America’s health care safety net lacks adequate federal funding, PPE and access to loans
SAN DIEGO – Community Health Centers are serving on the front lines of the nation’s battle against coronavirus. CHCs are nonprofit health care clinics that provide health care to 29 million patients nationwide, 25% of which are uninsured and 70% of which live in poverty. America’s 1,400 CHCs operate 15,000 clinics in medically underserved communities and subsist almost entirely on government funding.
Throughout this pandemic, CHCs have continued treating their patients by operating urgent care sites, providing delivery and pickup pharmacy services, offering telehealth and in-person primary care appointments and opening drive-thru coronavirus testing sites. Their care diverts hundreds of thousands of patients from overcrowded hospitals, which is essential in states like California, Florida, Washington and New York, where demand for inpatient care is at its peak.
In providing such care, CHCs face the same financial challenges other businesses and nonprofits face. Many clinics have already furloughed or laid off between a quarter and a third of their employees, less than a month into the pandemic. Some of the services that are considered “non-urgent,” like dental care or optometry, are not currently being offered. Many of the “non-urgent” health services helped finance primary or specialty care services, including care for immunocompromised patients who are living with HIV, diabetes and other chronic illnesses.
In spite of these realities, CHCs have received significantly less federal support than most other industry sectors. To date, CHCs have received only $100 million in funding from the first coronavirus response bill and $1.32 billion from the $2 trillion CARES Act. Comparatively, nonessential, non-health-care-related industry sectors have received billions more, including higher education at $14.2 billion for colleges and universities, the airline industry at $58 billion and the agricultural industry, including specialty farming like “tart cherry growers” at $9.5 billion.
While every CHC has been hard-hit by the financial realities of this pandemic, the nation’s largest CHCs, which have more than 500 employees, do not qualify for additional government support, such as Small Business Administration loans, that smaller CHCs have access to. Large CHCs are currently experiencing losses ranging from $5 million to $9 million per clinic, per month. This reality prompted 37 of the nation’s largest FQHCs, representing 3.3 million patients located in south Florida, New York City, Los Angeles, Boston, Providence, Santa Clara County, San Francisco, Seattle, Riverside, Bakersfield and San Diego, to urge U.S. Health and Human Services Secretary Alex Azar to allocate $7 billion of the $100 billion made available to health care providers in the CARES Act, to CHCs. The five largest CHCs in California, as well as 11 of the 15 largest CHCs in the nation, participated in this advocacy effort.
“As one of the largest CHC’s in the nation, we’ve faced tremendous financial strain over the past three weeks. We are seeing 60% fewer patients for medical services and 90% fewer patients for dental services than we were in the beginning of March, in spite of the fact that we have invested significantly in building capacity for virtual visits. We anticipate that we may face deep workforce losses and have to shutter some of our clinics by the time this pandemic runs its course,” Mikia Wallis, CEO of Borrego Health, said.
“New York has been devastated by this crisis. Community health centers continue to provide care for 2.4 million New Yorkers, keeping them healthy, at home, and out of hospitals – which is essential to saving lives and protecting our hospitals. At Hudson River health care, we have swiftly adapted, offering video and telephonic primary care, behavioral health and substance use disorder treatment services with extended hours,” Anne Kauffman Nolon, CEO of Hudson River health care, said. “We are also on the front lines of increasing COVID-19 testing, testing nearly 1,000 patients within our centers, establishing outside testing sites to mitigate exposure risks among providers and patients, collaborating to administer rapid antibody testing for first-responders and more. To sustain our direct response to this pandemic, we need support and resources now and longer-term investments to support virtual services.”
“AltaMed has the capacity to prevent further spread of COVID-19 in Los Angeles, one of the largest and most at-risk communities. CHCs like ours act as filters to direct only patients with severe symptoms to hospitals,” Cástulo de la Rocha, president and CEO of AltaMed Health Services, said. “To meet the increased demand, we launched six outdoor evaluation sites for the community at large and one specifically for our seniors in the PACE program. We’ve seen approximately 2,000 patients since the first site opened two weeks ago, but with fewer patients coming in for regular care, these vital services come at great cost to AltaMed. We have the ability to screen about 1,500 patients per day, but we cannot sustain and grow the effort without financial support.”
“Community health centers are on the front lines in California, serving 7.2 million people. They need to be as strong and prepared as possible to help combat this disease across our state. If they don’t receive additional resources, we are undermining one of our most vital assets at one of the most critical moments in this nationwide battle,” Carmela Castellano-Garcia, CEO of the California Primary Care Association, said.
Submitted by Borrego Health.