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One in 10 Montanans relies on a Community Health Center for primary care. These federally subsidized, locally directed clinics deliver lower cost and high quality, stretching every dollar they receive from patients and taxpayers.

Montana’s federally qualified health centers received $35.5 million in FY17 federal funds to serve vulnerable, underserved and rural communities. Most of those patients are below poverty level.

This holiday season isn’t as bright as it should be for Montana health centers. Congress and President Donald Trump haven’t reauthorized the funding that makes services accessible to all community members. Seventy percent of their federal funding expired on Sept. 30, and the House passed a two-year extension last month. The Senate hasn’t yet acted.

Federally Qualified Community Health Centers serve more than 100,000 Montanans – from Hardin and Miles City to Kalispell and Libby. Billings has two: Montana Migrant Council and RiverStone Health. Besides 17 main clinics, there are more than 40 satellite clinics.

RiverStone, for example, provides medical, dental and other health services from its main clinic on South 27th Street. It also delivers health care at Orchard and Medicine Crow school clinics, at Healthcare for the Homeless clinics at Montana Rescue Mission, the HUB and St. Vincent de Paul Society. RiverStone operates rural health clinics in Worden, Joliet and Bridger.

Last Friday, leaders of Montana’s Community Health Centers wrote to Montana Sens. Jon Tester and Steve Daines, asking their support of the “multi-year funding extension needed to bring stability for the patients we serve.”

Funding cliff

Eleven Montana health centers will be “seriously affected” by funding delay starting in early 2018, the leaders wrote, adding: “There are at least five Montana health centers that will struggle to survive if funding is not reauthorized to continue coverage for underserved and rural populations.”

Community Health Partners serves 11,000 patients in Livingston, Bozeman, Belgrade and West Yellowstone. Executive Director Lander Cooney said her organization’s grant runs through April, so the “cliff” isn’t as near as for some other centers. However, Congress also has failed to reauthorize the National Health Service Corps, which reimburses educational loans for doctors, dentists, nurse practitioners, counselors and other health care professionals who work in rural and underserved communities.

More than 50 percent of the licensed professionals working in Community Health Partners Clinics receive NHSC loan reimbursement, Cooney said. “If there was no NHSC, that would take a significant toll on rural health care,” she said. “Small, rural clinics just cannot compete without loan reimbursement.”

Physician training

Medical education itself is on the line, too. Congress has failed to reauthorize the graduate medical education program that funds three residency positions in the Montana Family Medicine Residency at RiverStone in Billings.

“If Congress does not act to fix the primary care fiscal cliff, $3.6 billion of this Community Health Center funding will be lost, along with all funding for the National Health Service Corps and Teaching Health Center program,” said John Felton, chief executive for RiverStone “For RiverStone Health Clinic, that means a loss of about $2.8 million, or about 20 percent of the clinic’s total budget.” Felton said that could result in loss of up to 25 staff members and loss of capacity to serve 3,200 patients.” RiverStone is fully funded until March 31.

Surely Tester and Daines understand how important these health care supports are in Montana. Politics has taken these community health programs hostage — along with the Children’s Health Insurance Plan.

That’s not what Montanans want. We want to take care of our neighbors who rely on community health centers, and we want to ensure that doctors are available to care for us when we need them.

We call on Tester and Daines to press their party leaders to send President Trump legislation that will sustain these vital health care programs for at least two years — before Christmas.