By Erica Hellerstein, The Mercury News

033120CoronavirusMercyCommunity health clinics that serve some of the region’s most vulnerable residents are struggling with how to keep their doors open while patient visits plummet during the coronavirus shelter-in-place mandate.

Statewide, patient visits are down by roughly half across California’s network of community clinics and health centers, leading to tens of millions in lost revenue each week.

Many local health clinics that primarily serve low-income residents and rely on Medicaid reimbursements to make up a large portion of their income. So the dramatic reductions in patient visits threaten their ability to stay open and care for the kinds of patients who are at a heightened risk of contracting the virus.

Experts say the Bay Area, which has been in lockdown longer than anywhere else in the nation, has been particularly affected, with some already instituting furloughs or layoffs.

“The Bay Area clinics are hard-hit,’ says Carmela Castellano-Garcia, president and chief executive officer of the California Primary Care Association.

There are about 1,300 community clinics and health centers (CCHCs) across California serving more than 7 million patients annually — nearly one-sixth of the state’s population. Many provide care to residents particularly at-risk of contracting the virus or uniquely vulnerable to it. Community health centers serve roughly 1 in every 3 MediCal recipients, and in 2019 worked with 486,628 migrant workers and 246,268 homeless residents, according to CPCA.

With patient visits down, Castellano-Garcia says California’s community clinics are collectively losing about $90 million a week. Up to 77 health centers statewide may not be able to make payroll within 90 days if the current trends persist.

“It is not sustainable,” she says.

In the South Bay, patient visits at Gardner Health Services, which works in Santa Clara and San Mateo Counties, have dropped nearly 60%, says Chief Operating Officer Efrain Coria, prompting financial losses of about $1 million a month. Gardner has reduced its workforce by about 22%, Coria says, and laid off 135 staff members, though he emphasizes he hopes to re-hire many of them in the coming months when and if things calm down.

In the East Bay, La Clínica de La Raza, which serves about 90,000 patients annually in clinics throughout Contra Costa, Alameda and Solano Counties, has seen in-person visits drop about 30% since the start of the pandemic, says chief executive officer Jane Garcia, resulting in financial losses of about $3 million over the past month. About 300 employees have been furloughed.

However, La Clinica’s health centers have seen some gains since the state eased some restrictions for telehealth services, allowing patients to connect with health providers electronically. Those visits are also billable to Medicaid.

“If that option had not been authorized, it would have shut us down,” Garcia says. “And you would have seen [our patients] in emergency rooms and hospitals, or they wouldn’t have gone in at all.”

Marc Gannon, chief operating officer of Fremont’s Tri-City Health Center, which serves about 26,000 patients in Fremont, Hayward, Union City, Newark, and San Leandro — 37 % of whom are on MediCal or uninsured and the majority of whom live below 200% of the federal poverty level — says the organization changed its business model “essentially overnight” from in-person visits to telehealth appointments.

But the clinic is still suffering declines in revenue. In-patient visits have decreased by about 35% since the start of the pandemic and Gannon says they are considering reducing staffing to manage the financial hit.

“This is financially a very difficult time, there is no way of sugarcoating this,” says Gannon. “We are analyzing sustainability on a day to day basis.”

Amid the financial challenges, Tri-City health care workers are still trying to check in with patients by phone, providing resources from MediCal and other safety net services that they may be eligible for or with behavioral health services for people struggling with isolation and loneliness due to shelter-in-place orders. Last week, they reached 3,000 of the network’s 26,000 patients.

The federal government recently granted the nation’s federally funded community health centers a reprieve, awarding $1.32 billion to health centers nationwide. But many say that’s not enough to cover their losses. The $1.3 million the South Bay’s Gardner Health Services expects to receive, which is supposed to cover a 12-month period, would last between five and six weeks, Coria says.

Still, Bay Area community health centers want to make sure that people know their doors — virtually and physically — are still open to people who need care.

“Community health centers are adaptive, resilient, and have been around for a very long time,” says Gannon. “We are going to survive this.”

Erica Hellerstein is a journalist with the Mercury News. This article is part of The California Divide, a collaboration among newsrooms examining income inequity and economic survival in California.

