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Community health centers face shutdowns as the coronavirus drives patients, funding away

Nearly a third of community health centers in Illinois could potentially close their doors as the coronavirus pandemic and social distancing take their toll.

Dr. Andres Malfa poses for a portrait outside Access Hawthorne Family Health Center, 3040 S. Cicero Ave. in Cicero, Wednesday morning, March 25, 2020.
Dr. Andres Malfa poses for a portrait outside Access Hawthorne Family Health Center, 3040 S. Cicero Ave. in Cicero, March 25, 2020. Community health centers face mounting financial pressures as fewer patients through their doors amid the coronavirus pandemic.
Ashlee Rezin Garcia/Sun-Times

Dr. Andres Mafla has practiced internal medicine at Access Hawthorne Family Health Center in Cicero for more than a decade.

Like most physicians at community health centers, Mafla treats patients who are low-income, underinsured or don’t have health insurance. Many patients are also immigrants and seniors with chronic conditions like diabetes.

Keeping his patients safe and out of the emergency room is Mafla’s number one priority — especially now amid the coronavirus pandemic.

“Primary health care is critical during a public health crisis. We’re the first line of contact for these patients, and we make sure they don’t need to end up going to the hospital, which as we know are bracing for the worst,” he said.

Now, despite being a critical front in the fight to keep the state’s health care system from collapsing, many community health centers might fall victim to the coronavirus as social distancing means fewer patients — and less government funding — coming through their doors.

“We’re seeing about a 70% drop in our patient volume right now,” said Jordan Powell, president and chief executive of the Illinois Primary Health Care Association, which represents 51 community health centers that operate nearly 400 clinics statewide.

The sharp decline in patients means 37% of health centers in Illinois are at risk of shutting down within three months, leading to “layoffs of more than 4,350 staff members, including front-line providers,” according to an analysis by Capital Link, a nonprofit financial services company that works with primary care associations nationwide.

“The shuttering of community health centers will drastically harm the state’s ability to combat the COVID-19 pandemic and underserved communities will lose access to the critical services they need,” Powell said.

“The number of unemployed and uninsured is in our communities is growing and when this crisis is over, health centers will be in even greater demand. If they are forced to close their doors, there is no guarantee if and when they will re-open.”

Access Hawthorne Family Health Center, 3040 S. Cicero Ave. in Cicero, Wednesday morning, March 25, 2020.
Access Hawthorne Family Health Center, 3040 S. Cicero Ave. in Cicero, March 25, 2020.
Ashlee Rezin Garcia/Sun-Times

About two-thirds of the 1.4 million patients served by community health centers in Illinois last year were covered by Medicaid or Medicare and 16% have private insurance. The rest — more than 300,000 people — were uninsured. Nearly 75% of all patients were black or Latino people.

Powell said community health centers save Illinois around $2 billion a year by acting as a safety valve for emergency departments and other, more expensive treatment options.

“We’re helping vulnerable people manage their chronic conditions and making sure they have their prescriptions filled, essential services that help keep people in their communities and not overburdening the health care system,” he said.

Last week, the Illinois congressional delegation wrote a letter to Gov. J.B. Pritzker asking him to shore up funding for community health centers as they face financial shortfalls due to the pandemic.

“During this national emergency, we cannot afford for our health care facilities to lack the resources they need,” the letter said. “It would be unthinkable for a community health center to be forced to close due to a lack of adequate revenue.”

In a statement, Pritzker’s office said it will “continue to work alongside our congressional delegation so that Illinois receives its fair share of COVID-19 related relief packages.” The Senate stimulus bill includes $1.32 billion for community centers nationwide.

The Illinois Department of Public Health revealed on Monday an additional 658 people have tested positive for the novel coronavirus raising its total affected population to 128,415.
The Illinois National Guard operates a COVID-19 drive-thru test site for medical personnel and first responders.
Ashlee Rezin Garcia/Sun-Times file

As the state figures out how to keep community health centers open, physicians are serving their patients as best they can given the circumstances.

Donna Thompson, chief executive of Access Community Health Network, said its 34 locations in Cook and DuPage counties are rapidly setting up telemedicine capabilities to reach as many patients as possible.

“We want to make sure people stay at home if they don’t need to come out,” she said.

Powell worries about those patients who don’t access to Wi-Fi or a computer at home. “Now that the public libraries are closed too, it’s that much harder to connect with them,” he said.

Other services provided by community health clinics are also on hold as health officials try to get their hands around the pandemic.

Marc Swatez, executive director of The Ark, a medical clinic and food depository in West Rogers Park that primarily serves Chicago’s low-income Jewish residents, said he had to call off the organization’s recent Alcoholics Anonymous meeting.

“We have almost 20 people a week for our AA meeting, but as the virus gets closer and closer to this building and our staff, I just can’t do it anymore,” he said. “Thankfully there are a lot of AA support groups online right now, but what if you don’t have internet at home? What are you supposed to do? You’re just sitting at home.”

Carlos Ballesteros is a corps member of Report for America, a not-for-profit journalism program that aims to bolster Sun-Times coverage of Chicago’s South Side and West sides.