Because Congress did not extend the Community Health Centers Fund by Oct. 1, every Community Health Center across America and its territories, including the Virgin Islands and Puerto Rico, faces drastic reductions in federal funding at the beginning of their next project period.

Without this fix, Community Health Centers face a 70 percent cut in funding. Because the direct cuts to federal grants do not take place immediately, some policy makers are under the inaccurate impression that the cuts will not impact health centers until January.

In fact, the funding cliff is already causing disruption, and funding uncertainty is already forcing cutbacks and operational instability now. For example, even before Oct. 1, 26 percent of health centers report that the potential for the funding cliff had already made it harder to recruit and retain staff.

Funding uncertainty is having an immediate impact and forcing hard decisions today. Because the Health Centers Funding Cliff is not yet fixed, health centers are considering or are already taking a number of actions that will have an immediate impact on their capacity to provide high-quality care to their patients.

• Seventy-two percent will implement a hiring freeze

• Fifty-two percent will cancel or delay facility renovation or expansion

• Fifty-three percent will cancel or delay performance improvement investments

• Forty-one percent will lay off staff

• Forty-seven percent will reduce staff hours and/or hours of operation

• Forty-two percent will begin tapping into and spending down financial reserves

Services for patients will be cut, including dental, medical, behavioral health/substance abuse (including opioid dependence), and enabling services (non-clinical services that improve access to care and health outcomes, such as case management, education, translation and transportation).

Failure to fix the Health Center Funding Cliff will ultimately lead to critical cuts in access to care.

• An estimated 9 Million people will lose access to care

• Around 2,800 Health Center delivery sites will be closed

• Around 51,000 providers and support staff will be laid off

The inaction by Congress to appropriate federal funds for fiscal year 2018 is causing needless worry for volunteer governing boards of directors and concern for the safety net delivery system across our United States.

Over the past two decades there has been a significant, steady increase in federal investment in the Community Health Center Program to gear up to serve millions more people. Why now would Congress intentionally withhold funding to see such an investment crumble?

Congress must act immediately to secure funding for the safety net providers across America. Without Community Health Centers to rely on, people will be forced back into hospital emergency departments for primary care.

Mary Geegan Middleton is the CEO of the Cassopolis Family Clinic Network.