The urgent texts started flying around 6:30 a.m. Tuesday for Denver Health CEO Donna Lynne and her team.
They suddenly weren’t able to access millions in funds via an online portal that routes federal money to state and local health agencies.
Denver Health quickly learned the problem was connected with President Donald Trump’s order to put a freeze on federal funding. By around 3 p.m., following a legal challenge, a court had ordered the funds to keep flowing.
“This has probably been the most chaotic day I think that we've experienced. And patients deserve care. I mean, I think we are playing with fire right now,” Lynne told CPR’s John Daley.
Work was underway on Tuesday afternoon to restore access to Denver Health’s access to the funding portal, but questions lingered about the long-term effects of the federal funding order.
In an interview, Lynne said the change came without warning or explanation, throwing the state's largest safety-net hospital into crisis mode. The shutdown threatened to affect about $1 million a day for the hospital.
Read the interview
This Interview has been edited for clarity and brevity.
What happened:
Donna Lynne: We found that we were unable to draw down routine funds that we're able to use to fund some of our programs. We're in the community in 10 different clinics, plus 19 school-based clinics. They rely on federal funding and we provide services to 200,000 people. We rely on federal funds to support some of that work. So it's very concerning that those funds appear to be frozen right now.
And from what I understand, for multiple of our other partners, other clinics, particularly federally qualified health clinics and educational institutions, that reached out to me. So they were not available.
John Daley: Was Denver Health warned of the change?
Lynne: No. That's part of the challenge, I think, is no communication other than the New York Times, the Washington press, and then as I said, our own employees who alerted us to their concerns, where their positions are federally funded
When we heard about the [Trump executive] order, we didn't understand the full implications of it. It did say it was going to go into effect Tuesday at 5 p.m. So when we sought to draw down the money Tuesday a.m., we were not able to draw that down. So [there was] confusion about the timing and lack of information about what the restoration might be.
Daley: How much federal money does Denver Health get?
Lynne: Just about $90 million a year could potentially be impacted. I mean, if the freeze is for a shorter period of time, obviously it's a prorated amount.
It affects some of the ability for us to do clinical research that actually saves people's lives, that helps physicians improve their practices based on new technologies, new pharmaceuticals, and other treatments.
(Editor's Note: Tuesday’s shutdown did not affect the hospital’s Medicaid funding, which helps it serve low-income people and some people with disabilities.)
I think one of the things we're very concerned about is Medicaid. Medicaid is a much bigger dollar amount for Denver Health. … [Potential effects on Medicaid funding] is sort of a worst case scenario in terms of the impact, but we know this [other] $89 million program that funds our clinics funds research is definitely in the frozen category.
Daley: What are the immediate effects?
Lynne: We've made a commitment to our employees that we are not going to stop services to our employees and to our patients. I worry a little bit about some of the small federally qualified health centers because their ability to keep making payroll could certainly be impacted by however long the freeze exists. I mean, and this happens across the United States, across Colorado, so patients could not be getting care in some of those clinics. Denver Health is committed to providing those services, but even we can't do it indefinitely for sure. I mean, this needs to be resolved quickly from our point of view.
Daley: What are federal and Congressional leaders saying?
Lynne: We haven't heard a word from the federal administration. We have heard from both Senator Hickenlooper and Senator Bennett, as well as the Attorney General.
Daley: Could Denver Health sue?
Lynne: We haven't looked into that. I mean, I think the basis of the federal law, and actually it goes back to 1974 and the Federal Impoundment Act, the jurisdiction is really attorneys general and Converse and the president, but not individual healthcare providers.
Daley: Has your legal team looked at this and what do they make of it?
Lynne: We are in constant communication with our legal team and trying to make sure that we respect what Washington is attempting to do, but also we've got to continue to provide services to our patients. We are not going to turn anybody away because of this.
Daley: What if the money doesn’t return?
Lynne: I think it would have serious impact on the safety net. I worry much more about the rural, some of our rural health centers, some of our, as I said, even in the metropolitan area, some of the community clinics or operating on days of cash on hand. And so I think they would be faced with some really hard decisions to make about keeping their doors open.
Daley: The federal memo was targeted at programs for DEI, gender affirming care and abortion. How does that affect Denver Health?
Lynne: We're currently subject to the Hyde Amendment, which prohibits using Medicaid funds to provide abortions. Now we have a complicating factor in Colorado because Amendment 79 was just passed, which gave a broad authority around the provision of abortion services. We're looking hard at what else might be impacted by the president's order, but we're committed to providing care to people who have medical, mental health and other needs in our community.
Daley: Have you ever seen anything like this?
Lynne: Never. Never. This has probably been the most chaotic day I think that we've experienced. And patients deserve care. I mean, I think we are playing with fire right now because there will be clinics, not Denver Health. There will be clinics that I think will be faced with the decision of whether or not they keep their doors open.
We communicated this afternoon with our employees to let them know that we're aware of the various executive orders, to let them know that we are working with a number of our elected officials and others, and that we are going to continue to provide care depending on how long this lasts.
But it's backwards to think that we wouldn't take care of people in [federally funded] clinics where you can prevent the acceleration of illness, where you can immunize people so that they don't get communicable diseases. That's the heart of what healthcare does, is it reaches people in their, and provides them preventive care. Otherwise, we'd end up with an emergency. We would end up across the state and the country with emergency rooms just full of people with really acute conditions. That's not what we want to be.
