Community health centers, which help millions of the nation’s poorest and most overlooked patients, are struggling with preparations for a surge of COVID-19 patients and facing tough financial decisions, their leaders say.

Officials representing community health centers say they’ve had to lay off employees as a lack of cases besides those involving COVID-19 has some centers concerned about their futures.

“It’s dramatically, immediately hitting everybody’s bottom line,” Anita Monoian, the president and chief executive officer of Yakima Neighborhood Health Services in Yakima, Wash., said of the coronavirus-based disease.

Monoian told CQ Roll Call last week that she’d had to furlough workers, as the health center prepared for the virus to reach that part of the state. She said she feared the health center would soon run out of tests and medical equipment.

The third bill (S 3548) to respond to the economic effects of the pandemic would extend funding for community health centers and other public health programs through Nov. 30, providing certainty beyond a current May 22 deadline but not the five years of funding that health centers want.

The bill would provide $1.32 billion in supplemental funds for community health centers. The measure would also allow community health centers to use leftover funds from fiscal year 2020 to maintain or increase staffing to address the virus, according to a Republican summary of the bill.

Steve Carey, the chief strategy officer of the National Association of Community Health Centers, said the extension to November would be helpful, but that he expected Congress to eventually provide a longer-term reauthorization.

More important is emergency funding for health centers, which the group will continue to push for in future phases of response legislation, he said.

“It has become clear to us that Congress wanted to address the most immediate issues and we proceeded in our advocacy with the expectation that they wanted to look at longer-term things as well,” he said. “It would be a help to know that we get a long-term fix, but we understand what leadership is doing.”

The Department of Health and Human Services on Tuesday announced it would distribute $100 million to 1,381 health centers across the country from funds provided in the first supplemental package to address the virus (PL 116-123). Each health center would get between $50,000 and $320,000, said Jim Macrae, associate administrator for the Health Resources and Services Administration Bureau for Primary Health Care.

“Clearly having the full set of resources would be helpful and we are working with Congress on that,” Macrae added, referring to efforts to reauthorize long-term funding for health centers.

Health care providers of all types across the country are sounding the alarm on their preparedness to treat patients with the COVID-19 virus. Officials at community health centers said their employees were no different. They had concerns about not having enough personal protective gear and trying to repurpose their offices to have enough room to treat patients with the virus.

They’re also balancing concerns about protecting their own personnel from contracting the virus and trying to maintain their workforce when doctors should self-quarantine for 14 days if they are exposed to the virus.

Still, the financial concerns weigh heavily.

“I’m really not sure what the future of our organization looks like if we don’t have some real relief very soon. Like yesterday soon, like last week soon,” said Jennifer Hasch, the dental services manager at Shawnee Christian Health Center in Louisville, Kentucky.

Hasch said she’d had to tell 12 team members they were being let go, including dental workers and employees who did community and school-based outreach.

She said she’s been ordering medical supplies through the health center’s dental supply company, since their typical medical supply company hasn’t had items they need available. The state’s oral health coalition, which she works with, is coordinating a push to ask dental offices in the state that are currently closed to donate protective equipment to nearby hospitals.

Hasch told CQ Roll Call that she’s nervous about what could come, given the reports out of New York where the number of cases and deaths are rising.

“What we’re seeing in New York — I can’t even imagine if that is my city in a couple weeks,” she said.

Michael Curry, the deputy CEO of the Massachusetts League of Community Health Centers, said health centers in his state saw their revenues drop between 50 percent and 70 percent as the virus became more of a threat.

The funding announced this week for health centers would help support centers in the short term, but long-term funding would be needed to make sure that health centers can weather the storm, Curry said.

“This is worse than the tsunami we warned about,” Curry said. “This is a pandemic that is financially causing significant strain to the financial operations of our health centers.”