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Community Health Clinics are on the Frontlines, But the Pandemic is Threatening to Wipe Them Out

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The following article was originally published April 15, 2020, and republished through a collaboration with KPCC and LAist.

Story by Alyssa Jeong Perry

The coronavirus pandemic is threatening to bankrupt California's vast system of community health clinics, which one in six Californians depend on for basic health care needs.

Many clinics in Los Angeles are the first stop for low-income, homeless and uninsured patients who think they may be infected by the virus. But other services have slowed to a crawl, hitting clinic budgets with a double whammy.

These safety-net clinics worry how much longer they can keep their doors open.

"Fifty percent of our revenue is cut and expenses are not," said Barbara Hines, CEO of QueensCare Health Centers in Central L.A.

NO PATIENTS, NO MONEY

Many community clinics are located in low-income neighborhoods and service a lot of essential, low-wage workers and people of color. Many patients are on Medi-Cal or Medicaid and clinics get reimbursed for their visits.

But clinics in L.A. have halted most routine visits to limit the spread of COVID-19, and that means lost revenue.

AltaMed Health Services, which runs a network of 35 clinics in L.A. and Orange counties, and South L.A.'s St. John's Well Child and Family Center had to close their dental clinics, which contributed to a significant loss in reimbursable visits.

Many of these networks have clinics that vary in size and operating budget, but they share a common concern: they are running short on money.

Besides the stark drop in patient visits, clinics are also now incurring additional costs, including personal protective equipment (PPE) for health care workers treating patients known or suspected to be infected with COVID-19. Due to the nationwide shortage, PPE prices have skyrocketed.

Jim Mangia, CEO of St. John's Well Child and Family Center, said his clinics have set up COVID-19 triage tents to evaluate and test patients, adding further stress to their budget.

Telehealth, which many clinics are using to treat their patients over the phone or internet,has also added costs, including software and training.

AltaMed is projecting a financial loss of $125 million through December if the pandemic continues.

"I think it's easy to see if we don't get the money we need, the business is going to have to make tough decisions," AltaMed spokesperson Berenice Núñez Constant said.

Health care workers are at AltaMed's Drive-thru COVID-19 testing in front of one of their clinics in East Los Angeles. | Courtesy of AltaMed Health Services
Health care workers are at AltaMed's Drive-thru COVID-19 testing in front of one of their clinics in East Los Angeles. | Courtesy of AltaMed Health Services

IS GOVERNMENT RELIEF ENOUGH?

Last month the federal government allocated $100 million to clinics nationwide to help with the COVID-19 response. And last week, the Trump administration, through the CARES Act, awarded an additional $1.3 billion to health centers.

However, L.A. clinics say their portion won't go far.

Mangia said St. John's will get close to $3 million, but that's only enough to keep their clinics open for about a month. Their operating budget is about $1.6 million a week.

Hines said QueensCare is applying for other emergency grants to make up for the gap in federal funding.

For its part, AltaMed joined a coalition of 35 other clinic networks in the U.S. to advocate for $8 billion in additional aid from the government.

Ninez Ponce, a professor at UCLA Fielding School of Public Health, thinks the government must give additional funding to avoid losing a vital health care resource for low-income people.

"A catastrophic loss of funding for clinics would ultimately mean that millions of patients in the safety net would potentially face additional barriers to accessing quality, comprehensive care," Ponce said.

In the meantime, clinics around L.A. are still operating.

"It's pretty stressful out here," Mangia from St. John's said. "Being the provider on the front lines, providing most of the testing and the triage, without the resources that we need."

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