[W]ASHINGTON — Almost three months after Congress skipped a deadline to renew a program of community health funding, health centers in Vermont are poised to lose millions in federal support next year.
As Congress is embroiled in year-end fights over funding the government and passing a GOP-led tax overhaul, Gov. Phil Scott and members of Vermont’s congressional delegation are calling on leaders in Washington to reauthorize the program.
It is a key funding source for a system of health centers that serves about a quarter of Vermonters.
Federally qualified health centers, or FQHCs, provide services that include primary care and dental and mental health treatment to people in underserved regions. Under federal requirements, the centers must serve all patients, regardless of their ability to pay, according to Tess Keunning, president and CEO of the Bi-state Primary Care Association.
The federal grants are a key support to the 12 health centers in Vermont. The centers operate a total of 63 locations across the state, from Richford to Arlington.
They collectively serve about 172,000 patients in Vermont, Keunning said.
Community health centers in Vermont are poised to lose $14 million if Congress does not move to reauthorize the program, according to the group.
The federal grants are disbursed to health centers over the course of several months.
Two health centers — Rutland Regional and Little Rivers Health Care, headquartered in Bradford — were scheduled to get their grant Jan. 1, according to Keunning. Three other centers would get their federal funding in February.
However, Congress still has yet to reauthorize the program.
“It’s the uncertainty that is so difficult,” Keunning said.
Health centers in the network are making contingency plans for how to deal with the potential loss of the federal grant, including implementing hiring freezes, reducing operating hours, or delaying capital maintenance.
“Often you have to make proactive decisions if you don’t have a confidence level of the resources coming in,” Keunning said.
The health centers will continue to operate as much as possible without changing their services, she said.
She expects the federal funding will be reauthorized eventually, perhaps within the next few weeks. Since the program’s launch in the 1960s, it has generally enjoyed bipartisan support, she said — much like the federal Children’s Health Insurance Program, which also lapsed when Congress didn’t reauthorize by a Sept. 30 deadline.
Sen. Bernie Sanders, I-Vt., said Tuesday that he believes the reauthorization of the program stalled because of congressional leaders’ priorities.
“Republicans were too busy trying to throw 30 million Americans off of health insurance and now trying to give huge tax breaks to the rich and large corporations,” he said, referring to GOP-led efforts to repeal the Affordable Care Act and overhaul the federal tax code.
Sanders noted that a quarter of Vermonters utilize the system supported through the program and said the state has one of the highest utilization rates in the country.
“It’s particularly important to Vermont, but it’s important for the whole country,” he said.
As Congress enters the final stretch of the year, with a deadline looming Dec. 22 to pass a new government spending bill, Sanders said the health program is “one of the key issues that we are going to be addressing.”
Sanders joined with Sen. Patrick Leahy, D-Vt., and the two senators from New Hampshire in a letter to Senate Majority Leader Mitch McConnell last week expressing concerns about the expiration of the program.
The program has supporters in both parties.
Last month Scott and fellow Republican Gov. Chris Sununu, of New Hampshire, wrote a letter urging congressional leaders to take action to avoid cutting federal funding to the centers in Vermont and New Hampshire.
Republicans in Congress also support the program. A bill passed the House last month with GOP support to reauthorize CHIP and the community health center program. However, Democrats objected because of how the bill would pay for the extension.
Congress has not taken further action on that legislation.
State lawmakers, too, are concerned about the lack of reauthorization of the health centers or the Children’s Health Insurance Program.
Rep. George Till, D-Jericho, said it’s a “potential disaster” for health care in the state.
Till, a physician, said he worked at a federally qualified health center for three years.
“Not funding FQHCs and CHIP is a completely irresponsible act by the Congress,” Till said. “FQHCs are a huge piece of our primary care network in Vermont and an absolutely essential part of our health care safety net.”
Alison Calderara, the CEO of Community Health Centers of Burlington, said it has been “discouraging” that Congress has not reauthorized the program yet.
The Burlington-based center receives $2.2 million in federal funding each year, she said. Though a relatively small portion of the overall $28 million budget, it is a key source of support, she said.
The federal funding helps pay for programs that provide health care to the homeless, offer a sliding fee scale to patients and more, she said.
The health center is “boots on the ground for Vermonters facing barriers to health care,” she said.
“That federal funding really is, you know, the heart of how we’re able to do that,” she said.
Community Health Centers of Burlington is scheduled to get its next federal grant in April. Calderara said she is “concerned, but confident” that Congress will renew the program by then.
However, she said, the situation has left the center’s patients and staff apprehensive about the future.
“It really feels like a cliff that’s looming,” she said.
