Local federally qualified health centers have been forced to cut staff and services because they have not received any money from the state’s uncompensated care fund since December.
The fund ran out of money then, in the middle of the fiscal year.
And with the start of the new fiscal year, the state is proposing that health centers wait another six months before receiving any more money.
Morton Comprehensive Health Services CEO John Silva said it is a serious financial issue for the centers.
“This could potentially be a death blow,” he said. “And there’s no other place to go.”
Morton has been losing out on about $200,000 a month since the fund stopped paying, he said.
Community Health Connection CEO Jim McCarthy said it has had similar struggles.
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The fund itself has shrunk. In fiscal year 2014, the Legislature appropriated $3.1 million. For fiscal year 2015, it has appropriated $2.5 million. That is a cut of more than 18 percent, said John Giles, director of the Center of Health Innovation and Effectiveness with the Oklahoma State Department of Health.
“It’s not a good situation for anybody,” he said.
The fund ran out last year because there have been more federally qualified health centers and satellite sites, and the cost of health care in general and the number of uninsured has been rising, he said.
The state has proposed to switch from monthly payouts to quarterly payouts and to delay releasing funds until January to create some stability, he said.
“We felt that we kind of needed to build some sustainability for the fund,” he said.
In a conference call Thursday, leaders of the centers were unhappy with the idea of waiting until January, so state employees promised to work on trying to release funds sooner, he said.
“We know there’s a need,” he said. “Clearly there’s a need.”
It is likely that the centers will receive only a percentage of their requests when the funds do start flowing again, he said.
“That’s just the reality when you have not much money and a lot of uncompensated care,” he said.
Silva said the delay was unconscionable.
“No payment until January is just absurd,” he said. “I don’t care how you couch it.”
The center has been forced to make layoffs and has notified contractors that they no longer will be able to use their services. It is working to make sure no services are changed and patients don’t notice the cutbacks, he said.
“It’s becoming a crisis,” he said.
McCarthy said Community Health Connection has had to cut its behavioral health services and also has had to cut staff.
The cost for uncompensated care at the center is more than $1 million a year, but it anticipates receiving about $300,000 this fiscal year, he said.
Decisions have been made at the state level without input for the health centers and the state doesn’t seem to have a sense of urgency, he said.
The federal government sees it as a state issue, and there is no mechanism for funding from local governments, he said.
“We are now cutting personnel, cutting services and trying to see where there might be alternate sources of income, which is mostly donations,” he said.
The state is not recognizing that preventive care offered by the health centers is the least expensive and most cost-effective form of care, he said.
“We are in a very difficult and untenable position,” he said.
