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March 11, 2020 04:25 PM

Community providers worry about expiring federal funds in light of COVID-19

Steven Ross Johnson
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    The country's community health centers are calling on lawmakers to renew federal funding set to expire in May in order to mitigate the impact of the coronavirus.

    More than 1,000 COVID-19 cases have been reported as of deadline in the U.S., according to the latest figures from the Centers for Disease Control and Prevention. Twenty-nine people have died.

    The World Health Organization on Wednesday officially designated the COVID-19 outbreak a pandemic in light of the more 4,000 deaths that have occurred globally since the virus was first discovered just three months ago.

    In the U.S., stakeholders believe community health centers and other primary care sites will play a key role in responding to the outbreak as nation-wide spread looks all but certain.

    "We have the infrastructure to really move in a brisk manner," said Dr. Ronald Yee, chief medical officer for the National Association of Community Health Centers. "If we have the proper equipment and funding, we can be right on the frontlines."

    But many centers expressed concerns that they currently were not prepared to handle a sudden surge of patients. Many reported they did not have enough personal protective equipment, raising fears they would have to shut their doors if many staffers became sick and were quarantined.

    At a press conference held Wednesday, the results of a national survey of more than 600 health centers across 47 states conducted from March 4 to March 9 by the international humanitarian organization Direct Relief found nearly 30% of them reported concerns about potential closure due to staff being isolated because of shortages in personal protective equipment. More than 40% of centers reported not having a reliable source for restocking supplies over the next two months.

    "A lot of concern was echoed back to us that although many have some stock on hand, they are being told regularly they're normal vendors for PPE are stocked out and have not given a reliable answer as to when they can purchase again," said Andrew Schroeder, vice president of research and analysis for Direct Relief.

    Yee urged Congress to reauthorize funding for the Community Health Center Fund program, which was created by the Affordable Care Act and makes up to 70% of the federal support community health centers receive.

    Congress is taking up legislation surrounding COVID-19 but in the form of a stimulus package that does not yet have many perks for the provider community.

    The current funding cycle for commuity health centers is set to expire May 22. Yee said if the deadline passes without a renewal of the program nearly 1,400 community health centers and their 12,000 sites would be left without resources to provide COVID-19 testing to the most economically vulnerable individuals.

    Currently, nearly half of the cases confirmed in the U.S. have been in California and Washington, but the number of states reporting COVID-19 infections continues to grow daily, up to 38 states and the District of Columbia as of Wednesday.

    So far, community health centers outside of hard-hit states have not had an influx of patients suspected of having COVID-19.

    Dr. Vian Nguyen, chief medical officer for Legacy Community Health in Houston, said they have tested only two patients for coronavirus, both of which were negative, so they still had ample resources to test individuals. She said her concerns were for patients once they test positive and need to go to a larger facility for additional care. Nguyen said cost may incentivize many infected patients to forgo going to another provide, which would cause spread of the virus to continue.

    "Of course hospitals wouldn't turn a patient away, but we have concerns that we wouldn't be able to assist with a patient's inability to pay as much as is if they were staying internally with us," Nguyen said.

    A number of health insurers and states have taken measures to waive any copayments or deductibles for patients who need tests for the coronavirus, as well as waive prior authorizations for tests and for covered services deemed medically necessary for members diagnosed with COVID-19.

    On Wednesday, Blue Cross Blue Shield of Illinois announced it was covering telemedicine visits in consultation with doctors about COVID-19.

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