Thousands of fragile and vulnerable patients — including many potentially arriving from the unfolding humanitarian crisis in hurricane-ravaged Puerto Rico — may lose access to health care at community centers in New Haven and across the cities of Connecticut. Meanwhile, others will be helped by fewer staffers coordinating their care.
That urgent situation was described to U.S. Sens. Richard Blumenthal and Chris Murphy at a press event convened Friday morning at the Fair Haven Community Health Center (FHCHC).
The senators and area community health center officials and patients discussed the potentially catastrophic effects if Congress does not vote to restore community health center funding nationally. The vote deadline for which is Oct. 2.
About $5.1 billion, or 70 percent of the annual total that the country’s 2,800 health centers receive, needs to be authorized by that date, said Deb Polun, senior director for policy and outreach for the Community Health Center Association of Connecticut.
“This is huge. This threatens our existence,” said FHCHC’s Chief Executive Officer Suzanne Lagarde.
FHCHC could lose up to $2.8 million, over 10 percent of the annual budget. It would lose 16 percent of its patients and untold number of staffers.
Statewide the estimated losses in funding would $37.8 million. And some 90,000 patients would lose access to health care, along with an estimated 530 health center workers, out of a total community health care center workforce of 3,300, according to Polun.
Lagarde noted that in the past community health centers have enjoyed bipartisan support for budget re-authorizations. (President George W. Bush, for instance, supported increasing funding for community health centers.) She described the lapse this year as a “casualty of the [political] noise.”
The senators were not as charitable. Sabotaging the 1960s-era War on Poverty community health centers—their mission is to take care of the most vulnerable, anyone who walks in the door, without regard to ability to pay—is part of the Republican agenda, they argued.
“The Trump administration is brazenly trying to burn down our health system,” said Murphy.
In the wake of the defeat of the latest attempt to repeal the Affordable Care Act, “they’ve admitted they’ll refuse to compensate the states enrollilng new citizens, they’ve stopped payments” to reimburse insurance companies and market public plans, said Murphy, who sits on both the health and finance committees of the House.
Murphy called for more public pressure to refund the health centers. Blumenthal described the nearly $40 million that Connecticut stands to lose if the funding “goes over the cliff” as a genuine investment. “It’s not only about [alleviating] pain and suffering. It’s about treating something before it gets (more) serious.”
Both senators said they did not want to offer false hope that the refunding could be brought up even as soon as next week.
The funding uncertainty along with the state budget stalemate are already having serious effects, said Cornell Scott Health Center CEO Michael Taylor.
“I’m looking to refinance our long-term debt before the end of the year. And I can anticipate lenders will be uncertain and nervous” if the funding falls off the cliff, he said.
Lagarde said she already has been turned down by one lender when she sought financing for capital expansion. “I’ve applied for a loan for expansion, and I’ve been denied already by one” lender. She said she fears the same result form another considering the loan. “It’s all about the uncertainty” from the lack of refunding, she added.
Two patients were on hand to describe to the senators the kind of now-endangered care they receive at the centers.
Neither wanted to be photographed or have their last names used. Jeannette said that she had been sick and then homeless for five months and grew hopeless, with every door closing on her until she came to FHCHC. The care coordinator there helped get her a job and housing for her family along with basic health care. Another patient, Jose, said his care coordinator not only signed him up for social security, but arranged for him to get necessary and extensive dental work done.
Eve Cumberbatch, the center’s head of mental and behavioral health services, described a chronically depressed woman unable to fill out forms without help, who as a result was in danger of losing her Medicaid coverage, which provided medication for her conditions.
“We may not have a care coordinator to walk this woman through,” said Cumberbatch. Those workers likely first to lose their jobs would not be medical and nursing staff, but more likely the social workers and coordinators of care.
“And the funding for our substance abuse program,” added Taylor.
A Perfect Storm: Patients From Puerto Rico
“We get the most vulnerable and sick people and we never turn them away,” said FHCHC Senior Vice President of Strategy Gloria de Jesús.
De Jesús noted that many Puerto Ricans may move here soon to join relatives in New Haven.
The senators both called the administration’s response to the hurricane’s aftermath in Puerto Rico inadequate. They promised to be vigilant, as Taylor urged them, to get the funding restored as soon as possible.