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June 5, 2024

Health centers push for action amidst worsening systemic crises

PHOTO | Isabel Tehan The new Edward M. Kennedy Community Health Center at 605 Lincoln Street in Worcester

Things have only gotten worse in the year since its last State House lobby day, but the Massachusetts League of Community Health Centers reiterated its priorities Tuesday, hopeful that lawmakers will include them in any of the multiple health-related bills expected to be considered in the coming weeks.

President Michael Curry started Tuesday's event by recalling last year's lobby day, which focused on the ways that a contracted post-pandemic workforce was exacerbating a capacity crunch amid massive demand for care at community health centers. One year later, the system "is under even further strain" as wait times soar for primary care appointments, the workforce continues to grapple with low retention, a persistent influx of migrants adds to the overwhelming demand for care, health centers are serving increasingly complex medical needs, and one of the state's largest hospital groups faces an uncertain future.

"We're also grateful to be here in the midst of what we believe will be an active and productive stretch for our Legislature in addressing some deep challenges with our health system. We anticipate [in] the coming weeks we might see new bills on systemic health reform from the Senate, a pharma bill from the House, movement on economic development legislation, and a housing bill. We also might see action on a pending supplemental budget," Curry said. "All of these are critical and several present opportunities for action on the crisis."

The League of Community Health Centers' priorities include establishment of a commercial payment floor that would ensure commercial plans pay health centers no less than MassHealth, a requirement that all pharmaceutical manufacturers ship drugs under the 340B program to pharmacies contracted by community health centers (something the Senate included in its drug prices bill), $50 million in bond funding dedicated for community health center capital needs, $20 million to fund programs developed by health centers to recruit and train workers from the communities they serve, $5 million in new state budget money to fund community health workforce initiatives like loan repayment and retention bonuses, and $4.9 million for a community health center grant line item in the state budget.

The organization is also seeking $75 million in stabilization and access expansion funding in the next supplemental budget, which Brockton Neighborhood Health Center CEO Sue Joss said is critically needed.

"As much as true systemic reform is needed, we also need immediate support from the Legislature to help us mitigate the crisis that we're seeing right now," she said. "When we can't see patients in primary care, they turn to the emergency room. In Brockton, that is an impossible situation. It's not good for health inequity. It's not good for the hospitals and it's especially untenable for the patients that we serve."

Joss said the Brockton area has seen a severe squeeze in health care capacity, pointing to the closure of Signature Healthcare Brockton Hospital following a fire and last year's abrupt closures of Compass Medical practices.

"Both Good Samaritan Medical Center and South Shore Hospital are operating beyond capacity in their ERs, maternity units and many other services that the hospitals offer. This has led us at BNHC to see sicker medical and behavioral health patients and find workarounds to sending them to the ER whenever we can," she said. "The influx of new migrants has added capacity challenges in Brockton and many other areas of the state. It led us at BNHC to start our first ever primary care waitlist for adult patients at the end of November. That waitlist at one point peaked at about 1,900 patients, we've now got it down to about 1,200 but new patients are being added to the list every week, actually every day."

Joss also said that her community health center in Brockton is already feeling the effects of the uncertainty around the bankrupt Steward Health Care and the future of its eight Massachusetts hospitals, including Good Samaritan. She said staff at the Steward hospital have been leaving for other jobs, leading to "sudden cuts in services."

"This has included reduced access to colonoscopies, severely reduced access to mammograms and bone density testing, the closure of Good Sam's oncology and hematology services, just to name a few," Joss said. She added, "Most recently, this week, we are facing the possibility of not being able to continue in Good Samaritan's OB coverage group, which would force us to back out of hospital maternity care. With Brockton Hospital's OB services still closed until at least September and South Shore Hospital's maternity unit operating well beyond capacity already, this would put our patients in a position of having to go to the emergency department when they're in labor. Not acceptable."

The challenges have all taken a financial toll. Joss said Brockton Neighborhood Health Center posted a $5 million loss last fiscal year and is preparing for another $5 million loss once the current fiscal year ends.

"We didn't make cuts last year because we felt that our capacity and our community was already so strained that we just couldn't. And now we're struggling to figure out how to avoid cuts that might devastate our already-struggling community that already has a lack of capacity," she said.

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