Last week, Congress was able to pass a continuing resolution (CR) to extend federal funding until December 9th. After weeks of negotiating and one failed attempt to bring the measure up for a vote in the Senate, the legislation was finally signed into law by President Obama after Republicans broke the logjam by agreeing to address the Democrats request to provide funding assistance to Flint, MI when Congress comes back for the lame duck session after the election.
The CR provides continued funding for federal operations until December 9th at existing levels, but there is a 0.5% across the board cut to all programs to comply with the Fiscal Year 2017 budget caps as funding levels need to adhere to the spending caps from the agreement signed in 2015. For health centers, when applied to the $1.5 billion in discretionary funding for the program, that equates to a $7.5 million funding reduction.
In addition to extending federal funding, the CR also includes several other funding provisions including $37 million in funding for the implementation of grant programs in the recently passed opioid addition legislation known as CARA or the Comprehensive Addiction and Recovery Act, $500 million in emergency supplemental funding for disaster response efforts to flooding in Louisiana and other states, and $1.1 billion in supplemental funding for activities related to the Zika virus.
The Zika funding debate was resolved 233 days after President Obama first requested funding to address the Zika virus. Of the $1.1 billion in funding provided by Congress, $40 million will be directed to health centers in Puerto Rico and the territories, $6 million for National Health Service Corps (NHSC) in Puerto Rico and the territories and $20 million for Maternal and Child Health special projects of regional and national significance (SPRANS) in Puerto Rico and the territories. The remaining funding is allocated to Zika-related efforts at the Centers for Disease Control and Prevention (CDC), vaccine development and research at the National Institutes of Health (NIH), vaccine development and diagnostics at the Biomedical Advanced Research and Development Authority (BARDA) and for Zika-related activities globally at the State Department and USAID. Overall, a positive end result for health centers and other health care providers on the front lines of caring for individuals infected by the Zika virus and for those at risk of infection. That being said, given what we continue to learn about the virus and its potential effect on unborn children of Zika-infected mothers, it is likely that we will continue to follow this issue closely over the coming weeks, months and years.
Congress will return after the election and they will quickly need to work to either pass another CR or a longer term funding bill by December 9th. At that time, the landscape will be changed due to the elections and it is unclear how they will choose to proceed. For health centers, a long term funding bill such as an omnibus as opposed to short term CRs is the best outcome in terms of stability in a year when we will be facing another funding cliff. Once the election is settled and Congress returns, we will be working on the Hill to ensure health center funding in FY2017 remains a priority.
PLEASE consider supplementing your response to the HRSA proposed compliance manual. In the current political climate HRSA should consider being out front in decreasing regulatory issues and placing more control in the hands of community Board of Directors. If HRSA did so, and emphasized the world “Community” in its dealings with Congress and the new administration, it is highly possible the help center program would be front and center as a leader in the de-regulation movement. We serve millions and millions of patients. We need to put that fact first in convincing HRSA to take the lead in the movement to make the word “Community” a meaningful and real word with real world consequences for the health center program. My concern is that if HRSA does not do so, and begin now to do so, the health center program will suffer – and our patients will suffer even more.
Now is the time for NACHC to lead the way and let HRSA officials know that the political landscape has changed, and for the sake of the program and our patients, HRSA should proactively lead a de-regulatory process before the new administration does it for them. Let’s strengthen our program by leading the effort for health centers to be businesses and seen as businesses that take care of people. Everyone wins if we do so. Our centers and our patients will suffer if we do not.