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Missoula's Partnership Health Center facing uncertain federal funding

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MISSOULA - Missoula’s Partnership Health Center is one of 1,400 community health centers across the country that went off a funding cliff at the end of September when Congress failed to reauthorize the Community Health Center Fund that has received bipartisan support for over 50 years.

According to the Montana Primary Care Association, Partnership served over 15,000 patients in 2016.

Besides direct federal funding, there is a battery of healthcare support funding that remains in jeopardy, which could impact the ability of health centers to deliver care.

Community health centers have a long legacy of serving people with limited access to healthcare.

“They started in the 60’s, during the War on Poverty. There are now almost 1,400 nationwide," said Partnership Health Center Executive Director Laurie Francis. "We’re one of those and one of 17 in the state of Montana."

MPCA reports that community health centers have been growing in Montana for the past four years. In 2016, they served 10% of the state’s population -- over 100,000 people.

They say 85% of their patients are low-income, but they are able to obtain care because of the 19 requirements which mandate that community health centers provide a spectrum of care to their patients and receive payment based on an income-driven sliding fee scale.

“Health centers were set up to help people who have a tough time affording care, and a difficult life in this country," Francis said. "Typically they are people with minimal income, sometimes with a lower educational level, often unemployed or underemployed.”

Francis told MTN News that if the program is not re-authorized -- which accounts for 70% of the federal funding they receive -- MPCA will cut about 10% of their budget effective at the end of May 2018 when their grant year comes up.

She says they are big enough to be able to maintain their services, but they are looking at ways to save money and would likely limit expansions they would have made.

Statewide, the picture is not so resilient.

“When we run through the numbers for the whole state of Montana, upwards of 27,000 Montanans could lose access to services,” said MPCA Communications Manager Stacey Anderson.

She says Partnership can make adjustments, but other smaller health centers don’t have that luxury.

“I mean, they are operating with 500 patients a year, not 15,000 patients a year," Anderson said. "And that is where the Community Health Center fund has been so instrumental in getting healthcare to rural Montana.”

Another fund that provided medical professionals to deliver this care also recently expired. The National Health Service Corps. pays recent medical school graduates student loans so they can take a pay cut to work in rural areas like Montana.

“I work with people in need, and is kind of really where my passion is at," said Ryan Boswell, a dentist working at Partnership with aid from the scholarship program. "The National Health Service Corps. essentially helps me afford to be able to do something like that."

Close to a dozen doctors and dentists work at Partnership because of the Corps.

Health centers -- in order to meet their 19 requirements -- also have to provide a wide range of services, and they serve every patient that comes in the door. When patients do not have insurance, are on Medicaid or cannot pay full price for services, federal funding makes up the difference.

“There is also cuts embedded in the Medicaid program that will directly impact community health centers," Anderson said. "People forget that we are a business. Not all of our funding comes from the Community Health Center program, it really depends on how big or small or how rural or urban you are. We actually do a ton of third-party billing."

Congress’ recent failure to reauthorize Child Health Insurance Program (CHIP) was just another hit that health centers will have to absorb if they cannot pass the bill currently headed to the US Senate to reauthorize it.

“Kids who are on CHIP, they come from lower-income families with fewer means," said Partnership’s Medical Director Dr. John Miller. "Some of them have pretty significant health problems and they rely on coverage to be able to get the health care they need. So, I was thinking of like, a six-year-old, who has asthma, and their family has to decide between housing, food (and) medications. How does a family make a decision like that?”

According to the Montana Budget and Policy Center, CHIP supports healthcare for over 23,000 kids in Montana.

A bill cleared the US House of Representatives last Friday to extend funding for community health centers and programs that support their doctors, as well as other programs. The bill, called the Champion Act, is on its way to the Senate for consideration.

But, because of funding offsets also written into the bill, health center advocates don’t expect it to get the bipartisan vote it needs to pass.

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