Health centers wait, worry as funding lags


    Dental hygienist Alicia Washington cleans Lyndsey Eagleston's teeth at the Nexus healthcare center in Toledo.

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  • Representatives of Ohio’s community health centers say access to care for 700,000 people statewide is threatened because of a continued holdup in federal funding, as Congress this week returns to discuss the nation’s budget. 

    The Community Health Center Fund, which provides millions of dollars to health centers across Ohio, expired Sept. 30 and has not been reauthorized. Established through the Affordable Care Act, the fund distributed $3.6 billion last year to clinics and health centers across the country.

    “Absolutely the funding cliff put that all in jeopardy,” said Julie DiRossi-King, chief operating officer for the Ohio Association of Community Health Centers, which represents about 50 health centers across the state. 

    Dental hygienist Alicia Washington cleans Lyndsey Eagleston's teeth at the Nexus healthcare center in Toledo.
    Dental hygienist Alicia Washington cleans Lyndsey Eagleston's teeth at the Nexus healthcare center in Toledo.

    Health centers received a temporary extension in December, but that will run out in March if Congress doesn’t reauthorize the funding, Ms. DiRossi-King said. That puts at risk the health care of 700,000 Ohioans who use those centers and has forced some centers to institute hiring freezes or halt expansion plans, she said.

    In northwest Ohio, those affected include facilities across Lucas, Wood, Williams, Henry, Defiance, Seneca, and Sandusky counties. 

    “Health centers have always had bipartisan support and continue to have bipartisan supporters, but [Congress] can't get down to business of running the country because they are too busy fighting,” said Janis Sunderhaus, CEO of Health Partners of Western Ohio, which operates 13 sites in places such as Lima, Bryan, Defiance, and Tiffin.

    “Health centers are common sense and we need a little bit more of that,” she said.

    Ms. Sunderhaus said she fears non-clinical services, such as medication delivery and education programs, would be among the first to go when clinics like hers face cuts. She said services that are expensive to provide — including dental care and opioid addiction treatment, would be difficult to continue. 

    “It really is across the board, and it would impact the urban sites and rural communities where many times it may be the only primary care center to go to,” she said. Health Partners of Western Ohio treated 35,000 patients across its sites in 2017 and stands to lose $3.5 million if funding isn’t reauthorized. 

    As funding expired last fall, more than 150 lawmakers from both parties — including U.S. Reps. Marcy Kaptur (D., Toledo), David Joyce (R., Russell Twp.) and Tim Ryan (D., Howland) — signed a letter urging Speaker of the House Paul Ryan (R., Wis.) and House minority leader Nancy Pelosi (D., Calif.) to fund what they called “a vital program.”

    And yet, as the government shutdown loomed it was the Children’s Health Insurance Program, which also expired Sept. 30, that became a bargaining item for both parties. While CHIP was extended for six years as part of the continuing resolution to end the brief shutdown in January, the health centers remain in limbo. 

    “This kind of a man-made crisis creates a lot of anxiety within our workforce,” Ms. Sunderhaus said of the health center funding cliff. “It makes them feel their jobs aren’t secure, then people start looking for other jobs.”

    These health centers are located in medically under-served areas and are required to treat people regardless of their insurance status or ability to pay. The goal is to provide a one-stop shop for services such as family medicine, dental, vision, behavioral health, and pharmacy, for patients who face barriers to accessing care such as transportation. 

    Ms. Sunderhaus offered their Hardin County clinic in Kenton, where before their arrival there were scant primary care options for low-income patients. 

    “Kenton is a great community to look at,” she said. “We do 2,000 primary care visits a month. Where the heck were they getting care before?”

    Miranda Hoffman, chief financial officer at Neighborhood Health Association in Lucas County, said they are focused on reminding Congress why the centers are vital to a community’s well-being. 

    “What we're trying to highlight with Congress are the great outcomes we have [for patients],” she said. “Should we not be here, those patients would not have access to those health care services.”

    Neighborhood Health Association, which operates 14 locations around Lucas County, receives about one-third of its funding from this allotment tied up in Congress.

    “It's pretty significant,” Ms. Hoffman said, adding it’s too soon to talk about any reductions in staff or services should the funding not get renewed. 

    “We definitely always look at where we could have cost savings,” she said. “We are much more confident that it will be resolved before we would have to take any action.”

    Diane Krill, CEO of the Wood County Community Health and Wellness Center, said her Bowling Green health center is in a more stable position than stand-alone clinics because it is affiliated with the Wood County Health District and gets some of its funding from the district.

    The center receives nearly $1.1 million in federal money to operate, not all of which comes from the community health center fund. 

    Since the health center fund expired in September, Ms. Krill said she’s informed members of both the boards of the health department and health center about the financial situation. She said the uncertainty has meant not replacing a behavioral health specialist who retired, although no decisions have been made for any potential cuts if funding delays continue.

    Similarly, the clinics affiliated with the Toledo-Lucas County Health Department get significant money elsewhere, said department spokesman Shannon Lands. Nearly $965,000 comes from federal funding while $3.8 million is from other sources, she said. 

    Health center advocates are designating Tuesday as a day to wear red to raise awareness for the issue and call elected officials urging them to authorize funding. Lawmakers must pass another short-term spending bill to keep the government open after Thursday, when current federal funding runs out.

    Contact Lauren Lindstrom at, 419-724-6154, or on Twitter @lelindstrom.