California health clinics risk losing hundreds of millions if Congress doesn’t act

Angel Lara gets a tetanus vaccine after his appointment.
Angel Lara gets a tetanus vaccine after his appointment.
Michelle Faust/KPCC

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Congress has a Saturday deadline to renew a federal program that funds community health clinics. If it fails to act, it will endanger more than $600 million for clinics in California, forcing many to consider cutbacks in their services.

The Community Health Innovation, Modernization and Excellence Act was introduced with bipartisan support in the House of Representatives earlier this month, but it has failed to move forward despite a Sept. 30 deadline.

If Congress misses the deadline, clinic funding distributed by the U.S. Health Resources and Services Administration would be reduced by 70 percent. The federal department says it hasn't determined how much of the $207 million in grant funding for clinics in Los Angeles, Orange, Riverside, San Bernardino, and Ventura counties would be cut.

Sitting in a conference room at the San Fernando Health Center, Northeast Valley Health Corporation CEO Kim Wyard says she worries about how a loss of federal dollars would affect the 70,000 patients who use this clinic and the 13 others run by Northeast Valley Health.

"Some of our health centers are devoted to serving the homeless, others are devoted to serving patients who are HIV positive, and others are in high risk schools," she says.

As part of an effort to keep people from going to emergency rooms for their primary care, the Affordable Care Act provided clinics with additional funds. Northeast Valley Health used its share to add staff and clinic space.

"We’ve been on an expansion track, because the demand was higher than we could meet with our current capacity," Wyard says.

That expansion could end quickly if Congress fails to act, she says, estimating that her clinics could lose a total of about $8 million. That’s less than 10 percent of Northeast Valley Health's total budget, but it would still be a big blow, says Wyard.

"We would be looking at something like between a 5 and 9 percent cut to staffing here at Northeast Valley Health Corporation in order to come up with that kind of savings," she says.

Cuts would also mean less capacity to treat patients, says Wyard. Without federal dollars, the 14 clinics would likely be able to see 10 percent fewer patients a year—about 7,000 people.

Angel Lara is among those hoping Congress comes through. The 58-year-old from Sylmar does maintenance on apartment buildings. He got coverage under Obamacare's expansion of Medi-Cal, and has been coming to the San Fernando clinic for a year.

Lara came to the clinic on a recent day to get the result of his latest blood test. The details of the test are critical to his health, because earlier this year his doctor told him he was prediabetic.

"The doctor told me to lower my [blood] sugar," he says. "When she said prediabetic, I got a little worried."

Results like Lara’s are not uncommon in this majority Latino, working class community. The region has high rates of diabetes.

Clinic doctor Allison Campos, who grew up nearby, is familiar with the problem. She says she sees the consequences of people who’ve gone years without regular medical attention.

"Sometimes, they come to us newly and they’ve had diabetes for 20 years, for example. Unfortunately, that’s when we start to see permanent damage in the body," she says.

Dr. Allison Campos practices family medicine at the Northeast Valley Health Corporation's San Fernando Health Center, near where she grew up.
Dr. Allison Campos practices family medicine at the Northeast Valley Health Corporation's San Fernando Health Center, near where she grew up.
Michelle Faust/KPCC

Campos believes the center’s expansion in recent years has helped many people avoid further complications.

"We have nutritionists. We have a clinical pharmacist—who is amazing—and we really go out of our way to try and provide the most comprehensive type of care that we can," she says.

CEO Wyard says those services could be on the chopping block if Congress doesn't renew clinic funding. A cut in federal support would also have a ripple effect beyond her chain of clinics, she says.

"It would not only impact Northeast Valley, but it would impact 12 other health centers across L.A. County" that provide health care for the homeless with funding Northeast Valley gives them out of its federal grant, says Wyard.

The San Fernando clinic is just one of more than 350 in L.A. County that are waiting to hear whether Congress will renew their federal funding.

Angel Lara also hopes the money comes through. He says he doesn't have a backup plan if it becomes harder to get an appointment at the San Fernando clinic.  Lara says his health is more important to him than ever and he’s making efforts to eat better and exercise, but seeing his medical provider is just as important to him.

As Nurse Practitioner Cristina Kim explains the results of his blood test, Lara learns his hard work has paid off. His blood sugar is lower, and he’s not diabetic. But Kim says she still wants him to exercise more and cut back on fatty foods.

Clinic staff say cases like Lara’s illustrate how federal support helps more people get the health care they need. And with the latest effort to repeal Obamacare dead, they’re hoping Congress will now turn its attention to renewing funding for community clinics.