Fiscal Cliff 2015


March 2015

Mendocino Community Health Clinic, Inc. (MCHC) is a Federally Qualified Health Center (FQHC) operating three facilities and providing medical, dental, and behavioral health care to more than 550 people a day in Lake and Mendocino Counties. Right now they—and other FQHCs—are facing a fiscal cliff: if federal funding is not approved soon, funding to FQHCs will be cut and local health care could be severely limited starting September 30.

MCHC and other local FQHCs provide health care to the most vulnerable people in our communities. According to the Health Resources and Services Administration, FQHCs include all organizations receiving grants under Section 330 of the Public Health Service Act (PHS). FQHCs qualify for enhanced reimbursement from Medicare and Medi-Cal, as well as other benefits in return for serving an underserved area or population, offering a sliding fee scale, providing comprehensive services, having an ongoing quality assurance program, and having a governing board of directors. 

FQHCs also work with the National Health Service Corps to hire doctors and then forgive some of their medical school debt in return for serving vulnerable populations.

  Traditionally, the reason the FQHC model has received funding year after year is because it is a cost-effective way to provide high quality care to people who can ill afford it. Rather than waiting until a person’s health condition requires expensive emergency treatment, FQHCs provide health care for all patients, regardless of their ability to pay, and FQHC providers help patients manage their conditions to stay healthy—better for patients, and less expensive for tax payers.

MCHC Chief Executive Officer Linnea Hunter explains it this way, “Let’s say you have diabetes. We provide nutrition education and encourage patients to get regular blood tests to keep the diabetes under control, because our reimbursement from the federal government depends, in part, on our patients staying healthy. A blood test is much less expensive than having a foot amputation, which is what can happen when diabetes gets way out of control.”

After the Affordable Care Act (ACA) passed in 2010, the federal government invested capital funds in FQHCs to expand their capacity to care for the additional patients expected as a result of the ACA.

“Doctors aren’t going into private practice anymore. FQHCs are the way of the future,” Hunter said.

So while it seems counterintuitive that this type of funding would be cut, the way federal lawmakers approve funding is not so straightforward. When a must-pass bill is introduced, lawmakers affix riders to fund their pet projects, and those pet projects are sometimes enough to kill a bill.

 “While we hope lawmakers will come to their senses, it is stressful to face a fiscal cliff,” said Chief Operating Officer Carole Press. “MCHC is relatively large, as FQHCs go, but we worry about smaller FQHCs like Anderson Valley Health Clinic or Mendocino Coast Clinics. They depend on this funding to keep their doors open.”

Press explained that MCHC’s federal funding allows the organization to hire hundreds of local people who spend their money in the community, supporting the local economy.

She said, “This particular decision in Washington, D.C., could have a very direct impact locally.”

Hunter said lawmakers who represent our area, including Jared Huffman, Barbara Boxer, Diane Feinstein, and Mike Thompson, all support FQHC funding, but it will take more than their support to pass a funding bill.

According to the National Association of Community Health Centers, on March 24, House leaders from both parties introduced legislation that includes two-year extensions of funding for the FQHCs, the National Health Service Corps and the Teaching Health Centers program. Without this funding, millions of low-income Americans in rural and underserved communities may lose access to primary and preventive health care.

To share your support for this funding, write to your local representatives: Congressman Huffman (, Senator Boxer (, Senator Feinstein (, and Congressman Thompson (

For more information about Mendocino Community Health Clinic, call (707) 468-1010 or visit 

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