Funding for community health centers uncertain amid continuing resolutions

Community health centers are nonprofit, community-driven clinics that provide primary and preventive care to all individuals, regardless of their insurance status or ability to pay. Health centers are located in low-income urban and rural areas across the nation and attempt to provide affordable health care to individuals.

"Community health centers are really like a safety net health care provider," Jody Link, director of policy and communications for Community HealthCare Association of the Dakotas, said. "... It's a way to guarantee that everyone has access to health care, regardless if you live in a rural community or regardless if you have insurance or not or whether you're able to pay or not."

There are 20 CHAD sites in 18 communities in North Dakota. In 2016, Link said community health centers in North Dakota served around 40,000 people.

The health centers receive federal funding that enables them to provide care. Link said that CHC's are not entirely federally funded, but it is a "significant" source. That federal funding expired on Sept. 30, 2017.

"The health centers have just kind of gone month-by-month with this uncertainty of whether or not they will have funding," she said.

The continuing resolution passed in December reauthorized funds for the program until the end of March, but Link said it made it challenging for centers to do long-term planning.

The latest House spending bill, which was passed on Tuesday, Feb. 6, extends funding for the centers for two years through the Community Health Center Fund. It is awaiting a Senate vote, but funding for the program has received bipartisan support.

North Dakota U.S. Sens. Heidi Heitkamp and John Hoeven sent a letter along with 64 other senators calling on Senate leadership to immediately extend funding for community health centers earlier this week.

"CHCs provide an important health care option for communities across our state," Republican Hoeven said in a statement. "This affordable and accessible health care is especially important for low-income households, helping to stave off preventable diseases and improving our quality of life. Extending this funding enjoys broad, bipartisan support, and we urge the Senate leaders to move forward on this priority immediately."

According to the Health Resources and Services Administration, in 2015, community health centers employed nearly 190,000 people across the country and served more than 24 million patients. One in 13 people nationwide rely on a CHC for their health care needs.

"I've long fought to protect access to affordable health care for our communities, and federal support is critical to helping these facilities continue to serve those in rural communities," Democrat Heitkamp said in a statement. "I'll keep fighting for a bipartisan compromise to make sure rural health centers and the North Dakotans who rely on them are supported as we continue to debate the budget."

Link said if funding for the CHCs is not included in the next continuing resolution, they will have to continue going month-by-month, which could eventually lead to the closure of some centers.

"If those funds are not reauthorized and reauthorized soon, health centers will be in a position where they have to make some difficult decisions, and that's the real challenge," she said.

Darrold Bertsch, CEO of Sakakawea Medical Center and Coal Country Community Health Center, said although the continuing resolution did provide funding for a limited amount of time, he hopes Congress will pass a bill that will give CHCs certainty for a longer period of time.

"As the saying goes, we hope they will stop 'kicking the can down the road' and do a more permanent budget fix," he said.

Coal Country has multiple community health center sites in western North Dakota, including one in Killdeer.

Even amid all of the uncertainty, Link said providers at the health centers are "doing everything possible" to make sure they are providing services to "those who need it most."

Link said she is "very encouraged" by the House bill and the support of the Senate. The Senate may vote on the bill on Thursday, Feb. 8.

"I'm feeling very confident that this week will be our week," she said.