Some health care programs in Spokane left in limbo amid federal spending bill

The Children’s Health Insurance Program was the big winner in the federal spending bill passed Monday, but several less-well known community health programs are still in limbo without permanent funding.

Community health centers, like the Community Health Association of Spokane, and Spokane’s Teaching Health Clinic, which offers medical residency slots, are among the programs whose funding is in jeopardy.

Neither program has had permanent federal funding since Sept. 30. Instead, they’ve been getting by on month-to-month payments authorized under temporary spending bills.

At CHAS, federal funds make up about 10 to 12 percent of the organization’s revenue. The organization has expanded dramatically following the passage of the Affordable Care Act, with 12 locations in Eastern Washington and Idaho.

Two new Spokane clinics are in the works, CEO Aaron Wilson said, but those plans have been put on hold until the federal funding is resolved.

“It’s really impacting more strategic development at this juncture, not knowing whether we will have funding beyond March,” he said.

Federal funds help CHAS offset the cost of caring for patients without insurance, who made up 12 percent of their total patients in 2016. In total, CHAS saw more than 65,000 patients that year, according to its annual report.

Community health centers around the U.S. pushed for permanent funding to be extended along with CHIP, but were left with nothing besides the month-to-month payments they’ve been getting. The spending bill included $1.48 billion to fund those payments.

“Really, it’s the same situation, just the ball got punted for three weeks,” Wilson said.

Spokane’s Teaching Health Clinic trains 80 medical residents in family medicine, internal medicine and psychiatry.

Eighteen of those slots are funded through federal dollars as part of the teaching health clinic program, which was created under the Affordable Care Act. The goal is to expand the number of doctors in rural and underserved areas by creating new residency slots, since residents tend to practice where they train.

Right now, the Spokane center is getting the equivalent of $81,000 per year per resident, which isn’t enough to cover actual costs, said Jim Zimmerman, the vice Dean of Administration, Accreditation and Finance at Washington State University’s Elson S. Floyd College of Medicine.

They’re hoping a reauthorization would raise that amount to $157,000 so the teaching health center can stop dipping into reserve funding to pay for residents. If that funding isn’t approved, 18 medical residents would be in jeopardy.

“Without the teaching health center funds, it would be very difficult to carry forward,” Zimmerman said.

The center is currently interviewing residents for the coming year and needs to have funding to lock those slots in, said Elaine Couture, chief executive for Providence Health and Services in Washington and Montana.

“We applaud continuing efforts by Rep. Cathy McMorris Rodgers to extend this vital program, and urge Congress to act quickly to continue funding,” Couture said.

Long-term funding for both programs was part of a CHIP reauthorization bill that passed the House in November, with support from McMorris Rodgers. But the Senate did not consider the bill, which Democrats opposed because of other funding cuts and revenue-generating measures it included.

Jared Powell, a spokesman for the Congresswoman, said she intends to continue pushing for reauthorizations for both programs to be included in the next spending bill Congress will consider once the one passed this week expires in three weeks.

“There is broad bipartisan support for both of these programs,” he said.

Senator Patty Murray also tweeted her support for funding both programs Tuesday, writing, “There’s no excuse for leaving families wondering whether their local health center will shut its doors, or leaving medical residents who want to help underserved communities in limbo.”

A smaller program that funds the Spokane Regional Health District’s nurse-family partnership also needs to be reauthorized.

That program, called Maternal, Infant and Early Childhood Home Visiting Program, provides grants for programs like Spokane’s that give first-time pregnant women and new mothers one-on-one home visits with nurses.

That funding expires at the end of the fiscal year, and could lead to the health district laying off nurses.

“At this point we’re continuing to employ the nurses with the hope we’ll continue to receive that funding,” said Sue Schultz, the program’s director.