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Vetoes will cost lives if funding isn’t restored

  • Author: Cheryl Kilgore
    | Opinion
  • Updated: July 26, 2019
  • Published July 28, 2019


Alaska’s Community Health Centers (CHCs) are the primary care safety net providers serving Alaska’s most vulnerable and underserved patients. CHCs serve 113,000 patients at more than 160 clinic sites across the state. We urge the Legislature and the governor to restore funding in the following areas:

Medicaid Adult Preventative Dental Program – Alaska CHCs are a primary provider of comprehensive dental services to Alaska adults. Preventative dental services are a gateway to whole person care that improves health outcomes for patients and decreases use of costly emergency services. These services are also closely linked to increasing the employability of low-income people seeking to rejoin the workforce. The loss of these funds doesn’t mean that the demand for comprehensive dental services diminishes, it shifts care into high-cost, limited effectiveness emergency room treatments and increased coverage and treatment costs for people with insurance.

Medicaid services cut – Alaska CHCs oppose the $50 million unallocated cut issued through the governor’s vetoes, in addition to the $89 million cut to Medicaid by the Legislature. Furthermore, the administration has not explained the amount of federal funds Alaska will lose as a result of this veto. As our communities’ struggle with the rise of crime, substance use disorders and the opioid epidemic, Alaska simply cannot afford to further erode the Medicaid services our vulnerable and underserved patients rely upon.

Power Cost Equalization – CHCs are currently contending with completely unanticipated increases to the cost of electricity needed to keep their clinics open that will be payable as early as Aug. 1. Cost increases of up to 50% are anticipated in some communities. A lengthy disruption of this vital program takes away from the care that can be provided to patients.

University of Alaska cuts – The No. 1 challenge faced by CHCs is recruiting and retaining a stable workforce. CHCs partner directly with UA to “grow their own” support and clinical staff, as well as directly benefiting every year from WWAMI graduates, nurses, dental hygienists, and physician assistants choosing careers in primary care, frequently in rural CHCs.

Behavioral health treatment and recovery grants – More than half of CHCs are also Community Behavioral Health grantees. These two highly complementary programs have worked hard in recent years to integrate and address the whole-person care needs of the patients who have a mild to moderate behavioral health issue as a co-condition with diabetes or hypertension, as well as providing ongoing care to patients who have severe emotional disturbances and mental illness, as well as substance use disorders. Cuts to these programs will result in a tragic shift of care from community-based providers to hospital emergency rooms and the corrections system.

CHCs understand how Social Determinants of Health influence the patients they serve. Services that support basic income, housing, legal services and food security have been significantly cut, and these services are vital in addressing the needs of our patients to improve their health outcomes while lowering all costs to the health system. Therefore, we are particularly focused on seeking action around the following programs:

- Basic needs: Senior Benefit program and Adult Public Assistance

- Housing: Homeless Assistance Program

- Community matching grant programs

- Alaska Civil Legal Services Fund

The ramifications of continued cuts will be borne by the most vulnerable of Alaska’s residents, who will seek relief in much higher-cost and inappropriate settings.

Some of our patients will undoubtedly lose their lives because of these cuts if legislators fail to take action.

We support reinstatement of operating budget funds, reallocation of dedicated funds, and a balanced approach to allocation of Permanent Fund assets between individuals and the programs on which they rely.

Cheryl Kilgore has been the Director of Interior Community Health Center for 23 years, involved in health and public health in Alaska for 38 years including serving as Past President of the Alaska Public Health Association and Alaska Primary Care Association. She and her husband, Bill, have lived in Fairbanks for 47 years and have two adult children and two grandchildren.

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