Even as Congress works to bring money to Community Health Centers after missing a critical funding deadline Saturday, those facilities are grappling with tough decisions to make up for a 70 percent reduction in federal funds that lapsed this weekend, health care leaders say.

Funding for Community Health Centers expired Saturday, along with funding for the Children’s Health Insurance Program and the National Health Service Corps.

Congress  began introducing legislation late last week to bridge funding, and passed a three-month funding extension for Teaching Health Centers, which provide residency programs for new doctors, particularly in rural regions. Just six exist in California, including one in Bakersfield.

Despite that, Community Health Center providers are planning for the worst.

Health facilities across the nation have begun instituting hiring freezes, limiting hours at health centers, reducing staff hours and tapping into their reserve funds, National Association of Community Health Centers Communications Director Amy Simmons said Wednesday.

“The health center funding cliff is affecting health centers right now,” Simmons said. “You can’t deliver healthcare effectively on a month-to-month basis. That’s a lot of uncertainty when it comes to patients’ lives being on the line.”

Roughly 72 percent of 518 national Community Health Centers surveyed by NACHC said they would institute a hiring freeze, 41 percent would lay off staff and 47 percent would reduce staff hours. About 52 percent said they would delay facility renovations and expansions.

In Kern County, Clinica Sierra Vista, the region’s largest Federally Qualified Healthcare Center, is in a holding pattern, CEO Steve Schilling said.

Clinica isn’t hiring new doctors, expanding facilities, creating new programs or bolstering offerings until it knows funding has been secured, Schilling said.

“I don’t want to have to go backwards and start cutting out. I’m standing still and waiting, and that’s not a good thing,” Schilling said.

If funding isn’t restored by the New Year, what federal dollars Clinica has will be spent. He’ll have discussions with his staff about reducing offerings in a month if funding doesn’t come through soon – but Schilling said he’s optimistic legislation will pass.

“We’re feeling a lot more confident now than we were a week ago confronting the cliff,” Schilling said.

Congress has so far proposed legislation to renew CHIP funding through the HEALTHY KIDS Act; restore Community Health Center funding through the CHIME Act; and double funding to $126.5 million for Teaching Health Centers through the CHAMPION Act.

Valley legislators, including Rep. Jeff Denham, R-Turlock, Rep. David Valadao, R-Hanford, and House Majority Leader Kevin McCarthy, R-Bakersfield, are supporting the CHAMPION Act.

“Clinica Sierra Vista is extremely excited to learn that our Congressman McCarthy has been so willing to step up and champion our efforts to continue our important Teaching Health Center here in the valley,” Schilling said. “Without his leadership, this probably would not be possible given the current environments in Washington.”

Denham championed an effort Friday to pass a three-month funding extension for Teaching Health Centers, but stressed that Congress needs to do more.

“While we continue to debate the healthcare in this nation, we’ve got areas like mine that have a lack of access. If you can’t see a doctor today, you have no healthcare,” Denham said on the House floor Friday. “If you’re graduating from medical school right now, you want to have the certainty you’ll have a residency program long term.”

Such uncertainty in Teaching Health Center funding, Schilling said, could discourage newly graduated medical students from applying for residency programs in rural areas where those THCs are located, exacerbating an already punishing doctor shortage. 

Harold Pierce covers education and health for The Californian. He can be reached at 661-395-7404. Follow him on Twitter @RoldyPierce