Community Health Clinics Face Deep Budget Cuts & Record Growth

LAKEWOOD, CO - DECEMBER 01: Physician's assistant Erin Frazier checks a young boy at a community health center for low-income patients on December 1, 2009 in Lakewood, Colorado. The Metro Community Provider Network (MCPN), which has 11 health centers in the Denver area, has seen a 138 percent increase in patients during the last year of recession. Community health centers such as MCPN could play a major role nationally if health care reform is passed, with increased subsidies from the federal government as well as millions of newly-insured low-income citizens seeking care. (Photo by John Moore/Getty Images) (2009 Getty Images)

Clinica Family Health Services in Colorado had a dream to see thousands more patients each year.

The Lafayette, Colo., community health center, which currently serves about 38,000 patients a year, wanted to hire additional staff and possibly build another clinic in an underserved area in the Front Range region, the most populous area of the state.

Now, those plans are at risk following a $600 million budget cut to community health centers in the federal budget approved in May.

“I think the opportunity to do all those things got sidetracked with the budget deal,” said Pete Leibig, CEO of Clinica Family Health Services.

Like many community health centers -- which are widely popular in Latino neighborhoods -- across the country, the organization is grappling with the effects of deep state cuts, combined with reductions in federal funds for growth. At the same time, community health center officials and advocates say the economic downturn led to an increase in demand for their services, and they anticipate the number of patients to double when an estimated 16 million more people are expected to become eligible for Medicaid in 2014.

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Community centers offer health care, regardless of ability to pay, in medically underserved areas and are touted as a way to cut down on costly emergency room visits.

BUT with fewer resources and high expectations for growth, health center officials are now tasked with finding ways to live up to the promise of health care reform.

“The need is still in these communities,” said Sean South, spokesman for the California Primary Care Association. “It doesn’t go away because we don’t fund it.”

According to the National Association of Community Health Centers, there are about 1,200 community health centers, with more than 8,000 sites, serving about 23 million patients in the United States. Expanding the nonprofit centers is a key component of health care reform, as the association states they are slated to increase capacity to 40 million patients by 2015.

In the past, South said, there has been bipartisan support for community health centers, such as the doubling of patients served under former President George W. Bush.

The last-minute federal budget deal reached last month slashed $600 million from the federal discretionary budget for health centers, which is about $2 billion a year, for Fiscal Year 2011. A spokesman for the U.S. Health Resources and Services Administration said the clinics will receive about $400 million more than they did the previous year, when combined with funds from the Affordable Care Act Community Health Center Fund. Advocates say about $300 million of that is designated for ongoing operations, leaving about $100 million left for expansion this year.

In Colorado alone, 15 health centers had sought $15 million to expand services and open new sites. “The need in Colorado, and the need nationally, far outstrips the dollars that are left after the cuts,” said Polly Anderson, policy director for the Colorado Community Health Network.

Some community clinics, which aren’t Federally Qualified Health Centers, are seeking the designation, partly because of health care reform. One such clinic is Clínica Tepeyac in Denver, where officials are considering adding evening and weekend hours to meet increased demand.

“We feel strongly that we are part of the solution in terms of increasing capacity,” said Jim García, founder and executive director of the clinic.

Jan Eldred, a senior program officer with the California HealthCare Foundation, said Federally Qualified Health Centers, which generally have larger budgets than those without the designation, are better positioned to weather sizable cuts from the state.

She said: “The smaller ones are just sort of living on a shoestring anyway.”

Matthew Rodriguez is a reporter for the YourHub section of The Denver Post.