Valley Voices

Washington’s assault on Valley’s rural health care centers

Fifty years ago, as they’d done for decades, the Valley’s endless supply of migrant workers harvested cotton, grapes and potatoes in an expanse of bounty spreading from Sacramento to the Tehachapis. But there was more than back-breaking labor going on.

The mood was changing in the fields, reflecting a hunger for social justice in the country, and an awareness was dawning that all of us have value and the right to decent treatment, a safe workplace and dignity.

And health care.

The Community Health Center Movement was born in the 1960s, a time of unlimited optimism that we could defeat poverty and despair in this country by embracing the belief that there is potential and worth in all of us, even the most marginalized.

That idea sounds quaint today, a little naïve, given the hostility to the poor in this country. Still, the Community Health Center Movement has endured, even flourished, and Clinica Sierra Vista, we are proud to note, is among the most successful in this nation of 1,200 such community-based networks.

But there is an assault on community health centers and our patients today, the likes of which we have not seen.

A dizzying array of threats looms in Washington and with just days remaining in the current session, panic grows by the hour that the vulnerable will lose their care, health centers will close, our promising residency program will suffer a setback, and many will lose their jobs.

Yes, it’s that bad.

The turmoil, of course, is rooted in the attempt to repeal the Affordable Care Act and replace it with whatever nasty little bill is currently being hustled. But don’t be fooled by the erasure marks on the “new” and euphemistically renamed legislation; the upshot is always the same: Millions would lose care.

And so it is with the Graham-Cassidy bill, whose proponents suffered a setback Tuesday. But let’s not celebrate just yet: The repeal-and-replace crowd will be back for more, and soon.

Yet, somehow, that’s not even the worst of it. If Congress fails to act before Sunday

▪  Community health centers like Clinica will lose funding. Congress must extend the Health Center Trust Fund, which is scheduled to expire on Sept. 30 or face the prospect of millions losing their access to care. One in seven Californians depends on a community health centers for primary care.

Clinica alone would take a $16 million hit, meaning 30,701 of our patients would lose access to their health care, health centers could close, services would be cut, and staffers could lose their jobs.

▪  Programs for medical residents at teaching health centers like Clinica’s would be put in serious jeopardy. There is no better strategy we know of to attract doctors to the criminally underserved Central Valley than by training our own residents and persuading them to stay.

Yet this beacon of hope on Niles and Fairfax could be a victim of Washington’s dysfunction, depriving nearby residents of the care of these wonderful doctors and the valley of a pipeline of primary-care providers.

▪  The National Health Service Corps program, an incentive program essential to bringing doctors to areas like the Valley, will lose funding. The program gives Kern and Fresno counties some leverage in competing with more desirable areas – and salaries – by forgiving student debt in exchange for service.

The cacophony in Washington is so loud, it seems nearly impossible to cut through the din. But without immediate action from our elected leaders, the roar you’ll hear Oct. 1 will be from a new source: Millions of people cut off from health care.

Stephen W. Schilling is chief executive officer of Clinica Sierra Vista, which serves 200,000 valley residents of Arvin, Bakersfield, Death Valley, Delano, Frazier Park, Lake Isabella, Lamont, McFarland and Wofford Heights. Connect with him at