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Automatic Federal Budget Cuts Will Impact Cape Health Centers!

By Elsa H. Partan

The federal sequestration of funds will hurt health centers in the region, including the Community Health Center of Cape Cod in Mashpee and Duffy Health Center in Hyannis. The centers have not yet decided how to close the looming budget gap, but possible solutions include raising patient fees, cutting staff, or running a budget deficit. Both health centers serve people with low income from throughout the region.

After Congress and President Barack H. Obama failed to reach a budget deal by March 1, $85 billion in automatic spending reductions began to kick in across dozens of government departments and offices ranging from defense to education. Those spending cuts are expected to continue over the next 10 years, totaling approximately $1.2 trillion in federal spending.

The Community Health Center of Cape Cod is bracing for a cut of 3.9 to 5 percent in its public health services act grant from the Health Resources and Services Administration, according to Karen L. Gardner, chief executive officer. That represents $50,000 to $75,000. The cut will likely take effect in June.

“It is just one more thing on top of already huge cuts to the state “Our state grant has declined by $500,000 over the last four years.”
The health center will consider raising its fees, she said. But because many of the health center’s clients survive on a very low income, increasing fees might not solve the budget problem.

“It may be meaningless,” she said. “If they can’t pay, they can’t pay.”

The health center will also rely on “other philanthropic efforts,” raising money from outside sources.

“We haven’t gone through all the what-ifs,” she said. “There might be less access to care.”

Like the Community Health Center, the Duffy Health Center in Hyannis is expecting to lose approximately $50,000 in federal funding from the Health Resources and Services Administration, representing a 5 percent cut, according to Heidi R. Nelson, CEO. Duffy provides medical care, mental health services and substance abuse services for people who are homeless or at great risk of homelessness.

“Fifty thousand dollars means that we will have to cut two staff members, either case managers or medical assistants,” she said. “Either that, or we have to have a loss in our budget.”

She added that the cuts will happen between June and October 1, a short period of time. “For that cut to happen over a five-month period, it feels like $100,000,” she said.

Duffy Health Center has a staff of 70 people, including 60 fulltime permanent workers. The annual budget is about $6 million.

The center also administers a rental subsidy program through the Department of Housing and Urban Development that is keeping 11 people from facing homelessness. The program is expected to face cuts because of the sequestration, a prospect that Ms. Nelson calls “frightening.”

“We have four contracts that amount to $200,000,” she said. “What they have done already is to give us a contract through July. If all this continues past July, we will have a shortfall and we will have to decide what to do.”

Turning people out of their housing is an “unacceptable” outcome, she said.

In a glimmer of good news, Ms. Nelson was told that programs that serve homeless people under the Substance Abuse and Mental Health Services Administration would not be impacted by the cuts. Duffy received a grant of $750,000 through the program, she said.

The Community Health Center of Cape Cod completed a $9.25 million addition on its original Mashpee building on November 1, an addition that has increased its costs.

“With the big new building, there are added electricity costs,” said Ms. Gardner. “The snow removal bill just came in, and I won’t say what it was, but this winter is crazy.”

Both Ms. Gardner and Ms. Nelson say they are communicating with the state’s congressional delegation to urge a fix to the budget problem. By coincidence, the National Health Care for the Homeless Conference begins Wednesday in Washington, DC, and the National Associations of Community Health Centers is holding its annual conference beginning March 20, also in Washington. Ms. Nelson said she and others plan to go to Capitol Hill to lobby lawmakers during the conferences.

As troublesome as the sequester is, the prospect of a government shutdown, just weeks away, is even worse. Congress is in the midst of negotiating a bill that would keep government operating after March 27, when funding runs out.

“If the government shuts down and they don’t pay us, it would be pretty critical,” she said.

The mission of Duffy Health Center is to prevent and reduce homelessness on Cape Cod through community collaborations and the provision of integrated medical, behavioral health, case management and housing services to persons who are homeless or at risk of homelessness.