Opinion: Lack of funding threatens health care

Optimus Health Care’s adult care clinic on Barnum Avenue, in Bridgeport.

Optimus Health Care’s adult care clinic on Barnum Avenue, in Bridgeport.

Ned Gerard, Staff Photographer / Hearst Connecticut Media

Nuliva Montilla’s opinion piece, “Expand health coverage for immigrant communities,” published Jan. 19, expressing her disappointment, frustration and concern with her inability to access care when she needed it, is a growing problem not only for immigrants but for all individuals in Connecticut who rely on Federally Qualified Health Centers for health care. In fact, the inability to access timely, essential health care at Connecticut FQHCs is causing a significant health care crisis for individuals living in historically marginalized communities in Connecticut that will continue to worsen without much-needed Medicaid rate increases for FQHCs.

FQHCs provide comprehensive primary health care, including medical, dental and behavioral health services, and some specialty services, regardless of one’s ability to pay. FQHCs also provide critical wrap-around services to assist their patients in overcoming barriers that impede a patient’s ability to access health care. Such barriers include financial, housing and food instability, lack of reliable transportation and translation needs. Despite FQHC’s efforts to reduce such barriers for patients, FQHCs are now finding it necessary to reduce the very services their patients desperately need.

Connecticut FQHCs are struggling financially. Since 2001, FQHCs have not received an increase in their Medicaid rates that cover actual costs. Rather, FQHCs receive an annual Medicare Economic Index adjustment that is far lower than the rate of inflation. While inflation as of December 2022 is 6.5 percent, Connecticut FQHCs received only a 2.1 percent MEI increase in October. Such a negligible increase is simply unjust given the rising costs of staffing, equipment and supplies, and maintaining and improving building infrastructure experienced most acutely by health centers with incredibly narrow or negative operating margins. Connecticut FQHCs, once stable, reliable and affordable health care options for thousands of Connecticut’s most vulnerable residents, have been forced to curtail services by reducing the number of locations they operate, shortening their hours of operation and decreasing the number of programs they provide in order to remain financially viable.

One of the results of reducing services is unacceptably long wait times (weeks or months) for an appointment, placing the health of individuals who rely on FQHCs for health care at significant risk. FQHC patients who are largely uninsured or underinsured have very few affordable health care options. Without FQHC safety net providers, patients will be compelled to forego health care until their condition is dire and they are forced to seek more expensive urgent or emergent care at hospitals. For individuals living in marginalized communities and the growing number of immigrants coming to Connecticut, this all-too-common scenario not only threatens the health, continuity, and quality of care they receive but reduces health outcomes, further widening the health disparities gap the current state administration committed to addressing.

Connecticut FQHCs desperately need their Medicaid rates increased to halt the erosion of essential comprehensive health care services provided by FQHCs. It is imperative that Gov. Lamont and the Connecticut Department of Social Services, the agency that administers the Medicaid program, prioritize rate increases for FQHCs to ensure their viability. The Community Health Center Association of Connecticut’s 16 FQHCs — Charter Oak Health Center, Southwest Community Health Center, Community Health & Wellness Center of Greater Torrington, United Community and Family Services, Fair Haven Community Health Care, InterCommunity, CIFC Health, Norwalk Community Health Center, Generations Family Health Center, Optimus Health Care, Community Health Services, First Choice Health Center, Cornell Scott-Hill Health Corporation, StayWell Health Center, Family Centers and Wheeler Clinic — are united in this effort.

Without proper funding, FQHCs simply will not be able to provide the thousands of Connecticut residents who now utilize FQHCs with accessible, affordable and quality health care and will significantly slow efforts to narrow the health disparities gap in Connecticut.

Karen Daley is CEO of Optimus Health Care in Bridgeport. Nichelle Mullins is President/CEO of Charter Oak Health Care in Hartford. Katherine Yacavone is Interim CEO of the Community Health Center Association of Connecticut.