SCHENECTADY — Hometown Health Centers and other medical facilities serving the poor lost an important chunk of their funding stream on Monday.
The subsidy for federally Qualified Health Centers technically ended in September, when the 2016-17 federal budget expired without a 2017-18 budget in place. But the health centers' funding was included in the regular extender bills that have kept government running — up until the one that was passed Monday.
“Washington is so upside-down right now,” Hometown Health CEO Joe Gambino said. “Funding like this should be a priority.”
Presumably the budget line became a bargaining chip — it could not have been omitted accidentally, Gambino said, but he doesn’t have any insight on what happened. It’s not a partisan issue, he added: Federally Qualified Health Centers operate in red states and blue states, in urban as well as rural areas — anywhere there is a population underserved by medical providers.
Because many of these patients can’t pay for the care they receive, Gambino said, the federal government pays a subsidy for their care. Putting aside compassion for fellow Americans, Gambino said, it’s a matter of good fiscal sense. Patients who can’t go to one of the health centers will either go to emergency rooms, which are more expensive, or not get care at all, which becomes more expensive if their medical problems grow worse without treatment.
“It’s a lose-lose,” he said. “I can’t believe our funding has been cut off.”
If it’s a short-term cutoff, there will be no visible impact to Hometown Health’s patients. If the cutoff lasts into next year, which Gambino doesn’t expect, or longer, Hometown Health will have to reduce staff or services. It likely can’t increase patient revenue to cover the difference, and its dedicated but small group of philanthropic supporters can’t fill the gap, either.
He said Hometown Health operates on a roughly $15 million annual budget, of which the federal government provides about $3.3 million. The cutoff that began Monday could cost Hometown Health up to $2 million this year, depending how long it lasts.
Hometown Health Centers is a non-profit operating in the black, Gambino said. On a good year, revenues exceed expenses by 3 percent to 4 percent, and the extra money goes into a reserve account. That reserve account will cover a short-term loss of federal funding but not a longer cutoff.
“We have to look at it not necessarily in the short term but what happens in the long term,” he said Thursday.
Founded in 1970, Hometown Health Centers has its headquarters and a clinic on State Street in Schenectady and also operates clinics in Amsterdam and in two Schenectady schools. Its 100-plus medical providers and support staff serve more than 17,000 patients — through about 80,000 visits — each year.
The only other Federally Qualified Health Center in the immediate Capital Region is Whitney Young Jr. Health Center in Albany.
Hometown Health and Whitney Young are in advanced exploration of an affiliation that might range from a simple partnership to a full merger. The two organizations have very similar missions and patient populations, and they serve adjoining geographic areas with very little overlap.
The next-closest FQHC is Queensbury-based Hudson Headwaters Health Network, which serves northernmost Saratoga County and the southern Adirondacks.