Every year many people forego healthcare services because they have no medical or health insurance. The rising costs of health care insurance force people to go without. If there is a healthcare emergency, it is ignored, or patients crowd emergency rooms. However, there is an alternative to medical treatment and healthcare that goes underutilized. Federally Qualified Health Centers (FQHCs), also known as community healthcare centers, provide primary healthcare services to everyone no matter their ability or inability to pay. “Everyone deserves the same access to appropriate and affordable health care,” says Ashley Slagel-Perry, who serves as director of Behavioral Health Integration & Corporate Compliance at Community Health Center of the New River Valley in Christiansburg.
Currently 30 healthcare organizations operate more than 150 healthcare sites across the commonwealth. These centers serve more than 356,000 patients every year. Some patients, such as Linda, who have Medicare and Medicaid and otherwise would not have any healthcare service at all, value the community healthcare center in their neighborhood. Linda has been a patient at Community Health Center of the New River Valley (CHCNRV) for more than five years. Linda is disabled and hearing impaired. “I give the place a 10. Dr. Hardy is my primary doctor and I get the best medical treatment from this facility. He knows me and what I need. If I were not able to come to this community healthcare center, I would suffer so much anxiety trying to make it to another place,” Linda shares. The CHCNRV sees more than 5,000 patients yearly. That number spiked from years before as more people became aware of the services provided at CHCNRV. Usage has increased greatly since the start of the coronavirus pandemic. Slagel- Perry says, “People are certainly making their mental health appointments more now. We always used to have cancellations, but now [during COVID-19], people are making appointments and keeping those appointments.” The pandemic has caused levels of depression and anxiety to rise, Slagel – Perry says, and adds “it’s good that patients keep those appointments to help address anxiety, addictions and depression because it helps address other medical needs as well.”
The CHCNRV is a full-service healthcare center with full-time doctors, nurses, technicians, and staff to handle all healthcare needs. The programs also provide medical, GYN, dental, behavioral health and medication assistance services to people of all ages. “We always want to make sure we can take care of the total person no matter their needs. We are here for our patients on several levels because different healthcare needs sometimes arise – as a patient is here to deal with one medical concern, another may be discovered – and we always want to be sure we handle that as well,” Slagel-Perry explains.
Carilion Clinic also sees the benefits of community healthcare centers. Dr. Nathaniel Bishop is the senior vice president of administration at Carilion Clinic and senior associate dean of diversity, inclusion and student vitality at Virginia Tech Carilion School of Medicine. “We have been long involved in looking at the overall health of our communities and participating with partner agencies. We have come to understand that community healthcare centers play an important role in the overall healthcare delivery for our community and for this region,” Dr. Bishop explains. The primary goal is to achieve health equity by eliminating health disparities and to achieve optimal health for all Virginians.
According to the Centers for Disease Control and Prevention, health equity is achieved when every person can attain his or her full health potential and no one is disadvantaged due to social position or other socially determined circumstances. Health inequities are reflected in differences in length of life, quality of life, rates of disease, disability and death, severity of disease and access to treatment. It is those inequities that Dr. Bishop says community healthcare centers can help tremendously with filling the gap in community healthcare. Even in recent months, some community healthcare centers have established testing sites for coronavirus. Linda confidently shares her sentiments about her visits to CHCNRV. “There’s no fear at all. Everyone is wearing a mask. They sanitize and they deal with only one person at a time,” she says. “I’m very safe in their care.”
For 45 years, the Bradley Free Clinic in Roanoke has filled the healthcare gap for thousands of patients. Janine Underwood is the executive director. She thinks the Bradley Free Clinic is a hidden treasure in the Roanoke community. Not many people know about the free healthcare services, and those who do know about the free services, perhaps the stigma behind “free” is a deterrent. For the six years Underwood has been the executive director, she, the staff and reputable volunteers have worked to change that stigma. There’s great value in the service at community healthcare centers, including the Bradley Free Clinic. “These are highly respected physicians and dentists in the community who are volunteering their time,” she shares. “Sixty percent of our volunteer doctors are Carilion doctors, doctors from Lewis- Gale and doctors from private practices in the community. We have the department head of the emergency department who volunteers here as well,” she says. “Dr. Thomas Kerkering, who was the head of the Infectious Disease Department at Carilion is a volunteer here. He actually treats a large portion of our patients.” The Bradley Free Clinic started a Hep-C program at the clinic. “If patients needed an appointment and had to go through Carilion, it might be three months out before they could see a doctor. Our doctors are volunteering their time and it is an amazing atmosphere where they are happy to be here. They are helping our patients and our patients are so appreciative. Really, it is just getting the people through that stigma on what a free clinic is and that this is a quality place, and these are quality doctors,” says Underwood.
The Bradley Free Clinic offers medical, dental, pharmacy, behavioral health, patient education, eye care, women’s health programs and even interpreters – all FREE. “We provide interpreter services if there’s limited English proficiency. We are trying to do everything we can to break down those barriers to make sure the Free Clinic here is everybody’s Free Clinic,” says Underwood. The Bradley Clinic is committed to fostering, cultivating and preserving a culture of diversity, equity and inclusion to reflect the communities that it serves. It is not just a mission statement; Underwood declares that is a promise. “We make sure we are intentional kin looking at diversity, equity and inclusion. We want to hear from our patients. We make sure our board structure; our staff and volunteers all understand and believe in this very important mission.”
According to Underwood, research and the most recent U.S. Census numbers show, while the Bradley Free Clinic sees more than 2, 000 patients and has over 18,000 medical visits a year, it’s has the capacity to see even more patients and could handle more visits. There are still about 16, 000 families and individuals who qualify for services at the Free Clinic. Those individuals are part of the low-income population who the Free Clinic is looking to add as new patients. To qualify for services at the clinic, individuals must be uninsured, or underinsured (considered to be someone on Medicaid). Individuals with a high deductible also might qualify for service. And finally, if you are under the 300 percent federal poverty level, you qualify. To make it easier to determine consider this: If you are single, making $37,000 a year and do not have medical insurance, you qualify for services at the Free Clinic. If you recently lost your job, you also qualify for Free Clinic services. Underwood encourages anyone with questions to contact clinic staff.
Historically, community healthcare centers have been a part of inner-city and rural neighborhoods. There always has been a critical need for access to healthcare. “The exact same needs in the community from 45 years ago are still the needs of today when it comes to healthcare. So often people will say free clinics are not needed anymore, but they are a safety net in the community that will always be there to fill whatever the gap is,” says Underwood. “There’s always going to be a gap and the community healthcare center will always be needed to fill the gap. There’s always going to be individuals that fall through that gaps.” And that’s what healthcare officials and organizations are trying to change. In fact, there is an all-out push to educate all Virginia communities about healthcare centers.
“Having access to good healthcare is a vital part of our well-functioning community. It’s a vital part of everything we do. Our mental health is critical as well. People tend to pass on critical health needs to pay bills. And when they do that, it can be disastrous.” Preventative health care is a key component to making sure everyone has a healthy foundation. ′