrence, Kan., will have to continue to tell patients they must wait at least two months for an appointment.

“When the money first became available, a lot of community organizations said, here’s a golden opportunity, let’s try to take advantage,” said Heartland chief executive Jon Stewart. “But like many others, we were shocked not to be awarded a grant.””