LaMalfa, Torres Small Lead Bipartisan Group of Lawmakers Urging Congressional Leadership to Preserve Critical Rural-Serving Health Programs

Apr 7, 2020
Press Release

(Washington, DC) – U.S. Representatives Doug LaMalfa (R-CA-01) and Xochitl Torres Small (D-NM-02) led a bipartisan group of 28 House colleagues urging Speaker Pelosi and Leader McCarthy to preserve long-term funding and resources for critical programs serving vulnerable populations and Americans in rural areas as the United States continues to face the COVID-19 public health emergency. The lawmakers sent the letter following enactment of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, which reauthorizes the Teaching Health Center Graduate Medical Education (THCGME) Program, Community Health Centers (CHCs), National Health Service Corps (NHSC), Special Diabetes Program, and Special Diabetes Program for Indians through November 30, 2020.

LaMalfa said: “In rural areas like Northern California, we have a severe shortage of physicians, resulting in less access to vital healthcare. The 12 Community Health Centers and Teaching Health Center Graduate Medical Education Programs in my district serve over 200,000 patients alone. THCGMEs, like Shasta Community Health Center in Redding, not only provide much-needed short-term care in medically underserved rural areas, but also help train physicians who will plant their roots and be there for their patients long-term. A 5-year reauthorization of critical funding for THCGMEs and CHCs helps grow the number of physicians in our area, while giving patients the stability they need.”

Torres Small said: Rural healthcare providers already operate at the margins. Right now, they’re under even more financial strain and uncertainty without a clear, long-term plan to preserve essential programs such as THCGME and Community Health Centers. Doctors and nurses are working around the clock to protect our families and neighbors, and it’s now on Congress to step up to end unnecessary doubt and secure long-term authorization for these proven community-based programs.”

“Much of rural Northern California suffers from acute and chronic shortages of primary care physicians and the challenges in recruitment are not getting any easier,” said Dean Germano, CEO of Shasta Community Health Centers. “Our best approach is to “grow our own” and the only way to do this is to be able to support an ACGME accredited training program like that which we have in Family Medicine. For the last several years we have managed to identify medical students who have roots in our community that we have now provided a Residency training opportunity to. By doing this, the data shows that this greatly improves the chances of retention following training if they grew up here. The only way we can afford to provide this training is through the Teaching Health Center program as the training of physicians in our country takes significant resources to accomplish. There is no short-cut to this training nor the expense. Without the Teaching Health Center program our community and our patients would be put at significant risk if we could not replenish and extend our primary care physicians in these otherwise hard to serve regions. For us, without the THC program, we would not have a Family Practice Residency program targeted to our rural health needs. It is therefore critical that the program has long term stable funding and the ability to extend the program to the many other regions of our State and Country that would greatly benefit from its obvious success.”

The full letter can be found here or below.

April 6, 2020

The Honorable Nancy Pelosi                                      The Honorable Kevin McCarthy                   

Speaker of the House                                                  Minority Leader                                             

U.S. House of Representatives                                   U.S. House of Representatives        

H-232, U.S. Capitol                                                  H-204, U.S. Capitol

Washington, DC  20515                                               Washington, DC  20515

Dear Speaker Pelosi and Minority Leader McCarthy: 

We write to thank you for your ongoing commitment to improving our nation’s health care system. As COVID-19 continues to affect communities across America, it is even more essential that our health care providers have the funding and resources they need to care for vulnerable populations. Thus, we urge swift action and robust funding to preserve critical programs that provide Americans across the nation access to the highest quality and most affordable health care.

The Teaching Health Center Graduate Medical Education (THCGME) Program, Community Health Centers, National Health Service Corps, Special Diabetes Program, and Special Diabetes Program for Indians are essential programs that offer rural Americans and vulnerable populations essential care. The Coronavirus Aid, Relief, and Economic Security (CARES) Act reauthorized these programs until November 30, 2020, making an important first step to ensure every American has access to care during the COVID-19 public health crisis. 

However, continued short-term authorizations leave health care providers and patients alike facing uncertainty as the expiration date looms. The absence of a long-term authorization undermines health care providers’ ability to invest in purchases such as medical equipment and forces them to brace for significant layoffs of staff. Additionally, failure to reauthorize the programs before they expire would result in patients across the country facing reduced access to care, worsened health outcomes, and increased treatment costs. This uncertainty leaves vulnerable communities feeling the consequences.

Chronic diseases like diabetes are the chief driver of the country’s $3.5 trillion annual health care expenditure, and a leading cause of death for Americans. These programs provide crucial solutions by increasing access to life-saving care and supplementing the country’s medical workforce. By providing high-quality, timely, and community-based care, these programs lower health care costs and improve health outcomes. For every dollar spent on primary care, the health care system saves $13 due to reduced hospitalizations and effective disease management.

Funding uncertainty threatens to jeopardize these programs and the essential care they provide. We urge immediate action to approve a five-year reauthorization so that these critical programs have robust funding and the stability necessary to achieve their mission of improving the health and well-being of all Americans.



Xochitl Torres Small 

Member of Congress


Doug LaMalfa 

Member of Congress     


Additional Signers: 

  1. Vicente Gonzalez
  2. Cindy Axne
  3. Debra Haaland
  4. Susan Davis
  5. Tom Cole
  6. John Garamendi 
  7. Ruben Gallego
  8. Terri Sewell
  9. Juan Vargas
  10. Collin C. Peterson
  11. Harley Rouda
  12. Brian Fitzpatrick
  13. David Scott
  14. Kim Schrier, M.D.
  15. Pete Stauber
  16. Sheila Jackson Lee     
  17. John H. Rutherford
  18. Abby Finkenauer
  19. Nanette Diaz Barragán
  20. Haley M. Stevens
  21. David Trone
  22. Bobby L. Rush
  23. Jim Costa
  24. Jesús G. "Chuy" García
  25. Susie Lee
  26. Sanford D. Bishop, Jr.
  27. Jahana Hayes
  28. Matt Cartwright