Pin it

Coronavirus Resources

  • 032720OutbreakCoronavirus
    April 20, 2020

    Tips for Spotting Fake News Stories — And Where to Find Sources You Can Trust

    Anytime there’s a significant news event — like a global pandemic, for example — you can expect misinformation to spread across the Internet. “Fake news” means stories that contain fabricated information, or information that’s based on rumor, shoddy methodology or a partisan agenda. With the…
  • Picture1
    April 17, 2020

    Recursos Alimentarios Durante COVID-19

    La alimentacion es una gran prioridad para muchos durante esta pandemia de COVID-19- cómo mantener a su familia alimentada en medio de despidos del trabajo, preocupaciones sobre salidas para conseguir comestibles y la posibilidad de transmisión por medio de los alimentos, todo mientras se trata de…
  • Groceries
    April 14, 2020

    COVID-19: Food Resources

    Food is top of mind for many during the COVID-19 pandemic — how to keep your family fed amid layoffs, concerns about grocery outings and food transmission, all while trying to maintain social distance. If you’re struggling to put food on the table, have questions about food safety or need help…
  • 200323 F BQ566 9001
    April 10, 2020

    COVID-19: Recursos Para Indocumentados y Sin Beneficios

    English version available here. A medida que la pandemia de coronavirus da vuelta la economía de la nación y deja a muchos sin trabajo, los inmigrantes indocumentados son particularmente vulnerables. En esta página encontrará recursos para ayudar a los miembros de la comunidad indocumentados y que…
  • 032720OutbreakCoronavirus
    April 07, 2020

    COVID-19: Resources for the Undocumented and Uninsured

    As the coronavirus pandemic upends the nation’s economy and leaves many without work, undocumented immigrants are particularly vulnerable. On this page you’ll find resources to help undocumented community members and the uninsured. UndocuFund for Disaster Relief in Sonoma County The UndocuFund,…
  • 032720OutbreakCoronavirus
    April 03, 2020

    COVID-19: Santa Clara County Resources

    Santa Clara County’s Public Health Department is providing detailed information about COVID-19 cases, deaths and hospital capacity on several data dashboards available online. The county has also assembled a variety of COVID-19 resources, as listed below and found at sccphd.org/coronavirus. Food…
  • 032720OutbreakCoronavirus
    Apr 03, 2020

    COVID-19: How to Help

    As the COVID-19 pandemic continues to take lives and strain resources, you might be wondering how you can help. Perhaps the most important thing you…
  • SR PD
    Mar 31, 2020

    Santa Rosa Police Department Mourns Loss of Detective

    Updated March 31, 2020, 4:00 p.m. The Santa Rosa Police Department reported today that Detective Marylou Armer passed away from complications from…
  • Medical
    Mar 31, 2020

    Coronavirus Resources

    The coronavirus pandemic has created new challenges for communities throughout the world. Whether you need help getting access to food, filing for…
  • 032720OutbreakCoronavirus
    Mar 30, 2020

    COVID-19: Financial Resources for Sonoma County Residents

    California and the nation have seen a surge in unemployment claims as the COVID-19 pandemic has forced companies to close their doors, leaving…
  • Library photo for website
    Mar 30, 2020

    Help the Sonoma County Library Tell the Story of Life During COVID-19

    The Sonoma County Library will be documenting life during the coronavirus pandemic with a special collection, and you’re invited to contribute. The…
  • 032920CalMattersEmptyRestaurant
    Mar 29, 2020

    California’s Shelter-In-Place Order, Explained

    By Byrhonda Lyons, CalMatters As President Donald Trump considers easing national restrictions by Easter, Californians are into their first week of…
  • 032920DowntownSantaRosa
    Mar 29, 2020

    Santa Rosa Outlines COVID-19 Support for Homeless

    The city of Santa Rosa says it’s following guidance from the U.S. Centers for Disease Control and Prevention to protect people experiencing…
  • gavin schools
    Mar 28, 2020

    Los Angeles Will Mirror New York As Coronavirus Surges, Newsom and Garcetti Warn

    By Judy Lin, Ben Christopher and Matt Levin, CalMatters Gov. Gavin Newsom and Los Angeles Mayor Eric Garcetti issued dire warnings Friday that the…
  • 032820CovidHandwashing
    Mar 28, 2020

    COVID-19: Sonoma County Resources for Seniors and Vulnerable Populations

    On March 17, Sonoma County’s health officer issued an order for all residents to shelter in place to help slow the spread of COVID-19. The order…
  • 032720CoronavirusResearch
    Mar 27, 2020

    Here’s What Happens to Science When California’s Researchers Shelter in Place

    By Rachel Becker, CalMatters As California officials desperately try to slow the spread of the novel coronavirus, Chris Miller is coaxing a sample of…

Science & Health News

Northern California
Public Media Newsletter

Get the latest updates on programs and events.