Legislature should keep reimbursing community health centers for telephonic health care visits

Recently I watched the protests on the streets of Bakersfield over the death of George Floyd in Minneapolis. On the third evening of protests, I caught a glimpse of one of Clinica Sierra Vista’s nurses in the crowd of peaceful protesters with a sign that read “Black Lives Matter to Nurses.” 

It reminded me that just like these protesters, we all have a message that needs to be heard. 

At community health centers throughout this nation, medical professionals come to work believing that health care is a right, not a privilege. 

Community health centers have been providing care for 55 years, protecting the most vulnerable populations in our community, regardless of who they are or their ability to pay. The staff of Clinica Sierra Vista over the last several months have left the safety of their homes during the COVID-19 pandemic to perform more than 2,600 COVID-19 tests, serving the more than 140,000 patients we see each year in Kern and Fresno counties. 

The daily sacrifices may be routine by now, but they don’t go unnoticed. Neither does our employees fight for social justice on behalf of our patients. It’s all around us, and it’s inspiring. 

I’ve never been more honored to stand behind these frontline health care workers who put themselves out there every day taking care of the homeless, uninsured, minority, LGBTQ, impoverished, stigmatized, mentally ill, under educated and immigrant populations of our community.  

Unfortunately, the legislators and governor of California in order to balance a historic impending budget deficit, have put forward proposals that will drastically cut services to community health centers in the May revise draft. Those cuts target the most vulnerable populations and their ability to receive care and have a voice in the system. 

Since January, Clinica has provided more than 35,000 telehealth visits to our patients, that includes doctor or nurse consultations, ER visit follow ups, prescription refills. Thousands of services provided to a vulnerable population amid one of the greatest health challenges in more than 100 years. 

While health care providers have been compensated for virtual video visits, the addition of telephonic visits was newly added due to the COVID-19 pandemic. Clinica quickly added virtual visits to our capabilities at the beginning of the pandemic but realized the patients we serve are largely not ready to adopt this new technology. 

More than 99% of Clinica’s telehealth visits have been by phone.  We are struggling daily to teach our patients how to use the virtual visit platform and the many benefits of doing so. There are many barriers for our patients, including access to smart devices and reliable internet services which can prohibit the adoption of this technology despite our efforts. 

The May revise budget further adds to this challenge with the removal of payment for telephonic visits. This change further destabilizes our ability to provide care to the most vulnerable in our community, including patients such as the elderly, high risk pediatric patients, adults with multiple or serious health conditions that place them at high risk for severe complications or death of COVID-19. These patients are best served from the safety of their homes where they are sheltering in place during this pandemic. Telephonic visits also help people just getting back to work receive care while not jeopardizing their new employment. 

Many community health centers throughout the state have struggled with the financial effects of the COVID-19 pandemic. The reimbursement of telephonic visits was a lifeline for many of the smaller practices at a time when everything came to a standstill, and we were struggling with ways to protect our workers and patients along with the high cost of doing so. 

Gov. Gavin Newsom, there is still time to do the right thing. Fix this budget and stabilize our safety net providers allowing community health centers to continue to take care of our patients through telephonic visits. 

We must remind the governor these budget proposals are hurting all of our citizens equally, and it’s our job to pursue justice for all our patients.

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Stacy Ferreira serves as the interim-CEO for Clinica Sierra Vista, stacy.ferreira@clinicasierravista.org. She wrote this commentary for CalMatters.