Johnson Health Center in Lynchburg, Va., funds 15% of its budget from federal grants, helping to pay for such community work as managing chronic care and helping patients find resources that can address their social needs.
That percentage translates to more than $3 million of Johnson Health’s $20 million annual budget coming from federal grants, largely through the Section 330 program. Part of the Public Health Service Act, Section 330 authorizes grant awards to federally qualified health centers and sets eligibility requirements for grants.
“We are really heavily engaged with our patient population on programs that don’t bring in any revenue, but touch the patient,” CEO Gary Campbell said.
Procuring a major share of that grant funding has become an increasingly daunting task. “The difficulty for us is that every couple of years we have to allocate a lot of advocacy work toward maintaining our funding,” Campbell said.
That’s because the largest share of Johnson Health’s federal grant funding comes from the Community Health Center Fund; the CHCF program was created by the Affordable Care Act in 2010 and awards grants to community health centers whose patients come from medically underserved populations. The vast majority of the more than 1,400 community health centers throughout the country are in a similar position of not knowing if and how much of that federal grant money will be awarded.
Though the fund has historically enjoyed bipartisan support, efforts to renew its funding before the program expires have run into some challenges. For the past two reauthorization cycles, partisan debates over more contentious policy issues have turned the CHCF program into a political bargaining chip that led to funding being passed either at the last minute or months after it expired, the latter known as going off the fiscal cliff.
The fund is once again set to expire in September. But this time advocates say lawmakers are giving them hope there won’t be a repeat of 2017’s delayed reauthorization process, but that instead more-stable, longer-term funding will be approved.
A House Energy and Commerce subcommittee this month voted to move forward on the Community Health Investment, Modernization, and Excellence Act, which would provide four years of CHCF funding. A Senate version of the bill was introduced in January by Sens. Roy Blunt (R–Mo.) and Debbie Stabenow (D–Mich.). And in late June, the Senate Health, Education, Labor and Pensions Committee passed the Lower Health Care Costs Act, which included a proposal to extend CHCF funding from two years to five years.
“We’ve had five, now six, different bills introduced with long-term extensions of our funding,” said Jennifer Taylor, director of federal affairs for the National Association of Community Health Centers. “That is very different from where we were in that last funding-cliff authorization.”
“This year right out the gate people were really rushing to be able to offer proposals to get on the record early in favor of doing this,” she added. “There is a real good-faith show of support from all sides here that they would like to avoid going over the cliff.”
Initially designed to help community health centers invest in expanding services and health sites, the CHCF has increasingly been used to cover daily operational expenses. An analysis published in early July by the Government Accountability Office found nearly 80% of the $15.8 billion in grants funded by the CHCF from 2011 through 2017 went toward supporting ongoing operations and services, while only $3.2 billion of the grants were awarded for projects to increase services.