“In the wake of last year’s historically devastating wildfires, several state legislators have introduced a bill that would make it easier for community health clinics to help those affected by natural disasters.”
On February 5, 2018, community health center advocates united across the country in a “Day of Demonstration” aimed at fixing the funding cliff impacting health centers and their patients. Advocates nationwide wore red and voiced concerns to their members of Congress urging them to include health center funding in the budget package that was passed by both houses and signed by the President in the early hours of February 9th. CPCA members throughout California joined with their counterparts in all 50 states and took to social media, traditional media, held events, and put calls into Capitol Hill – showing the strength and solidarity in our movement.
I myself joined colleagues at the Capitol to meet with Congressional members and discuss with them personally what was at stake for community health centers and the communities they serve. I personally met with Congresswoman Judy Chu, Congresswoman Lucille Roybal-Allard, Congressman Tony Cardenas and Congresswoman Doris Matsui – as well as staff for Speaker Nancy Pelosi, Senator Kamala Harris, and Congressman Kevin McCarthy. Throughout our visits, the overwhelming consensus was clear – community health centers have bipartisan support and are greatly valued by all. Unfortunately, we were caught up in the political dysfunction of Washington D.C. This made it even more critical that we rise above the politics of D.C. and make our voice heard in the halls of Congress.
By all accounts we were hugely successful in our efforts, and thanks to our advocacy both chambers of Congress took appropriate action to fix the funding cliff with a two-year extension to health center funding! This is an amazing accomplishment and I want to thank all of the health center leadership, staff, advocates, board members and patients that showed up – both at the Capitol and in their communities – to help us achieve this monumental win. I would especially like to thank the health center leaders that joined me in Congressional District meetings including: Community Health Partnership, Gardner Family Health, North East Medical Services, AltaMed Health Services, and the San Francisco Community Clinic Consortium, among others.
This tremendous effort was led by the National Association of Community Health Centers (NACHC), our national organization, with the help of CPCA staff and one of our federal lobbyists Angie Melton, all of whom played a pivotal role in the overall success of the day. The greatness of the day and the importance of this fly-ins was not lost on me. We are all busy. We all have a million things to do day-to-day. But we cannot lose sight of the critical role these “Days of Action” play in pushing our agendas and promoting our issues, or the fact that our voice is louder when we all come together and advocate as one. We need to continue our efforts on issues that are important to us and the communities we serve – including immigration. While I am very pleased that Congress averted the health center funding cliff, I am deeply concerned about the future for DACA recipients. The Senate will begin their floor debate on immigration legislation next week, and I hope that the House of Representatives shows the same commitment to an open process. DREAMers are an integral part of the fabric of our communities in California – they are patients and, in some cases, employees at our health centers, and they are also our neighbors and friends.
I call on Congress to find a fair solution that allows DREAMers to continue to thrive in their lives as Americans and I hope that you will join me in doing so. We have the opportunity here and now to join together and have our voices heard on DACA. We can build on this momentum and this victory for health centers. I hope to see an even stronger delegation of advocates at NACHC’s Policy and Issues Forum in March and at our own Day at the Capitol in Sacramento in April, because we still have much to fight for!
“We are caught up in Washington’s political dysfunction,” said Carmela Castellano-Garcia, CEO of the California Primary Care Association. “These centers are a lifeline for millions of people, especially in rural areas where they may be the only health care provider for miles around.” She said the budget …
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With all that is going on at the federal level, including the potential loss of 70 percent of federal funding for health centers, it can be easy to lose sight of what is going on here in our own backyard. Our legislative leadership and our Governor have stood up for and continue to protect our immigrant community by making California a sanctuary state and enforcing protections to this population. We are indeed fortunate, especially compared to other parts of the country, considering that California’s proposed budget by Governor Brown had many positives, specifically for our patient population. The Governor remains committed to the ongoing support of vital health programs including the Child Health Insurance Program (CHIP), Medi-Cal and the Affordable Care Act (ACA) – all of which impact our patients. While we don’t take for granted how progressive our state is on many issues, we can’t stand idly by when proposals that undermine our ability to do our work and serve our patients are being considered.
Unfortunately, undermining the safety net is exactly what Governor Brown’s proposal to eliminate the 340B drug discount program from the state’s Medi-Cal program will do. 340B is a federal drug discount program intended to ensure low-income patients receive their prescription drugs at a much-reduced cost. The program also allows the health centers and other safety net providers the ability to utilize the savings (between the discount and the market price of the drug) to reinvest in patient care. The 340B program in Medi-Cal enables health centers to stretch their resources to ensure that underserved and low-income patients receive the necessary comprehensive services they need, services that are beyond the reach of the Medi-Cal program. Without this essential and critical lifeline for the safety-net, there will assuredly be some devastating impacts – ranging from a reduction in clinic hours of operation to the elimination of wrap around culturally competent medication assistance for patients, to staff layoffs.
I remain flabbergasted that this proposal is in the budget. Why would California want to undermine the safety net at this point in time? The Administration is well aware that health centers are facing a dramatic and unprecedented reduction in federal funding unless Congress reauthorizes the health center program. If the funding is not reauthorized, it will be a hit of some $240 million this year and then over $400 million in the years to come. To layer on top, another multi-million dollar hit by eliminating the 340B program from Medi-Cal simply makes no sense. Not to mention Congress’ continued focus on undermining the ACA and the Medicaid program. The safety net does not have sufficient margins or reserves to withstand such dramatic revenue losses without some dire consequences. And these consequences impact the lives of over 6 million patients that consider a community health center their medical home.
In light of this, we must remain steadfast in the protection of programs currently safeguarded as part of the budget. The continued congressional interest in dismantling the ACA was seen in the passage and signing of a Tax Reform bill that included the elimination of the individual mandate. This proposed state budget reminds us that, while the state continues to safeguard ACA coverage options, significant federal funding changes or an ACA repeal could disrupt benefits and coverage.
We must continue to fight for our patients and the programs that impact them. We are asking the Governor to reconsider his misguided elimination of the 340B program and work with health centers and other safety net providers to make the 340B program work for our state and our patients. Join me in advocating for health centers and their patients! Become a health center advocate today – click here to learn more.