Investing in the Health of Vulnerable Virginians

Proposed budget amendment would add $5M for Virginia clinics.

Free and charitable clinics are vital to the health of our community and economy but rising healthcare costs coupled with stagnant funding and increased patient demand have put their sustainability at risk. It's a concerning situation for Virginia's healthcare safety net, one that lawmakers can remedy in the state budget.
In 2016 – the last year in which the state's free clinics received an appropriation increase to support their delivery of health care services – state funding covered almost one-third of the aggregate healthcare services costs of the Virginia Association of Free and Charitable Clinic member clinics. Over the past seven years, that percentage has shrunk to just 18%.
To alleviate financial strain and ensure continued access to high quality care for the Commonwealth's uninsured, the VAFCC is urging lawmakers to allocate $5 million in state funding for clinics in the General Assembly's approved budget. The investment would support local clinics which are on the frontlines of caring for vulnerable Virginians. 
In Richmond, Health Brigade is the state's oldest free and charitable clinic. It welcomes uninsured, low-income patients every weekday with a growing array of medical, mental health, community outreach and care coordination services. “With many of our clinic's patients coming from under-resourced communities, Health Brigade is one of the few places they can access critical lifesaving care. But that care comes with a cost as the clinic's expenses have jumped significantly over the last several years,” shares Karen Legato, clinic executive director.
About 30 minutes away, the Free Clinic of Powhatan's front desk received about 20 inquiries per week last month from patients seeking services. The clinic averaged four calls per week a year ago. Today, it can no longer accept new dental patients until it expands its dental clinic hours. The clinic, which serves patients in Powhatan, Amelia, Cumberland and Chesterfield counties, focuses on medical, dental and behavioral health and is beloved in the community. Much of its recent growth is due to expanded eligibility, word of mouth and local partnerships. The clinic is doing everything it can to support its community, but without more support, the clinic worries its growing wait lists will only get longer.  
In urban and rural settings alike, inflation and growing medical supply and labor prices are making the work of free clinics more expensive. Throughout Virginia, the annual cost of care provided by VAFCC members rose 170% with annual per patient costs up from $353 to $950. Other factors, such as decreases in volunteer providers and more complex patient care needs, increased costs for interpretation and translation services, and ongoing COVID-19 testing, vaccinations, and treatments make running clinics more expensive as well.
Yet free clinics are more important than ever. Playing a critical role in the overall health of communities, free and charitable clinics serve as a comprehensive medical home for thousands of vulnerable Virginians, many of whom have chronic conditions. We often describe patients as “underinsured” and “uninsured,” but instead, we should put a face to these patients: They're our neighbors, grocery store associates, childcare professionals, small business employees and hourly workers. These clients are mothers, fathers, brothers and sisters – they're our community.
By providing culturally sensitive and holistic care that not only addresses health symptoms but also social determinants, clinics improve the health and wellbeing of our communities while reducing costly and unnecessary hospital emergency room usage and avoidable hospital readmissions. VAFCC members provided more than $114 million worth of healthcare services to some 75,000 vulnerable Virginians in the past year. 
As the cost of care goes up, so has patient demand. Uninsured patients at clinics increased by 28% in the past fiscal year and already through the first half of this fiscal year, clinics have gained nearly 8,000 new uninsured patients. Anecdotal feedback shows that increased living costs and the current unwinding of Medicaid coverage along with rising need for chronic care as well as dental and behavioral health services in the wake of the COVID-19 pandemic are leading more people to seek care from clinics.
Unfortunately, the private sector, which generously provides funding to support much of the work of individual clinics has struggled to make up for the widening shortfall. Charitable donations declined during the public health crisis and have not returned to pre-pandemic levels. What's more, fewer grants that support healthcare services are available post-pandemic.
While free and charitable clinics can make a little go a long way, the reality is, their capacity is now stretched too thin. We urge our legislators to help us help the thousands of Virginians who count on their local free clinic to support their health. Lawmakers boldly have created a state with a robust and nationally recognized safety net. It's critical they continue this legacy by funding the state's free clinics today. The health of our fellow Virginians can't wait.


A Lifesaving Investment

Working towards a Virginia where all people have access to comprehensive, quality healthcare by supporting and advocating for our member clinics so that hardworking individuals and families are protected from healthcare crises.