Clinics scramble for funding

A network of health clinics that care for some 60,000 New Orleans area residents is in jeopardy if in-state funding is not identified by mid-August to help finance them.

Legislators overwhelmingly approved a resolution directing the governor and state health agency to identify a source or sources of funding to bring in federal dollars for the Greater New Orleans Community Health Connections initiative.

Louisiana received special permission from federal officials to embark on the clinics as the health care system was decimated by 2005’s Hurricane Katrina.

The proposed $25 billion-plus state budget in Gov. Bobby Jindal’s hands does not contain state funding for the clinics continuation. Neither legislators nor the administration added funding.

Now, the Jindal administration is pressing New Orleans officials to tap a $15 million local Community Development Block Grant that is coming their way in the wake of Hurricane Isaac.

A total of $11.3 million is needed in order to extend the health clinic network at its current level of funding. The money would attract sufficient federal funds to provide $29 million for annual clinic operations.

New Orleans health commissioner Dr. Karen DeSalvo said she is hopeful that in conversations with state officials “we can figure out how to finance it.”

“We are looking at what’s the best source of match “ DeSalvo said. She said she is hopeful that a solution will be found. Otherwise, “it would be a doomsday scenario for the community, a financial hit for the region,” she said.

The clinics provide primary care and mental health services to people in Orleans, Jefferson, Plaquemine and St. Bernard parishes. Adults with incomes up to 200 percent of poverty ($22,250 for an individual or $38,180 for a family of three) who have been uninsured for six months are eligible for coverage through the waiver — with limited cost-sharing based on income.

The program has been funded through a state — not local — Community Development Block Grant.

State Department of Health and Hospitals Secretary Kathy Kliebert said the federal Centers for Medicare and Medicaid Services requires a program extension request to be filed by June 30 which will be done by her agency.

CMS has indicated that the details of the application would need to be completed no later than mid-August, which includes the finalized funding source, she said.

“We have let New Orleans city officials know that if they fund the local match we are happy to work with them in applying for an extension of this waiver. New Orleans is about to receive $15 million in CDBG dollars. These funds can be used as a local match for this waiver, if New Orleans so chooses,” Kliebert said.

State Sen. David Heitmeier, D-New Orleans, who sponsored the legislative resolution, said proponents are hopeful that the block grant money can be used. “That’s a very good use because $1 turns into $3,” said Heitmeier, referring to federal match ratio. “It’s a needs based program and there are a lot of needs,” he said. “There’s a high, good utilization.”

Heitmeier said CMS has assured there is time to get a program expansion approved “if we found the money.”

“You have to show increased access, better health outcomes” have occurred as a result of the program to have it considered for renewal, he said. And officials can do that, he said.

The clinic network was supposed to be a bridge until the Medicaid expansion called for under the federal Affordable Care Act kicked in Jan. 1, 2014. Those who would still not qualify for the Medicaid expansion would be eligible to receive federal tax credits to buy private health insurance.

DeSalvo said 83 percent of 60,000 people seen in the clinics would have been eligible if Louisiana had opted to participate in Medicaid expansion. If clinic funding cannot be found, those people will no longer get services, she said. The others would be eligible for the tax credits.

“This will not only be a significant hardship for thousands of residents who depend on the neighborhood clinics for routine care, but will be a financial disaster for the clinics themselves, who will no longer have a way to get paid for their services,” said Steve Spires, health care analyst for the Louisiana Budget Project.