Health Center Funding Cliff Update

Congress Finds Agreement on FY18 Funding

  March 22, 2018  | 

Artwork Credit: U.S. Digital Service (USDS)

Congress has passed a $1.3 trillion  FY18 spending package  that will provide dedicated and reliable funding for the federal government through September 30, 2018. The legislation was signed into law by the President earlier today.

The bill provides $654.6 billion for defense and national security, and $589.5 billion for investments in critical priorities such as education, health care, roads and bridges. Overall, there's roughly $3.3 billion to battle the opioid crisis and improve access to mental health treatment throughout the bill, including a new $1 billion State Opioid Response Grant program and an additional $160 million for the SAMHSA Mental Health Block Grant. The FY18 spending package also provides the Health Resources and Services Administration with $415 million to battle the opioid epidemic, including dedicated funding for Community Health Centers (more below). The bipartisan compromise also provides $687 million to expand broadband access in rural communities, including a $625 million pilot through the U.S. Department of Agriculture. Finally, regarding the stability of health insurance marketplaces, the bill does not contain funding for cost-sharing reduction payments to insurers.

Most importantly, the bill builds upon Congress' historic commitments to Community Health Centers by:

  • Providing $1.626 billion (+$135 million) in discretionary 330 grant funding to expand quality primary care access at health centers across the country. Combined with the mandatory Community Health Center Fund, this brings the total funding for  health centers in FY18 to $5.4 billion;
  • Directing at least $200 million in Section 330 grant dollars towards quality improvement or service expansion grants to support behavioral health, mental health, or substance use disorder services; and
  • Replenishing the Health Center Loan Guarantee Program with $20 million, which will leverage up to $743.5 million in private loan activity.

The spending package also reflects Congress' commitment to expand the next generation of health center providers and develop the health center workforce in the years to come. Specifically the bill:

  • Allocates an additional $105 million to the National Health Service Corps (NHSC) to expand the delivery of substance use disorder treatment services. This brings the total FY18 spending for NHSC to $415 million (mandatory and discretionary);
  • Expands NHSC loan repayment eligibility to substance use disorder counselors;
  • Provides $100 million for the White House's new Rural Communities Opioid Response program;
  • Provides $114.8 million to replenish the FTCA judgement fund to ensure coverage for individuals serving at health centers against claims; and
  • Creates a new $350 million Public Service Loan Forgiveness (PSLF) fund, to provide relief to PSLF applicants who are ineligible for PSLF due to choosing the wrong student loan repayment option.

Despite the fact that the FY18 spending package is over 6 months late, it brings positive news for programs across the health care landscape. Most agencies and departments saw substantial increases in funding due to higher budget caps, including the Centers for Disease Control and Prevention (+$1.1 billion), Substance Abuse and Mental Health Service Administration (+1.3 billion), Health Resources and Services Administration (+$550 million), and National Institutes of Health (+$3 billion).

As always, NACHC continues to work with members of both parties in Washington to ensure leaders understand the importance of long-term funding for Community Health Centers. Please feel free to reach out at [email protected] if you have additional questions, comments, or concerns about how the FY18 spending package impacts the future of health center funding.

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