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What Connecticut can learn from New York about community health

The state relied on community health centers like never before during the COVID-19 pandemic. Now, the centers are advocating for more federal funding to continue their work.
Lynne Sladky
/
AP
The state relied on community health centers like never before during the COVID-19 pandemic. Now, the centers are advocating for more federal funding to continue their work.

Over 250 community health centers provide a wide range of healthcare to hundreds of thousands of Connecticut residents a year who otherwise might not have access to medical services.

“We offer medical, dental, behavioral health, substance abuse, and pharmacy,” said Don Thompson, CEO of StayWell Health in Waterbury. “And we take care of approximately 417,000 patients, which is 11% of the population in the state of Connecticut. 25% of our patients are the title 19 population.”

But the health centers now grapple with significant underfunding, which has impacted patient care and led to staff shortages.

These centers rely on government funding to remain open — but their Medicaid payments are based on a formula developed from the cost of healthcare in 2001.

Karen Daley, CEO of Optimus Health Care, Inc., which has 30 sites throughout Bridgeport, Stratford, Milford, and Stanford, said the company is considering closing some locations.

“With the increase in inflation, and the increase in the cost of services, such as our staffing, supplies, and the ability to maintain our infrastructure and our buildings, we are starting to pare back on our services, because that's the only way we can remain viable,” Daley said.

Daley said retaining staff has been difficult because big hospitals have better pay and benefits to offer.

“When your staff is feeling the impact of inflation on their own personal finances, they're going to look to their employer to hopefully raise their salaries,” Daley said. “That has not been possible for us to do this year.”

She said the cost of healthcare continues to rise, specifically since COVID-19.

“The cost of goods certainly has gone up since the pandemic exponentially,” Daley said. “And the other aspect is, you know, trying to maintain, if not improve the infrastructure of our buildings because, you know, we just need to be able to have a health center that's inviting, and that's modern and has the latest technology.”

Shortcomings in Connecticut have led community health leaders to seek guidance from other states, like New York.

“They're recognizing that community health centers have a number of costs that are not being covered within the existing rates,” said Sabrina Trocchi, CEO of the Wheeler Clinic in Connecticut.

Trocchi said community health centers in New York have worked with their state and its Medicare agencies in a way that Connecticut centers have not been able to.

“So things like keeping facilities up to date and having the state-of-the-art equipment to serve our most neediest, or their most neediest patients, recognizing that salaries and benefits needed to be increased in order to be able to have a workforce that is qualified and ready and available to meet the community needs,” Trocchi said.

Now, they’re hoping that Governor Ned Lamont can follow Governor Kathy Hochul in finding a way to support the centers with the state’s over $1 billion surplus. Or leveraging federal coronavirus relief funding, before it expires in the 2023-24 fiscal year.

U.S. Senator Kirsten Gillibrand of New York rallied to use those funds last September. New York City used $35 million to establish a public health corps with more than 500 community health workers.

“I was proud to successfully negotiate the inclusion of key community health force provisions of this bill into the American Rescue Plan,” Gillibrand said. “By providing $3 billion to establish a new national public health workforce based on my health force legislation, the American Rescue Plan is helping to strengthen our public health infrastructure and aid our country's vaccine distribution campaigns.”

Trocchi said the first thing Connecticut needs to do is raise its rates.

“It is unacceptable for us to be paid at a rate that was established in 2001, based on what has changed, and based on what we need to pay our staff in order to be able to keep them and in order to recruit additional staff,” Trocci said.

A bill proposed in Connecticut by state Rep. Jaime Foster (D-East Windsor) would raise the rates and find job opportunities for individual community health workers, known as CHWs, but not centers.

“I think sometimes policy progress and scientific progress is incongruous, sometimes science is way advanced ahead of what we're doing policy-wise,” Foster said. “And sometimes it's the other way around. But here, I think the cost savings of CHWs in the health care system, and the benefits to the population of having a CHW are really strong.”

Thompson, of StayWell Health, said they have made some headway to get rate increases for the centers, but are also challenged by a government that is trying to save money.

“The reality is the Department of Social Services has to approve this,” Thompson said. “And in the past, they have not approved what we call changes of scope when you're adding on a service or a new site. And I can understand the reasoning. They're trying to keep their expenses down too.”

Without more funding, they warn that the state’s two largest hospital systems, Hartford Healthcare and Yale New Haven Health, will continue to gobble up their local centers — and their staffing.

That will also be difficult for uninsured and residents without access to preventative healthcare.

Molly is a reporter covering Connecticut. She also produces Long Story Short, a podcast exploring public policy issues across Connecticut.