As Virginia continues to reopen its economy while trying to avoid a resurgence of the coronavirus, the state’s network of free clinics is playing a pivotal role. By screening and testing for COVID-19 in addition to meeting the ongoing health care needs of uninsured patients, free clinics are preventing the escalation of the virus, reducing unnecessary emergency room (ER) visits and preserving hospital capacity. What’s more, free clinics continue to provide an invaluable range of services that go well beyond primary medical care. These include dental, pharmaceutical and behavioral health services, as well as programs addressing social determinants of health such as food insecurity and a lack of transportation.
At the outset of the pandemic, free clinics quickly responded, implementing telemedicine and other strategies to monitor their patients’ conditions, while also safely screening and referring individuals for COVID-19 testing. Currently, many clinics now are conducting onsite testing, often in collaboration with their local health departments and hospitals. Additionally, free clinics serve as trusted sources of vital COVID-19 public health information and education to vulnerable populations.
Free clinics are experiencing an influx of new patients as more and more Virginians lose their jobs and their employer-sponsored health care due to the economic fallout from the pandemic. This increase in the number of uninsured comes on top of an estimated 226,000 Virginians with incomes between 139% and 300% of the federal poverty level, who had no health coverage prior to the onset of COVID-19. That’s according to the Profile of Virginia’s Uninsured, a report recently released by the Virginia Health Care Foundation/Urban Institute.
However, the free clinics’ ability to continue to meet this rising demand for their services is in jeopardy due to the pandemic. The cancellation of major fundraising events and unbudgeted expenses such as the purchase of personal protective equipment, the investment in telemedicine solutions and the hiring of staff to make up for volunteers who are staying home, have placed a heavy financial burden on the clinics. In the words of Karen Legato, executive director of the Health Brigade free clinic in Richmond: “We’re doing all we can to provide services and meet the growing needs of those in the community who are left out of public services and have few places to turn to for help right now. Life was already challenging, but when you add in the coronavirus, it just becomes overwhelming.”
Several free clinics operate in areas of the state where the coronavirus is more prevalent, and where African American and Latino communities are suffering from disproportionately higher infection rates and deaths due to underlying socioeconomic and health disparities. Both the pandemic and the nationwide protests sparked by the tragic and senseless death of George Floyd have shined a spotlight on the urgent need to address the systemic racism that underlies the inequities suffered by African Americans and other people of color. With their holistic and humanistic approach to patient care, free clinics are committed to continuing to address health inequities, including structural barriers to accessing quality care, experienced by African Americans and other at-risk minority populations.
Many individuals in disadvantaged communities suffer from a high incidence of chronic conditions like heart disease, cancer and diabetes, which makes them more susceptible to COVID-19. One such patient is Jaqueline, a single African American mother who was referred to the Health Brigade following a visit to the ER for uncontrolled diabetes. In her words: “My [blood sugar] numbers were in the 400s as I couldn’t afford my medications. I’m a single mom, my priorities are my kids, my bills, and then my health.”
As a result of medication management for her diabetes, as well as mental health counseling and participation in the Health Brigade’s “Food Farmacy” program, which focuses on nutrition education, Jaqueline was able to regain control of her own health. Marveling at her experience with Health Brigade, she commented: “I don’t know what I would have done without their support; it was like a buffet of services all under one roof.”
Clearly, the need for free clinics in Virginia never has been more apparent or urgent. Additional financial support from public and private sources is critically required for the clinics to continue to operate on the front lines of the response to COVID-19, while providing vital preventative and chronic care to the uninsured. Otherwise, the state’s health safety net will be severely weakened, limiting access to care for tens of thousands of vulnerable Virginians and putting their health — and potentially the health of their neighbors, coworkers and communities — at increased risk.