Nonprofits need funds to help vulnerable

By Paul Whitney and Anna Zamora-Kapoor

WSU HEALTH EQUITY RESEARCH CENTER

People are scared, and for good reason: The coronavirus is an equal opportunity threat. But in this case equal opportunity does not mean equal impact. People who were already disadvantaged before the pandemic disproportionately suffer the most serious consequences of COVID-19. Systemic discrimination, stagnant incomes and less access to preventive health care increase the likelihood of chronic health conditions that make COVID-19 more deadly. These same preexisting social conditions also make people more vulnerable to the pandemic’s economic disruptions.

Washington’s community health centers and nonprofit organizations fill a critical need by providing health care, assistance and advocacy for the most disadvantaged people of our state. These organizations are shouldering a crippling burden during the pandemic, but at what cost? The Health Equity Research Center at Washington State University surveyed 14 health care organizations across Washington to learn how the pandemic is affecting their ability to provide services.

Some of the problems they reported echo news reports nationwide. Demands are outstripping the capacity of the centers to meet patient needs. Staff are overwhelmed with pandemic-related patient needs and stay-home restrictions; there is little opportunity to deal with other medical issues.

Dylan Dressler, clinic director of NATIVE Project in Spokane, said, “We had to temporarily stop doing women’s and men’s health, including children’s immunizations.” Also, the Spokane Regional Health District had to temporarily stop doing home visits for women, babies and toddlers who are participating in its maternal child care program, reported SRHD Administrative Officer Amelia Clark.

Patients and community members are contacting these trusted organizations for help dealing with the extraordinary stresses people are facing in daily life, including unemployment, loss of medical insurance, inability to pay bills and access to food. The Martin Luther King Jr. Center’s Family Support Services Manager Adell Whitehead said, “We closed our senior program because now our seniors are at home. Unfortunately, we are not able to deliver meals to their homes. We helped some sign up for Meals on Wheels, and others may go to our food bank.”

Like their clients, these organizations are suffering from the economic consequences of the pandemic. They’ve had to spend unbudgeted dollars on extra staff hours required for their COVID-19 response and equipment for at-home workers. In one week, the NATIVE project spent thousands on software, Wi-Fi boosters, laptops and other hardware to enable telehealth services.

Community health centers also depend on Medicare reimbursements. Even as they screen, test and triage potentially infected patients, they have seen a 30-70% drop in traditional visits funded by Medicare. The federal government’s relief package allocates some funding for these centers, but according to Chris Kaasa, Senior Policy Adviser at the Washington Association for Community Health, the estimated amount that will come to our state will cover only about 10% of the expenses of the community health centers in the next three months. Compounding the problem, donations and opportunities to work on grants dropped, imperiling services.

We repeatedly heard the dedicated staff of these centers express fear, not for themselves, but of the prospect of closing their doors, furloughing employees or reducing services, leaving their patients more vulnerable.

State funding is needed by the community health centers to maintain operations, staff and services during these exceptional times.

Donations to nonprofits are also critical to addressing increasing unmet needs. Finally, state officials must work with community health centers and nonprofit organizations to address the medical needs that are currently de-prioritized by the health care system.

Paying attention to the needs of our community health and nonprofit organizations is an ethical and moral imperative. Because gaps in medical care access create opportunities for additional waves of COVID-19 infections, it is also a matter of self-interest for those who will never visit a community health organization. In other words, keeping community health centers functioning is in everyone’s interest.

Paul Whitney, Ph.D., is director of Washington State University’s Health Equity Research Center (HERC), which studies the social determinants of health to understand and mitigate the causes of health disparities. Anna Zamora-Kapoor, Ph.D., is an assistant professor in sociology and medical education and clinical sciences, and the community liaison for HERC at WSU. More information is available at healthequity.wsu.edu.