SIOUX CITY | As another deadline to reauthorize critical funding for community health centers approaches, Mari Kaptain-Dahlen, CEO of Siouxland Community Health Center, is optimistic that this time the issue will be resolved.
Extending community health center funding is on Congress's December to-do list along with negotiating an immigration deal and approving a disaster emergency spending package. A slew of other pieces of health care legislation, including extending funding for the Children's Health Insurance Program (CHIP), have to be approved before the government runs out of money again on Dec. 22.
According to the Kaiser Family Foundation, Iowa and South Dakota are projected to exhaust funding for CHIP, which provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid, between February and March 2018, while Nebraska's funding could dry up sometime in April.
The Iowa Primary Care Association says 28,322 Iowans will lose access to their health care provider if funding cannot be secured for community health centers.
The Community Health Center Fund, which was established in 2010 by the Affordable Care Act, accounts for 70 percent of the federal funding that the nation's more than 1,400 community health centers receive. Community health centers in other states, including North Dakota and South Dakota, are already reporting staff losses and recruiting challenges due to funding uncertainty.
"There's a bill that was introduced in the House to extend our funding for two years and then the Senate actually has a bill that never got out of committee that would extend us for five years," said Kaptain-Dahlen, who said she has heard from Iowa senators Joni Ernst and Chuck Grassley that they are working hard to ensure resolution before Jan. 1. "We are confident that our funding will be secured and that people will be able to access care and we will provide care as we always have."
Prescription drug benefits
Siouxland Community Health Center provides a number of medical services, including general health exams, behavioral and social services, HIV testing and counseling, prenatal care and dental care, as well as a pharmacy for all its patients.
The health center, which has been named a Level 3 Patient-Centered Medical Home, participates in the 340B Drug Pricing Program, which allows hospitals and other health care providers that are "covered entities" to obtain prescription drugs from drug manufacturers at discounted prices. For example, an albuterol inhaler, which costs between $80 and $90 at a big-box pharmacy, is just $10 at Siouxland Community Health Center.
Shelby Petersen, director of operations for Siouxland Community Health Center, said there are times when patients need a particular medication, but can't afford it even with the health center's sliding fee discount for uninsured patients under 200 percent of the poverty level.
In those desperate cases, she said pharmacy staff refer patients to Center for Siouxland. Through its prescription assistance program, which is currently funded by United Way of Siouxland and Interfaith Resources, the nonprofit Sioux City human service agency issues vouchers to Siouxland Community Health Center patients to ensure they receive their medications.
Jonette Spurlock, executive director of Center for Siouxland, said the program serves about five Siouxland Community Health Center patients a month on average. A patient can receive up to $50 in prescription assistance twice a year.
"We do not check income guidelines. We understand that everybody gets into a bind. If they're running short and they need help, they just need to call," she said. "We've helped in a variety of different cases -- sometimes people just run short for their monthly meds. We've helped people who are between insurances and still need their prescription coverage."
Petersen said more patients became eligible for Medicaid under the Affordable Care Act, which gave states the option of expanding their Medicaid programs to low-income adults. The expansion of Iowa's Medicaid program, she said, eliminated the need for many health center patients, who became eligible for prescription drug coverage under Medicaid, to rely on the prescription assistance program that Center for Siouxland offers.
"If we have a patient come to the pharmacy and they have nothing, we will always tell them, 'Go downstairs and talk to one of our financial counselors,'" she said. "Usually they can leave here signed up for something if they came in here without a payer source."