More than just numbers
When most people think budgets, they think numbers. I think of the more than 7,000 people Manchester Community Health Center serves, representing some of the region's most vulnerable populations. Of our patients, 45 percent are uninsured. Another 35 percent are on Medicaid, with that population largely comprised of mostly women and children. Almost 50 percent of MCHC do not speak English fluently, meaning one out of every two patients needs an interpreter. Keeping staff current with the many changes in health care, as well as the many demands of a culturally diverse and under-served population, is challenging - and expensive.A proposed 47 percent state budget cut to community health centers is an alarming number. It's even more terrifying when you look at what it means in terms of people. If cuts of this magnitude are made, wait times at MCHC will increase from roughly three to four weeks to five to six months due to the drastic reduction in capacity that would be necessary.At the same time, MCHC is seeing a significant increase in the number of people reaching out for services. This number has grown dramatically since the health center first opened its doors in 1993 and shows no sign of slowing down in today's tough economy.Manchester Community Health Center has already suffered an economic blow, losing $115,000 this past November when Medicaid stopped paying for prenatal chart review. The agency's total operating budget barely exceeds $5 million. If the state cuts its primary care contract at the level recommended by the House, MCHC will suffer a loss of over $211,000.The House budget proposal contains $4.5 million in cuts to the community health centers' primary care contracts over the biennium. This $4.5 million cut will devastate health centers, likely resulting in the closure of some. The remaining health centers will have no choice but to eliminate people, since 80 percent of the health centers' expenses are in people. It's estimated that, statewide, over 50 layoffs will result - at a minimum. Since so many programs are run by just one person, when that person goes, de facto, so does the program.All of this while the threat of federal cuts looms large. If the federal government implements a 15 percent cut to the organization's base grant, as may be the case, it will mean a loss of about $112,000.If cuts of this size are made, many programs - such as perinatal care coordination, diabetic education, breast/cervical cancer prevention and nutrition - would have to be entirely eliminated as they are each a "one-person show," and without that person, there is no program. These services have been successful in preventing the advancement of many diseases. Such budget cuts will further vastly increase the use of hospital emergency rooms for non-emergency care and result in the layoff of clinicians. The ramifications are far-reaching.At MCHC, we seek to address the needs of a diverse community, regardless of age, ethnicity or income. Our mission is to meet the community need for access to quality healthcare services for the underserved. That mission is in jeopardy if cuts of the magnitude proposed are implemented.Edward G. George is president and CEO of Manchester Community Health Center.