HJAR Nov/Dec 2019

HEALTHCARE JOURNAL OF ARKANSAS I  NOV / DEC 2019 51 LaShannon Spencer CEO Community Health Centers of Arkansas Congress aided Community Health Cen- ters in keeping its doors open, at least for a little while. Congress re-authorized fed- eral funding to CHCs through November 21, which is good news. The less than good news is that fund- ing for those centers, which serve upward of 210,000 Arkansans, remains in jeopardy. Among other uncertainties are what will hap- pen to two vital programs if Congress and the White House doesn’t allocate dollars after November 21: 1. The Teaching Health Center Graduate Medical Education Program helps fed- erally funded Community Health Cen- ters recruit, train, and pay for physician and dental residencies of newly gradu- ated health care professionals who oth- erwise wouldn’t accept lesser-paying jobs in rural and other underserved communities. 2. The National Health Service Corps gives scholarships to, and repays medical and dental school loans for those invalu- able professionals who agree to provide health care in distressed areas with a shortage of doctors and dentists. The National Health Service Corps is pret- ty enticing on its own. So much so, that 43 percent of doctors and dentists in the corps spend years, if not their entire careers, prac- ticing in the rural communities that are home to 19 percent of the U.S. population. Still, that cadre of rural doctors and den- tists isn’t sizable enough to meet patient needs. The lack of a hometown doctor often forces too many rural residents to delay care, which means they often wind up in much worse shape physically, psychologically, and financially. Often, when they do finally get to the doctor, an originally small problemmay have turned into a big, expensive problem, and the more serious health challenges often have become gargantuan. Compounded over hundreds and thousands of patients across rural Arkan- sas, the suffering affects whole communities, and the quality of life for people in those communities. Count the ways: lost hours at work, lost wages, and unpaid house notes. The list goes on. Health experts note rural dwellers, on av- erage, can expect to die three years earlier than city dwellers—an ever-widening gap. Rural residents are more likely to be poorer, older, and more debilitated by preventable chronic illnesses than their counterparts in the city. Many of these disparities are di- rectly linked to rural residents’ limited ac- cess to medical care. This isn’t just anArkansas problem. Forty- four million people, or 13 percent of Ameri- cans, live in a county with a primary care physician shortage, defined as less than one primary care physician per 2,000 people, according to a report from UnitedHealth Group. Continuing to provide federal fund- ing to Community Health Centers, including Community Health Centers of Arkansas’130 medical facilities, would be good medical stewardship, and beneficial to communi- ties in a host of other ways. Each of those 130 facilities is a small business, helping to drive local economies. Every $1 Congress spends on federally qualified health centers generates $5.73 in local economic activity. As that kind of economic rollover gets rep- licated nationwide, federally funded centers save the U.S. healthcare system $24 billion a year by helping patients avoid unnecessary, costly trips to the emergency room, and in- patient hospital stays. As with every statewide network of Com- munity Health Centers like ours here in Ar- kansas, federal funding is not something we can do without. It is our lifeline. It is a vital supplement to what is paid by our patients’ private health insurers, by government- sponsored Medicare and Medicaid, and by what the wholly uninsured pay out-of- pocket on an income-based sliding scale. Our fiscal model is strategic; we aim to be good stewards, to ensure all our revenues are properly invested, and we purposely locate our clinics in underserved areas, es- pecially rural areas that for-profit medical providers may not find as attractive. More- over, Community Health Centers are key to combating the rising tide of opioid abuse, as U.S. Sen. John Boozman, R-Ark., noted last year. “Innovative, effective approaches are nec- essary to address the ever-evolving opioid crisis, especially in rural areas where the risk of abuse is higher. Through their work “Federally funded centers save the U.S. healthcare system $24 BILLION A YEAR by helping patients avoid unnecessary, costly trips to the emergency room, and inpatient hospital stays.”