A continued freeze on federal funds and uncertainty about the future of Medicaid have put a North Coast hospital in a wait-and-see situation.
Columbia Memorial Hospital, or CMH, is in the middle of a massive expansion and renovation project at its Astoria campus. The hospital is due to receive a $20 million resiliency grant through the Federal Emergency Management Agency. While that funding still seems likely to come through, a request for matching funds from the state is not as certain.
CMH plans to ask the Oregon Legislature for $6 million in matching funds during the current session. So far, the proposal has received positive support from a number of lawmakers.
“Six million is a lot to ask for a single project in any community, but I think this one rises to the top of the type of project they like to see,” said state Rep. Cyrus Javadi.
One thing that might get in the way, however, is uncertainty over Medicaid.
House Republicans adopted a federal budget resolution at the end of February that suggests Medicaid could face major cuts.
Around 1.4 million Oregonians rely on Medicaid — through the Oregon Health Plan — for their health care. That includes just over half of the state’s children. According to data collected by the Oregon Health Authority, nearly one third of the residents of Clatsop, Columbia and Tillamook Counties are enrolled in Medicaid — nearly 40,000 people across the three counties.
In Clatsop County, around 34% of the population, or more than 14,000 people, are enrolled. Of these, nearly 5,000 are children.
The Oregon Health Plan is funded by state resources that are matched by federal dollars. Cuts to Medicaid would push costs onto the states — and the need to absorb those costs could mean requests like CMH’s fall farther down the priority list or are not considered at all.
“Medicaid is such a big part of our budget,” Javadi said, adding, “And if we cut some of that spending even a little bit then we either cut … medical expenses and treatment for people throughout the state or we have to backfill it from the general fund. And if we start backfilling from the general fund, it’s gonna be the local community projects that are going to be on the cutting board.”
CMH still plans to proceed with its request, said CEO Erik Thorsen.
If the state does not — or cannot — supply a match, he said the hospital will find another way to fill that funding gap. Overall, the project is well-funded, he added.
What could have a bigger impact is if the FEMA grant does not come through.
For now the hospital is continuing with all the necessary steps to receive the grant and has not been notified that the grant is in jeopardy, Thorsen said.
“But there is a great deal of uncertainty around FEMA grants and just federal government assistance in general,” he said.
Payments from the FEMA grant are due to be distributed as construction happens and won’t begin until the foundation work on the hospital is underway. That work is not scheduled to begin until August.
If the FEMA grant does not come through, Thorsen said the hospital will need to make big design decisions for the part of the expansion project that includes the construction of a new facility.
The building plans currently feature a number of components to make the campus more resilient to earthquakes and tsunamis. This includes a vertical evacuation staircase and safe refuge space on the roof for nearly 2,000 people.
Thorsen said that, overall, he is not worried — at least not yet.
“I really am trying to take a wait-and-see approach,” he said, “and I’m trying not to overreact to some of the uncertainty and messaging that comes from the current administration … I’m just trying to wait until I get the clarity that’s necessary to make the right decisions.”