We Need Congress to Act and Support the Teaching Health Center and Community HealthCenter Programs

On July 1, a new academic year unlike any other began for medical residents throughout the nation. However, one of the positive stories to emerge from the current COVID-19 pandemic has been the role medical residents at the nation’s 56 Teaching Health Centers (THCs) like ours here in Redding played to combat the coronavirus, including screening and testing patients at community health centers like ours and adapting telehealth for countless individuals with chroni diseases.

The heroic efforts of our residents at Shasta Community Health (working closely with our sister CMS funded Family Medicine program at Mercy Hospital) also validate the Teaching Health Center Graduate Medical Education (THCGME) program, which Congress created over 10 years ago to help expand the primary care physician workforce in medically underserved areas. The outsized return in access to care and the increase in physicians demonstrate why policymakers must swiftly extend the program, which is due to expire on November 30, 2020. As noted below, this is particularly time-sensitive given the financial hardship faced by community health centers like ours due to the COVID-19 crisis.

America has a shortage of primary care physicians and dentists and needs medical residents like those at our THC, who train for three years in community health centers before joining us or organizations like ours, many of whom stay in the Northstate. THCs provide an alternative to traditional hospital-based graduate medical residency programs and are sponsored by community-based clinical organizations such as Federally Qualified Health Centers like ours, Rural Health Clinics, or Consortia of non-profit health care organizations. So far, more than 1,100 THC graduates have completed their residency, and a substantial percentage have continued practicing in primary care and become doctors in underserved communities.

During the COVID-19 crisis, THC residents were essential as we pivoted quickly and adopted new ways to provide primary care like telemedicine. For example, in March, our Health Center including our Family Medicine Residency program moved very quickly to telemedicine (including phone and video appointments) for almost half of our outpatient appointments at that time. A delivery transformation like this can normally take many months and sometimes a few years but as an organiztion we did it in literally a few weeks with our Residency program stepping right up. While the pandemic forced many people to stay at home, those with chronic diseases in particular were put at great risk if they could not stay connected to their doctors/clinicians. Telemedicine provided that bridge in a safe and secure way.

The THCGME program deserves a five-year extension and increased funding so that more medical students can benefit. Since 2015, despite broad bipartisan support for the THCGME program, Congress has only passed several short-term funding extensions for THC residencies. THCs and medical residents need long-term certainty and stability because sponsoring organizations (all nonprofits with low margins and significant local needs) are balancing uncertain federal funding and significant COVID-19 financial losses that threaten their stability.

The stellar performance of the nation’s THC medical residents during their COVID-19 baptism by fire should convince Congress to enact immediately the multi-year extension for the THCGME program. Our nation’s health care safety net is stronger today due to investments in the THCGME program. THC residents remain committed to working medically-underserved communities struggling with the fallout of the COVID-19 epidemic. As legislators consider another COVID-19 emergency response bill this month, they should fully fund this excellent source of primary care physicians and dentists.

In addition, in the wake of the COVID-19 epidemic, Congress needs to recognize that Community Health Centers such as ours, that are also Teaching Health Centers, are closing sites and furloughing staff to remain open. We at Shasta Community Health Center, with the help of a significant Payroll Protection Act forgiveness loan, has managed to keep our primary care delivery system mostly intact (dental being the unfortunate exception). We continue to balance the fiscal and operational realities of the challenges of this time of the pandemic with the needs of our patients and community. We need Congress to ensure that the Community Health Center system and the THCGME programs are protected and sustained. These programs are among the few that have wide bipartisan support and we are thankful to Representative LaMalfa for his personal leadership in his party for their support of both of these programs. That said, there is urgency for a multi-year extension of the Community Health Center and THCGME programs in the bills now working their way through Congress.

Dean Germano is the chief executive officer of Shasta Community Health Center in Redding.

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