Community health centers in Harlem worry about state budget battle

Research from the National Library of Medicine found that proximity to a healthcare facility can make a significant difference in a person's health. 

Neighborhood health centers that serve some of the city's most vulnerable are raising concerns about their ability to do this work with funding from the New York state budget still in limbo. 

"Right now, the budget hasn't been passed"

Angelique Torres, a Harlem native, knows this all too well. As a busy mom of two, getting her kids to the doctor can be a mission, especially when she has to travel outside her neighborhood. 

"[My son] actually had eyes, ears and an ENT appointment. So, I had to take the bus on the train and it was raining. It was already too much," Torres said. " So from there, we just ended up taking a cab because it was raining and we just had to go all the way downtown." 

That's why Angelique and her kids prefer to go to Boriken Neighborhood Health Center, which is just a few blocks from home. Boriken is part of The East Harlem Council for Human Services. It offers a one-stop-shop for health care, from pediatrics and dentistry to the pharmacy and specialized services like cardiovascular care. However, doctors at Boriken say they do not have a clear picture of how much funding they should expect as negotiations over the state budget continue.

"Right now, the budget hasn't been passed. The [federal] government has allocated $60 million. The [state] Senate, in their one-house bill, has appropriated $100 million. In the [state] Assembly, $80 [million]. So, still falling short of the $300 million that we feel we will need to continue to offer the services," said Dr. Adam Aponte, an East Harlem native and CEO of Boriken Neighborhood Health Center. 

"We've gotten it past the first hurdle" 

That $300 million dollars is not just for Boriken. It's also for the more than 50 Federally Qualified Health Centers (FQHCs) across New York State.

FQHCs are facilities that care for a vulnerable population or underserved area, accept Medicaid, and offer sliding fees based on a patient's income and family size, among other requirements. They are often found in low-income neighborhoods and serve around 2 million New Yorkers every year, according to the NYS Department of Health. 

New York DOH reported that compared to the state's general population, community health centers disproportionately care for people who may otherwise experience barriers to healthcare, "including people with incomes at or below 100 percent of the federal poverty level, those without health insurance, people from racial and ethnic minority groups, and those with limited English proficiency." 

Doctors and local lawmakers say these centers can often interrupt the cycle of health inequalities. The logic is simple, they say: if you can't easily get to your doctor, you're less likely to go to the doctor, which only makes you sicker.

Democratic State Senator Cordell Cleare says she's been pushing for that additional funding the budget negotiations.

"I'm going to continue to fight to make sure this stays in the budget. We got what was called the "One-House [Budget Resolution] in the [State] Senate. We have gotten these allocations put in our one-house proposal. Now we have to make sure that the [State] Assembly and the Governor, those two other branches agree," Cleare said. "That's what budgets are. It's really agreement between the Assembly, the Senate and the governor. So we've gotten it past the first hurdle." 

Cleare said even as negotiations drag on, she's hopeful that centers like Boriken will get the funding they need. 

"This is important. This saves lives. This gives me a healthier community. [FQHCs] are certainly the most accessible. They're close. They're familiar, they're familiar culturally," Cleare said. 

"They're going to wind up in the emergency room"

Aponte said without sufficient government funding, his facility will have to scale back the services they offer, forcing patients like Angelique Torres to travel even farther for care.

"What that's going to lead to is that patients, instead of coming here for primary care, they're going to wind up in the emergency room ... which is way more expensive." said Aponte. "What we do here is much more economical when we do this preventive care. Then when a patient winds up in the emergency room, just even think about taking an ambulance to the emergency room, the cost of the ambulance, then the cost of the emergency room, that is way more expensive."

Aponte is also concerned about the future of telehealth. The use of virtual doctors visits has nearly tripled compared to before the COVID-19 pandemic and remains popular due to the convenience. However, currently in New York State, FQHCs do not legally receive the full reimbursement rate that other healthcare facilities do. 

Governor Kathy Hochul's office said in a statement, "The Governor will continue to negotiate in good faith with the Legislature to pass a state budget that protects healthcare access for New Yorkers."

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