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Health center funding shrinks

Health centers across America are at a crossroad, where the future is obscured as legislators hash out the details of the impending national health care reform. But one thing is clear, health centers are expected to double their patient load by 2015, according to the National Association of Community Health Centers.

"We don't know what exactly is going to be next," said Patricia Talbot, chief executive officer of the Sonoma Valley Community Health Center. "It causes us quite a bit of anxiety."

Clinics such as the Sonoma Valley Community Health Center are already feeling the pressure. At a time when the demand for sevice has increased exponentially as more residents lose their jobs and employer health insurance, the centers are watching their funding cut on the federal, state and local level.

Susan Torrez, chief financial officer at the center, said that the number of patient visits the clinic has seen has increased by 6,000 to 7,000 visits a year in the past few years, putting immense pressure on the center to boost the number of services it provides. At the same time, funding on every level has been pulled back, making it increasingly difficult to maintain a balanced budget.

It began with the California state budget crisis three years ago, when Medi-Cal started delaying payments. Then the state grants began to dry up. "We were getting, at one point between three grants, approximately $215,000 a year," Torrez said, adding that in 2010, the center had one state grant worth $25,000.

Then changes came at the county level two years ago. Sonoma County used to allot $20,000 a year for the center to staff walk-in immunization clinics twice a week, where patients can get anything from the vaccines infants need to tetanus booster shots.

"We had to pull back our immunization clinics, which is wrong because it's the right thing to do," Talbot said, adding that the clinic can only be offered once a week on Tuesdays now, treating a no more than 10 families a day. "We can't get everybody in who needs us. People get upset, they don't understand we can only do so much with the money we've got."

This year, the health center saw added pressure to provide immunization due to a new state law that required every student from seventh to 12th grade to get vaccinated against pertussis. Talbot said the state provided the vaccines for free, but the center had to cover staffing and equipment costs such as syringes. 

"All the other costs are ours," she said. "We actually did a pertussis clinic before school, all at our own costs. We still feel it's the right thing to do."

The final financial blow came this year from the federal government. In order to deal with the increased demand for services, legislatures allotted grants for community health centers, with the Sonoma Valley Community Health Center slated to receive a grant of $170,000. The facility planned to hire a case manager to work exclusively with chronically ill patients to better monitor their progress.

"We wanted to keep people out of hospitals and emergency rooms," Talbot said.

But when the mid-year budget review came up, all of that grant funding was wiped out. "We have to take that hit because we budgeted for this money," Talbot said.

But the biggest storm is brewing on the horizon, set to change the way many Americans access their health care. The national reform is already taking shape, and all indications point to the fact that health centers will see the biggest increase in patient volumes.

"There's a lot of literature that says health centers will take on the government health plan," Talbot said. New laws will require everyone to purchase health insurance, with the federal government poised to sponsor a low-cost plan that is expected to utilize health centers as the primary care facility.

"We were told by our national partners that most health centers will increase by about 45 percent (in volume)," Talbot said.

When that change will happen and how the government will handle the funding of this shift in the paradigm of health care is still being debated on the floors of the House and Senate. For now, centers can only brace themselves to handle a significantly higher load of people. The Sonoma Valley Community Health Center is making plans to expand into a new space that will be better suited to handle the flow of new patients.

"We can't get everyone in the door because we don't have enough rooms, we don't have enough providers," Talbot said. "We are actively involved in building out new facility. We have land we are working on, we're doing financial planning and we're working on a design."

The Sonoma Valley Community Health Center is located at 430 W. Napa St. and can be reached at 939-6070.