Dave Ramsey, President and CEO of Charleston Medical Center in West Virginia, was surprised when Senators Joe Manchin (right) and Shelley Moore Capito (right) staff phoned this summer to ask if the 956-bed hospital has any projects for what needed funding.
Since it is a non-profit teaching hospital and regional referral center in one of the poorest states in the country, the answer was naturally yes.
Senators asked because after a 10-year hiatus, Democrats in Congress are returning earmarked funds that allow individual lawmakers to target funding in appropriation bills to specific home needs.
Manchin and Capito received a collective $ 15 million in a Senate Health and Human Services Funding Bill to fund new clinical imaging equipment, an expanded intensive care unit, and a new teaching and research building designed to attract medical students to the Charleston Area Medical Center.
“We have a very poor composition of payers. We are not a wealthy hospital. We are not from a wealthy state and we are challenged every year when it comes to capital, ”Ramsey said. “That these three projects were selected is a great experience for us, and it takes a little pressure off our capital requirements.”
Nonprofit hospitals and other service providers are slated to receive millions of dollars in targeted bills that could be accepted as early as next month.
Congress could commit about $ 15 billion in FY2022 in earmarked appropriations, which is less than 1% of federal discretionary spending.
Of these, the Senate has committed more than $ 728 billion to health-related projects to be allocated by the Health Resources and Services Administration, according to a Modern Healthcare analysis.
The House version includes $ 367 million for projects to finance the construction and renovation of medical facilities, including the purchase of new equipment. The House and Senate will have to resolve differences between the bills, but the $ 15 billion limit allows funding for all projects that have already been included in the appropriation bills, said Franz Würfmannsdobler, a senior adviser to the Bipartisan Political Center who advocated the return of targeted marks.
Most of the funds will go to health care providers, including non-profit hospitals, academic health centers, community colleges, nursing homes and nursing homes, health departments and local governments, mental health providers, and other non-profit organizations. organizations.
Most of the money is for premises and equipment, given that access to capital can be difficult for cash-strapped suppliers.
Especially since the outbreak of the COVID-19 pandemic, some of these projects have been put on hold and receiving targeted funding could give them the boost they need.
Brooklyn Hospital Center in New York will receive one of the largest appropriations in a Senate bill: $ 9.2 million to modernize the emergency room at the request of Democratic Senators Kirsten Gillibrand and Chuck Schumer, who is the House Majority Leader.
This funding will help the 464-bed public clinical hospital complete the modernization of the emergency department, taking into account the lessons learned from the pandemic, including the need for more isolation wards. The improvements had been part of the strategic plan for the system for several years, and there was no clear way to fully fund it. Then the marks returned.
“It was a little wish-list as we were trying to figure out how to do this,” said Lenny Singletery, the hospital’s senior vice president of external affairs.
The dollars will also go towards new examination and treatment rooms, a rapid assessment room, psychiatric observation, cardiac treatment and deceased rooms, new waiting areas and new equipment for specialist services.
“We had no idea we were going to get the money to complete the project, in addition to purchasing equipment badly needed for an institution our age,” Singletery said.
Republicans have banned reservations after they won a congressional majority in the 2010 elections, citing corruption, waste and rising federal spending.
Proponents of a targeted resurgence argue that the money would have been spent anyway, and that letting legislators control where they go is preferable to letting federal agencies make those decisions.
The new earmarked funding process is also more transparent and requires member requests and approved projects to be published online. Earmarked allocations are limited to non-profit organizations and government agencies. Members are limited to 10 requests per year.
“In the past, concerns were that big influential old-timers in the House and Senate received most of the earmarked money, and other members could be expelled due to lack of power,” said Kevin Kosar, a senior fellow at the American Enterprise Institute. … “This will democratize him,” he said.
It is also true that influential legislators, especially those on the Senate Appropriations Committee, have received some of the largest spending on health care.
The Senate bill allocates $ 30 million to the University of Missouri to build a new health and life sciences center, a priority for Home State Senator Roy Blunt, the top Republican in the spending group.
Blunt has won several other grants, including $ 12 million for the Missouri Primary Health Care Coalition in Jefferson City and $ 10 million for the Jordan Valley Community Health Center in Springfield for both premises and equipment.
Meanwhile, Senator Lindsay Graham (RS.C.), another appropriator, won $ 17 million to renovate an operating room at Beaufort Memorial Hospital.
Despite these large numbers, the median target in the Senate bill is around $ 1.3 million.
While requests for FY2022 appropriation are no longer being accepted, requests for the next fiscal year are likely to start coming in over the next few months and be completed by the spring.
Nonprofits interested in targeting should check their members’ websites to see what types of projects have received approval this year and to contact trade associations and community groups that have good contacts on Capitol Hill, Michelle Gilbert said. senior political analyst at the Bipartisan Political Center.
Inquiries go through the offices of the members, and projects selected by legislators’ staff must also be approved by committee staff. The requesting organizations also need to demonstrate that the community supports the project, she said.