The Pittsburgh Foundation

Themes Heard from Community Health Center Providers

Below is what the Foundation's Program and Policy department staff heard after reaching out to nonprofit community health center providers to better understand their concerns, challenges and needs to inform our most immediate grantmaking, convening and public policy activities.

Most CHCs have access to the information they need to make decisions for their organizations. 

“It's not a lack of information, but we don't have time to read and digest the emails I'm receiving.”   

CHCs are seeing a decline in patient visits, and have had to suspend some programs, so are already losing revenue. They are expecting significant loss throughout the COVID-19 pandemic. Several CHCs also had to halt construction projects that were slated to increase their capacity to serve patients and bring in additional revenue.

“On an average day we see 100 patients, now we only see 20. It's going to have a serious impact on our bottom line. We haven't laid anyone off. But we're not generating the revenue.” 

“We were about one week from opening up a pharmacy, and the governor shut down the construction. We’re on verge of starting construction for a new office, to grow the practice, and that was also shut down. We need advocacy to please allow construction projects to keep going. They have allowed waivers for hospital construction. Why not health clinics?”

Concerns about future staffing shortages were felt among all clinic providers, and concerns about getting staff tested were felt by many providers.

“Staffing is a big concern because there are so few of us. If one of us gets sick, that's a staffing shortage.” 

“We have had to pull out symptomatic staff members, who we were not able to get tested. We’re having a terrible time referring patients and clinical providers for testing. In the absence of testing, we must assume that they have it. This is no way to run a community health center, a public health system or a country.”

The limited supply of Personal Protective Equipment (PPE) could cause CHCs to close. It remains a major concern and barrier to care.  

“We don't have enough PPE for our staff… And we can't even order it. We’re trying to determine if we run out of gowns if we have to shutter operations.” 

CHCs shared a sense of urgency in continuing to provide care for their patients to keep them healthy and out of the hospitals and avoid future issues from diminished routine care.

“The need of all of our collective services are going to be greater and greater and greater. We need real changes to change health insurance. We HAVE to survive this, because we are going to be desperately needed. As we get a hold of the pandemic and people get back to normal, we’re going to see an inundation of people needing care. There is SO much deferred care. We haven’t been doing preventative care for a month.”

Providers shared concerns about preparing for an increase in behavioral health needs from patients and being able to meet the demand given insurance-related reimbursement restrictions.

CHCs shared a need for a more coordinated, organized approach, among themselves and with other health care leaders, and a call for alliance of community providers.

“I'm feeling frustrated with the lack of coordination of our efforts… I thought that during a state of emergency, there would be some coordination of our efforts by local health departments, state secretary of health, and some direction about the role of FQHCs. We've been left on our own.”  

Recommendations for Providing Support to Community Health Centers

  • Fund start-up costs or gap funding related to new telehealth services.
  • Fund supplies, especially PPE, and operating support. 
  • Support advocacy efforts to make sure that free clinics are considered in aid packages, and that look-alike FQHCs can benefit from federal aid.  
  • Support advocacy to allow health clinic construction projects to continue to increase capacity to serve patients.
  • Provide emergency funding for individuals, including cash and food.
  • Support coordination of CHCs to come together to support and learn from each other.
  • Advocate for a stronger, more coordinated behavioral health system with less restrictive regulations, that would allow more patients to be included and receive care.