Health Center Federal Policy

Fiscal Year 2015 Spending Deal Reached – What Does it Mean for Health Centers?

by NACHC Federal Affairs Team

Tuesday night, with the Thursday deadline to avert a government shutdown looming, Congressional negotiators came to an agreement on a final spending plan for Fiscal Year 2015. The legislation, known on the Hill as the “CRomnibus,” (a combination of “CR”, short for “Continuing Resolution” and “Omnibus”) has been negotiated over several weeks by a bipartisan group of House and Senate appropriators, and includes 11 of the 12 annual appropriations bills including the Labor, Health and Human Services (LHHS) spending bill.  Only the Homeland Security bill is put on a shorter timeline, setting up a clash over immigration policy early in the New Year.

What does the bill include for Health Centers?

The LHHS spending bill for FY2015 in the package includes a total program level of $5.1 billion in funding for the Health Centers program – $1.5 billion in discretionary funding and $3.6 billion in mandatory funding through the Health Center Fund. This funding level, which would make available an additional $1.4 billion beyond what was spent on Health Centers in FY2014 is in line the NACHC FY2015 appropriations request to allow for full access to the final year of funding through the Health Center Fund.

How will this money be spent?

As in previous spending bills, the appropriations committee outlined in the text of the legislation how Congress would like a portion of the $1.4 billion increase allocated. The legislation states of the $1.4 billion increase in funding:

  • No less than $165 million for base grant adjustments
  • No less than $350 million to support: new access points including approved and unfunded applications for fiscal year 2014, grants to expand medical services, behavioral health, oral health, pharmacy, and vision services
  • Up to $150 million for construction and capital improvements

The Health Services and Resources Administration (HRSA) has been able to access the FY2015 funding under the Health Center Fund since September 30, 2014. To date, they have allocated FY15 funding in a couple of areas for Health Centers. Tuesday, HRSA awarded $36.3 million in quality improvement awards to 1,113 health centers and in November awarded $51.3 million in funding to establish or expand behavioral health services at 210 health centers. If the CRomnibus passes, we anticipate we will see additional funding awarded in the specific areas outlined by Congress – NACHC will be working closely with the administration on a plan for how the additional resources are allocated.

Does this bill “fix the cliff”?

No. As previously noted, the increase in funding in the legislation represents the final year of the mandatory Health Center Fund. This legislation does not address the impending Health Center Funding Cliff which will occur unless Congress Acts before September 30, 2015. Despite a major push, Congress did not address the longer-term funding shortfall still facing Health Centers, the National Health Service Corps, and Teaching Health Centers. In fact, all long-term health issues, including a physician payment fix, CHIP reauthorization, and others, were taken off the table for action before year’s end. NACHC and health center advocates will have to push harder and louder than ever next year to ensure the sustainability of both new and existing resources.

What’s the timeline for this bill to pass?

It is anticipated the bill will be on the floor for debate tomorrow. Since the government will shut down if not funded by Thursday at midnight, it is expected the House will simultaneously file and pass (with Senate support) a very short 2-3 day extension of funding through a CR to give the Senate time to work through their process if they consider the CRomnibus. As with all legislation, it’s not over ‘til it’s over, so we’ll be following this closely and posting any updates to the blog.

The full NACHC press release on the legislation can be viewed here.