Patients Across New York State Are Counting on Community Health Centers. Can They Count on Albany?
Community health centers (CHCs) serve more than 2.5 million people every year at nearly 900 sites across New York State. They provide primary and preventive care, dental care, behavioral health, vision care, OB/GYN, and substance use disorder services to one in every eight New Yorkers. They are the backbone of the safety net. And they are in trouble. Without immediate action from the state, the safety net could collapse.
For decades, New York has relied on community health centers to do the hard work of prevention and providing continuous care to vulnerable communities. CHCs are often the only source of primary care for communities that might not otherwise have a doctor’s office. And they serve everyone who walks through their doors, even if they do not have insurance or the ability to pay.
But the state’s reimbursement system has not kept up. Medicaid is the single largest source of revenue for community health centers, representing about 42 percent of total CHC revenue. But New York’s outdated Medicaid reimbursement approach for CHCs pays rates based on costs from a quarter of a century ago. Meanwhile, everything else has changed. Costs have risen. Workforce shortages have intensified. Demand for care has grown.
Seeing this crisis, the Governor and the Legislature authorized up to $40 million in the previous state budget for community health centers, a band aid on a gaping budget wound created by 25-years of underfunding. While we are grateful for the show of support, it is nowhere near enough to protect New York’s nearly 80 community health center organizations who provide care to one in every eight New Yorkers.
Fast forward ten months: CHCs have not received a single dollar of that funding. Worse yet, we have learned that the state has no plan to release those funds. At the same time, changes at the federal level mean 1.5 million New Yorkers are expected to lose their health insurance. When people lose coverage, they do not stop getting sick. They do not stop needing medications, prenatal care, vaccinations, mental health support, or treatment for substance use disorder. They show up where they have always shown up when they need trusted care: at CHCs.
Community health centers will continue to provide care to their current patients, plus all of those newly uninsured patients. But without Medicaid reimbursements, CHCs will lose an estimated $300-million in revenue each year to provide that care. That loss of revenue means an estimated 1,700 full-time jobs lost statewide, including more than a thousand physicians, nurses, dentists, behavioral health staff, and other clinical positions.
This challenge is not about abstract numbers on a spreadsheet. This is about the mom who needs to get her child’s asthma under control. It’s about the older New Yorker who can no longer get care close to home and ends up in the ER. It’s about a person in recovery who can no longer see the counselor they’ve come to trust. It’s about hard-working New Yorkers across the state losing access to the care they rely on to control everyday health issues like diabetes, depression, high blood pressure, or cholesterol so they can continue to proudly work to support their family.
If the safety net collapses, we all lose, but patients lose the most. We cannot afford to disrupt this critical healthcare delivery system that uniquely cares for the most vulnerable New Yorkers. But Governor Hochul’s proposed budget provides no assurances that CHCs will receive needed financial support.
That is why CHCANYS is calling on Albany to strengthen the safety net, keep doors open, protect jobs, and help ensure access to care in every region of the state by releasing the $40 million from the previous budget and making a transformational investment of $300 million in community health centers in the budget being negotiated now.
I believe they mean it when the Governor and lawmakers say they want to protect the safety net. But belief does not keep health center doors open. Investment does.
Patients across New York State are counting on community health centers to continue providing the care they need and deserve. Can they count on Albany?
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