Aid to non-Steward hospitals, health centers hung up in talks

BOSTON (SHNS) – Millions of dollars in potential state aid to strained hospitals remain in limbo on Beacon Hill, and one pending proposal would also deliver relief to struggling community health centers across Massachusetts.

The Healey administration last week disclosed that it has committed $417 million so far to help new operators keep six Steward Health Care hospitals open as new owners gradually take over.

But amid the turmoil over the surviving Steward Health Care hospitals here, and two that have closed in Ayer and Dorchester, lawmakers have generally agreed but have yet to deliver smaller amounts of funding to stabilize other flailing facilities in diverse communities that treat a high volume of patients on public health insurance.

The potential aid remains lodged in stalled supplemental budgets, and hospital market oversight packages. Both bills have receded into the darkness of a summer legislative recess and it’s unclear if lawmakers have made any progress in private negotiations.

Senators in late July approved sending $45 million to “fiscally strained” hospitals in their supplemental budget , plus $25 million to “fiscally strained” community health centers. The House version, which passed in late June, does not feature that type of health care support.

Michael Curry, CEO of the Massachusetts League of Community Health Centers, said centers had requested $75 million from lawmakers even before the Steward bankruptcy crisis.

Curry said community health centers need state relief to improve access to primary care for patients in underserved communities, bolster recruiting and retention efforts to tackle worker shortages, and keep up with heightened patient demand fueled by the migrant crisis.

“Care delayed is care denied, and that’s essentially what this comes down to,” Curry said. “If you are in need of primary care and you need to be screened on a regular basis for a condition, if you need access for your teeth, your oral health, your mental health, your substance use disorder, or your overall physical health, and you can’t get in to see your primary care provider — or you don’t have a primary care relationship — that is denial.”

State investments in primary and urgent care services at community health centers can ultimately reduce patient demand at costlier health care settings, including hospital emergency rooms, Curry said.

Asked why the Senate bill falls short of the league’s $75 million funding request, Senate Ways and Means Committee spokesperson Sean Fitzgerald defended the $25 million injection.

“Community health centers, like many hospitals in the Commonwealth, were financially distressed even before the Steward crisis and remain so,” Fitzgerald said. “$25 million is a fiscally responsible allocation to assist these community health centers, and as always, the Senate will revisit the needs of centers in future spending legislation.”

The fiscal 2025 budget contained $7.3 million for community health centers and $5 million for community health center workforce investments, Senate Ways and Means pointed out.

A $25 million investment for community health centers would be a “drop in the bucket” when considering patient and facility needs, said John DeMalia, CEO of Community Health Connections, which includes five centers in Fitchburg, Gardner and Leominster. DeMalia said the Leominster Community Health and Urgent Care Center is the closest CHC facility to now-closed Nashoba Valley Medical Center in Ayer.

“We have the ability to step up, but we need some financial backing in order to do so,” said DeMalia, who estimated the Leominster center could take on 2,000 additional visits per month.

But DeMalia said that’s contingent on hiring more staff, potentially enlarging the facility, and adding equipment like X-ray machines. When health centers cannot scale up capacity in response to a nearby hospital closure, patients are forced to travel longer distances from home, he said.

“That is the burden on the patients,” DeMalia said. “If you don’t give them someplace to go, they have to go further and go to more expensive care. Ideally, they would come to us for primary care, urgent care and keep the cost of health care down.”

NeighborHealth, which includes the East Boston Neighborhood Health Center and South End Community Health Center, is expected to experience the “secondary impact” of the Carney Hospital closure, said CEO Greg Wilmot. As Boston Medical Center and Beth Israel Deaconess Hospital-Milton absorb former Carney patients, Wilmot said patient backlogs will affect other community providers.

“I think the funding is definitely helpful — that $25 million will definitely have some significant impact to the financially strained community health centers across our state,” Wilmot said. “I will just comment to say it’s not sufficient, based on what we’re hearing, what we’re experiencing at our center, and what we’re hearing from our colleagues across the state.”

Wilmot noted that NeighborHealth, primarily at its Boston site, has also seen a 7 percent increase in uninsured patients over the last two years, which providers have attributed to an influx in migrants, who may need more intensive care and language services.

Beyond community health centers, the fate of legislative support for fiscally strained hospitals is also uncertain. Fitzgerald stressed the $45 million hospital aid allocation in the Senate bill would not flow directly to Steward.

“To be clear, Steward Healthcare would receive no funding from this, or any other, provision of the supplemental budget, should the line item be included in the final version,” Fitzgerald said. “The purchase of a Steward hospital by another hospital system would not disqualify other hospitals from the purchasing hospital system from receiving financial relief.”

Meanwhile, in the scrambled hospital oversight bills, the House version allocated $35 million to eligible hospitals annually for two years, while the Senate increased the volume to $45 million annually, Mariano’s office said. That legislation and the supplemental budget are “still being negotiated,” a Mariano spokesperson said.

The Massachusetts Health and Hospital Association says hospital operating margins have worsened over the past fiscal year.

“This is a deeply stressful time for hospital operations in Massachusetts, and our providers have a steep mountain to climb toward true recovery,” an MHA spokesperson said. “We are enormously grateful that the legislature is considering financial support for a subset of these hospitals, especially as the Steward crisis adds yet another layer of pressures to their daily demands. MHA and our members look forward to being a resource to elected leaders as they explore this further and help us stabilize the commonwealth’s most essential sector.”

The supplemental budgets have not been assigned to a formal negotiating panel while the hospital market oversight bills were sent in late July to a six-person conference committee chaired by Sen. Cindy Friedman and Rep. John Lawn.

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