Feb 6, 2018 4 min read

MT. MORRIS – Community health centers across the state and nation are on red alert.

Congressional authorization for community health center funding expired Sept. 30, and temporary federal grants are set to expire March 31. Many health centers are planning for or implementing cuts in anticipation of a loss of as much as 70 percent of their funding if a short-term spending bill to prevent a government shutdown that Congress is trying to pass does not include its reauthorization.

On Tuesday, community health center staff at Cornerstone Care in Mt. Morris, Greensboro and Burgettstown wore red shirts as part of a National Association of Community Health Centers “Red Alert” effort to bring awareness to their potential funding loss as advocates met with members of Congress in Washington, D.C.

Cornerstone Care currently serves over 20,000 patients annually across eight locations in Washington, Greene and Fayette counties, and with its mobile unit. The organization provides a number of health services to uninsured or underinsured patients, especially in rural areas. A 70 percent loss in funding translates to $2.3 million dollars. Thirty to 40 staff members across Washington, Greene and Fayette counties could be cut, which represents 20 percent of the workforce. That loss of funding could mean the closure of outlying locations and a wage and hiring freeze.

Quality-of-life programs, such as educational services, could disappear. Sarah DeCarlo, psychiatry and counseling department practice manager, said that though no firm decisions have been made at Cornerstone Care, many community health centers are developing contingency plans if funding doesn’t come through.

“It’s just kind of scary right now because we’re getting lost in the conversation,” she said. “We save the system a lot of money here because we’re catching patients that would be going to the emergency room for their primary-care doctor.”

Carla Lagaza, practice manager at Cornerstone Care’s Mt. Morris location, which offers family practice care, dental and behavioral health services, said all this uncertainty leaves her feeling on edge. If that office were to close, transferring care for current patients “would be devastating.”

Waiting lists are unusually long, especially for psychiatric care in rural areas. There’s also a question of whether other providers would accept patients that rely on Cornerstone Care’s sliding fee scale. Reducing mental health services is the worst thing that could happen to an area ravaged by the opioid crisis, DeCarlo said.

“Dental is huge with the sliding fee for people that may not have dental insurance,” DeCarlo said.

And in Mt. Morris, Cornerstone Care is providing more than just treatment. It’s also a teaching health center. Amber Warren leads that program, which teaches family practice medicine.

“As a teaching health center, we recruit residents that want to work in rural areas,” she said, encouraging new doctors to come to areas that face a huge physician shortage.

Their patients, Warren said, can live in areas so rural that receiving health care in a metropolitan area is not a realistic possibility. Community health centers act as a safety net so that some very sick individuals do not fall through the cracks.

DeCarlo said that in her 17 years with Cornerstone Care, this is the first time she’s truly been aware of funding issues. This is the first time that cuts and pay freezes have been a real possibility. She said she’s worried, but also encouraged.

“The last thing we want to do is spread panic,” she said. “But this shouldn’t be a partisan issue.”

In recent budgetary talks, community health has been one of the last health programs to receive federal funding.

Community health centers currently receive temporary monthly grants from the Health Resources and Services Administration, and these grants are set to last through mid-April. The federal funding was last authorized in 2015.

The Pennsylvania Association of Community Health Centers said that more 800,000 people use health centers across the state, resulting in a $1 billion savings. 

DeCarlo said Cornerstone’s current situation is similar to that of the Children’s Health Insurance Program, funding for which has been reauthorized for six years. Officials hope that a bipartisan bill that would provide short-term funding while a more long-term solution is explored can be reached Thursday. A two-year extension, though not ideal, is the most likely funding outcome at this point, DeCarlo added.

DeCarlo and Lagaza encouraged anyone who has benefited from a community health center to contact his or her representative in Congress.

“We’re not here to play politics. We’re here to take care of the patients,” Lagaza said.