Community health centers worry about budget reductions

A new economic study says that community health centers that deliver care to low-income communities are a $1.2 billion a year benefit to the state's economy that makes up for some of their cost to taxpayers.

The report, which the Community Health Network of Washington and allies paid for, grew out of their yearly frustration at sustaining public funding for health care. Its release Wednesday coincided with the colossal budget mess emerging at the state Capitol.

Community health clinics provide low-cost or subsidized medical care to people who lack health insurance or have incomes below the poverty line. But a shortfall of roughly $5 billion in the state's next two-year budget has led to spending cutbacks ordered by Gov. Chris Gregoire and could prompt reductions in spending across the board next year, including for clinics.

The report says Washington's community health network, which includes such clinics as the Sea Mar Community Health Clinics in Olympia, put about $683 million directly into communities in 2006. That included pay for 5,100 health care providers who in turn purchased taxable goods and services.

The spending was multiplied by a factor of 1.77 in the state economy, bringing the total effect to $1.2 billion, according to the analysis by consultant Dobson DaVanzo & Associates. The report said the spending added nearly $41 million to the state's tax rolls and more than $134 million to the federal treasury.

That's just one piece of the argument for retaining funding for the centers, which rely on state and local funds for much of their work, activists say.

"I think it's safe to say that the vast majority of the funding sources for community health centers are at risk in the next legislative session. We don't think they will be eliminated" but could be reduced, said Rebecca Kavoussi, director of government affairs for the Community Health Network of Washington.

The network commissioned the study along with the Washington Association of Community and Migrant Health Centers.

The centers serve about 600,000 Washington residents, many of them uninsured, and also provide a medical home for many indigent patients who have trouble being seen by private providers, even if they are covered by Medicaid, the state-federal program.

In Thurston County, Sea Mar Community Health operates a medical clinic on Olympia's west side and both a dental clinic and a mental health clinic in Tumwater. The staff of 65 sees about 10,000 unique patients a year.

The community health centers rely on Medicaid and State Children's Health Insurance Program money for 51 percent of their revenue, as well as 12 percent from the state's subsidized Basic Health Plan for the working poor, 9 percent from state, local and private grants, and about 8 percent from federal grants, Kavoussi said.

All told, spokesmen for the governor's Office of Financial Management said Medicaid and the state Health Care Authority would pay $321 million in general-fund-related dollars in 2009-11 for services provided through the centers — if no cuts are made. That would equal $681 million with federal matches, before policy reductions are factored in.

Other funds also go to the clinics through managed care and Department of Health programs.