The potential loss of federal Low Income Pool (LIP) dollars, and the lack of a plan to replace this program, will dramatically affect millions of individuals and families who are low income, among the working poor, as well as Medicare and Medicaid recipients throughout Florida.
More than 1.1 million patients who receive healthcare from Federally Qualified Health Centers (FQHCs) could be affected most directly.
Over the past several weeks, the news media has focused attention on the significant losses that may affect hospitals with the sunseting of the Low Income Pool (LIP). It is certainly true that these financial hits will be felt with the loss of more than $1.3 billion in LIP funds, and even that doesn’t reflect the true total losses should this happen. But there are other implications and other organizations that will be impacted by the loss of LIP funding directly — and these losses will be felt most directly at the local level, where healthcare is actually delivered.
Florida’s federally qualified health centers (FQHCs), also known as community health centers (CHCs), provide quality, comprehensive primary and preventive care to well over 1 million Floridians in urban and rural communities at 370 locations throughout the state. You cannot travel more than 50 miles anywhere in the state without being able to find an FQHC service location, though most are even more conveniently found than that.
Medicaid covered 40 percent of the CHC patient-base, while over 44 percent were completely uninsured. Our FQHCs provide the primary safety net care for these people, keeping many out of the emergency rooms, significantly reducing costs, and providing a caring, patient-centered, medical home environment. FQHCs have participated in LIP funding since its inception and are a true example of a public-private partnership doing great work locally, providing quality primary care to the communities they serve.
All 52 FQHCs participate in LIP funding by providing their own local match, mostly through partnerships with county commissions, taxing districts, and public health trusts. This match has resulted in the FQHCs drawing over $43 million in LIP funding each of the past three years. Our FQHCs have used this funding to increase the number of providers, expand the number of locations and add to our state’s access to comprehensive primary-care services by expanding options such as dental and behavioral health to each of the centers, in addition to the advances in medical service provision.
Many FQHCs have also worked closely with area hospitals through emergency-room diversion programs across the state, which will help patients control their healthcare costs and enhance their ownership in their continued well-being.
The loss of LIP funding will have a serious consequence for hospitals, yes, but also to our FQHCs. Since 2004, FQHCs have increased their patient population statewide by almost 92 percent. We’ve increased our Medicaid population by more than 200 percent and our uninsured population by 48 percent. We’ve been able to use LIP funds to increase our clinical workforce significantly (medical by 93 percent, dental by 185 percent and behavioral health by 137 percent) to meet the growing needs of a growing state population, while also expanding access and hours of operation.
These statistics go to show that for FQHCs, the concept of LIP (and the utilization of local investments as the basis for matching funds) is a smart concept; one that has proven successful over many years. Florida’s Legislature has embraced the efforts of FQHCs, and we urge it to work with CMS to find a way to continue this great program.
Andrew Behrman is president and CEO of the Florida Association of Community Health Centers.