Thousands of health clinics serving the nation’s poorest residents face closure and cutbacks amid the coronavirus pandemic, a trend that could imperil hard-hit communities long after the disease is contained.
One in 11 Americans – about 31 million people – depend on safety-net health clinics for care not otherwise available because they have no health insurance, live in isolated areas, speak no English or are homeless. These clinics include about 12,000 community health centers funded by federal tax dollars and 1,300 charitable clinics run with donations and volunteers. But a drop in donations, uncertain federal funding, staff and volunteer shortages, and an overall lack of pandemic preparedness has forced some to scale back services or shut their doors.
As a result, America’s most vulnerable residents are at risk – not just from the COVID-19 pandemic but because they’re now losing access to care for other pressing medical needs. “The gaps that pre-existed, they still exist. And they’re getting bigger as this emergency unfolds because we’re having to redirect the resources we have at this new threat,” said Thomas Tighe, CEO of the medical nonprofit Direct Relief.
In Orlando, Florida, the nonprofit Grace Medical Home closed about half its specialty care clinics because its volunteer doctors all fit the high-risk profile – elderly, with preexisting conditions – for severe COVID-19. On top of that, the group had to cancel its annual fundraiser.
In Hollywood, California, the federally funded QueensCare Health Centers has protective gear on its shelves but can’t find a supplier to guarantee that more will be sent. And in Washington state, the Olympia Free Clinic cut its entire staff one day down to the sole volunteer not considered to be in a high-risk category for the coronavirus. “We’re flying by the seat of our pants,” said Dr. Mike Matlock, the free clinic’s medical director.
The challenges are exacerbated by where safety-net health providers work and because so few were prepared for a pandemic. Most are located in counties that federal officials have found are ill-prepared for a disaster or are having a shortage of health care services, according to a USA TODAY analysis of federal data and clinic locations. About two-thirds of those extremely vulnerable communities already have confirmed cases of COVID-19.
Just half of those clinics had plans for handling an infectious disease epidemic, according to a survey in early March by Direct Relief. Many are now rushing to adapt. The emergency coronavirus relief bill Congress passed last week provided $2 billion for community health centers. Experts said that’s less than half of what they need to handle both normal services and coronavirus response through November. Meanwhile, the doctors, nurses and volunteers that staff these clinics are scrambling to address the influx of potentially infected residents while trying to manage their regular caseload of broken bones, pregnancy checkups and diabetes-related infections.