California Community Clinics Struggle to Survive During Coronavirus Pandemic

Jane Garcia, CEO at La Clínica de la Raza, advocates for health care services for undocumented and uninsured immigrants in Contra Costa County on Sept. 22, 2015. La Clínica is losing $3 million per month in revenue during the coronavirus pandemic, she said. (Farida Jhabvala Romero/KQED)

La Clínica de La Raza has cared for generations of Bay Area patients since its inception nearly 50 years ago. With dozens of clinics in Alameda, Contra Costa and Solano counties, the nonprofit sees roughly 90,000 mostly low-income patients per year.

But many people are no longer seeking routine care since local stay-at-home orders began in mid-March, and La Clínica is losing $3 million in revenue per month, said its chief executive Jane Garcia.

Patient visits have plunged by 40 percent, and the organization has closed non-emergency dental services and downsized optometry as well. Garcia said she has had to furlough about 300 employees.

“This is unlike anything we’ve experienced before,” said Garcia, who has led La Clínica for 38 years. “Not being able to provide the services is a big problem for communities who are already underserved.”

Nonprofit community clinics and health centers care for patients regardless of their ability to pay or their immigration status. However, during the coronavirus public health emergency, many clinics across California are struggling to keep their doors open. 

Statewide, federally qualified health centers are hemorrhaging nearly $90 million per week because patient visits — and reimbursements from Medi-Cal insurance — have dropped by half as people hunker down at home, according to Carmela Castellano-Garcia, president and chief executive of the California Primary Care Association, a lobbying group that represents 1,300 community clinics and health centers.

“This is unsustainable,” Castellano-Garcia said. “We are the leading providers of care for California’s most vulnerable populations and community health centers’ future is very much threatened by the COVID-19 pandemic.”

Last week, 180 health centers in California were awarded $193 million in federal emergency aid to ramp up COVID-19 testing and respond to the pandemic, according to the U.S. Department of Health and Human Services.

But Castellano-Garcia said those funds are not enough to keep nonprofit health care providers afloat, and 200 clinic sites have temporarily shut down across the state.

“Community health centers are absolutely at risk of closing and losing services permanently if more federal and state relief is not forthcoming,” she said.

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In Southern California, Borrego Health has shuttered nine of its 27 clinics, including weekend operations serving migrant farmworkers in the rural Coachella Valley, where there are few other service providers.

The organization has laid off 65 employees and eliminated or reduced hours for 250 others since the pandemic began. That represents nearly 30 percent of the nonprofit’s staff, said Mikia Wallis, Borrego Health’s chief executive.

“We need the federal and state government to do what they've promised — to make us whole, and help keep us operational,” said Wallis, in a statement. “Without immediate financial support from the government, we will be forced to lay off frontline healthcare providers — those providing care directly to our patients — next."

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The California Primary Care Association has joined other community health providers nationally in asking HHS Secretary Alex Azar for an $8 billion share of the coronavirus stimulus aid package that President Donald Trump signed last month. The association is also lobbying Congress for more financial help as the pandemic continues.

HHS is working to ensure all funds appropriated by Congress are made available to support the nearly 1,400 health centers and over 236,000 providers on the frontlines of this pandemic, according to an agency spokesperson.

“Secretary Azar is leading an administration-wide policy process to determine how to distribute relief funds in a way that is fast, fair, transparent and simple,” the spokesperson said.

Congresswoman Anna Eshoo (D-Palo Alto) said that while lawmakers are currently drafting an upcoming COVID-19 stimulus bill, there is broad bipartisan support for community health providers.

“Our community health centers and clinics are an essential part of the overall health care delivered in our country, they are the backbone,” said Eshoo.