Rural and Small Town Health

The VAFCC presented to the House Select Committee on Advancing Rural and Small Town Health Care.

The Virginia Association of Free & Charitable Clinics presented during a June 18 meeting of the House Select Committee on Advancing Rural and Small Town Health Care in Farmville on the state of Virginia's free clinic safety net, an essential healthcare safeguard serving more than 91,000 vulnerable patients in 2023 that equated to more than $121 million worth of care. Just under half of the VAFCC's 68 member clinics provide care in rural and small-town communities. These clinics saw patient demand grown in CY2023, and growth continues this year due to Medicaid unwinding and ongoing economic pressures (e.g., inflation, low wages, and lack of job opportunities in rural areas).

Primary challenges experienced by rural and small town clinics in sustaining their services include the ripple effects of the pandemic (e.g., the spike in demand for mental health and dental care; more complex chronic care needs of patients; ongoing decrease in provider and non-provider volunteer numbers, and donor fatigue leading to drop in fundraising (primary source of clinic funding); substantially higher clinic operating and capital costs due to runaway inflation and need to hire more paid providers and paid administrative staff; and decreased hospital support, including less funding and the reduction or elimination of charitable and discounted services such as blood labs, imaging, and specialty care.

Recommendations the VAFCC gave for improving rural health care and safety net sustainability included:
  • Further investment in healthcare workforce development initiatives
  • Enhanced incentives for providers, particularly recent graduates, to serve in rural and small-town communities
  • Increased coordination between VHWDA and AHECs to place health care students in clinical internships within safety net clinics, including free clinics and FQHCs
  • Further liberalization of scope of practice regulations where needed and appropriate
  • Participation in more interstate licensure medical and dental profession compacts
  • Continued investment in improving broad band access
  • More emphasis on health education and literacy in public schools
  • Greater investment in rural public health, with emphasis on enhancing collaboration between local health departments and free clinics
  • More investment in SDOH support services and programs
  • Greater access to lower cost medications
  • Medicaid reimbursement for community health workers
  • Higher Medicaid reimbursement rates for providers
  • Maintenance and enforcement of existing COPN charity care conditions
  • Enhanced state funding of free clinics
  • Inclusion at federal level of free clinics as eligible entities for HRSA grants for medically underserved areas and health provider shortage areas
While in Farmville, VAFCC member clinic, the Heart Of Virginia Free Clinic, welcomed committee members for a tour and shared challenges to accessing health in their rural community.


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.