Cheri Rinehart: Community health centers on covid-19 front lines

Amid all the uncertainty in our nation as we face and fight the covid-19 pandemic, one thing is certain: Community health centers (also known as federally qualified health centers, FQHCs) will continue to care for all regardless of insurance status or ability to pay.

The most vulnerable Americans in urban and rural communities across the state and across the country will be among the most heavily impacted by covid-19. FQHCs are critical “shock absorbers” for the health care system. They provide access to quality care to people not needing emergency or intensive care, offering a safer and better alternative than going to hospitals where exposure risk is higher and care access is rightly prioritized to those most acutely ill.

In Pennsylvania, there are more than 300 FQHC locations that nearly 900,000 Pennsylvanians rely on for access to quality, affordable health care, today and every day. Community health centers serve one in 14 people in Pennsylvania, one in five Pennsylvanians who are uninsured or covered by Medicaid, and an increasing number of those insured by Medicare. In line with the health center mission of health equity and serving our most vulnerable, 88% of FQHC patients — prior to the covid-19 crisis — were struggling financially. The state’s FQHCs are open to all Pennsylvania residents regardless of insurance status.

As always, FQHC doctors, nurses and other professionals continue making increasingly difficult choices on the front lines, as the number of infections continues to climb. These health centers have not shut down and are continuing to serve the medical, behavioral health and dental needs of their established patients as well as new patients seeking a source of care because of changes in life, insurance, health or job circumstances. During the coronavirus public health emergency, most are also now offering access to services via telehealth, an important alternative not only for patients, but also for the health care providers in FQHCs.

While the federal Department of Health & Human Services has provided some short-term relief, the $1.32 billion in the CARES Act averages to around $50 per health center patient and is insufficient. FQHCs care for 29 million of our most economically disadvantaged Americans in every state and territory. Whether it is providing basic check-ups, child health services, women’s health, routine care for common illnesses, and advanced care for not-so-common illnesses, health centers have been a high quality, affordable solution for more than 50 years.

In recent years, Congress and successive presidential administrations have asked health centers to expand services. They are on the front lines of the opioid epidemic as well as treating other substance abuse and mental illnesses. Increasingly they are treating our military veterans who often live too far from a VA hospital. And when natural disasters strike, health centers take on the role of first responders, caring for victims of floods, fires, hurricanes, and earthquakes. Now they are being asked to do everything they can to treat the covid-19 pandemic to prevent a surge of patients that will overwhelm our hospitals.

The missing link is long-term funding. We are disappointed that Congress failed to extend health center funding beyond November of this year. The fiscal uncertainty makes it challenging to hire new doctors, nurses, and clinical staff, or expand already stretched services to serve more patients in need. As we fight the unknowns of the coronavirus threat, we need stability more than ever.

Congress needs to consider a five-year fix for health center funding instead of the short-term measures that have become all too common. A five-year funding cycle would provide much needed certainty to plan for future public health challenges, to hire and train needed medical staff and respond to the ever-increasing needs of our patients. It would also dramatically increase the ability of FQHCs to respond to a second or third wave of this pandemic, or worse, an unforeseen future disease.

Community health centers must keep their doors open and must be highly operational during this unprecedented emergency. They must be supported so that they are there to respond to what will be a much greater need after the emergency.

Cheri Rinehart is CEO for the Pennsylvania Association of Community Health Centers.