By Calvin Pynn, contributor
Since Virginia expanded Medicaid eligibility in 2019, The Free Clinic had been seeing fewer patients; then came the coronavirus. Both were among the considerations that led to the Board of Director’s decision to close the clinic by the end of December, bringing a 30-year chapter in local healthcare to a close.
“There’s a few factors and I wouldn’t say any one really outweighed the other,” said Josh Hale, president of the Board of Directors. “Finance certainly was one of them.”
One effect of COVID-19 on organizations like the clinic has been the difficulties it poses to fundraising.
“Having galas and get-togethers and attracting dollars that way is really something that’s a challenge these days,” Hale said.
The Free Clinic was one of several local organizations that lost funding in the current city budget, adopted several months into the pandemic. While City Council has allocated more than $13,000 annually for the Free Clinic in years past, that amount fell to $5,500 in the current fiscal year.
The pandemic also challenged the clinic’s volunteer-centered care model, making it unsafe for many volunteers – largely comprised of retired healthcare workers – to come into close contact with patients. Despite the challenges, the staff took them in stride, said Susan Adamson, a nurse practitioner who volunteers at the clinic.
“After having been through many transitions and challenges over the years, I was really proud of how the Free Clinic responded,” Adamson said. “We had an outpouring of community support. So many of our volunteers have been standing behind us and wanting to come in, but for about three months, we really had to pare down our services to keep everybody safe.”
That included pivoting to a telemedicine model and only opening one day per week for patients who needed to be seen in person.
“We really flexed very quickly and I’m proud of how hard everybody worked to make sure that we didn’t have any gaps in patient services, even though they looked different,” she said. “We didn’t let any patients down during that time. We maintained services. It just had a different look to it.”
By the time the Free Clinic resumed a normal schedule in July, the Board of Directors was already assessing its future. Although it explored options to keep the clinic open, the board decided in September that the most viable option was to close.
Volunteers were notified on Tuesday – and for Adamson, it came as a surprise.
“I think all of us sort of realized that something was going to have to change,” she said. “We didn’t know that it was going to be a closure of the clinic, we weren’t aware of that. And we certainly didn’t know that this timeline that would be so aggressive would happen.”
Jerry Weniger, director of James Madison University’s Physician Assistant program, also did not expect the news so soon.
“We had heard some rumors just in the last couple weeks on that it might be happening, but I really was not aware of how quickly it was going to happen or that it was for sure,” Weniger said. “That’s information that’s just privy to the board.
The university has partnered with the Clinic for several years through a Health Resources and Service Administration grant that allowed students in the physician assistant program to train there.
“Over the last four years, we have gotten a very clear indication from our students who have completed this experience that it was valuable to them,” Weniger said. “They feel like they learned a lot about cultural competence working with a diverse population of patients that come through the free clinic.
The lost learning opportunity, however, pales in comparison to the community’s loss of an affordable healthcare option, he said.
“There’s a significant population of people in our community that are vulnerable and rely on the Free Clinic for care of chronic conditions like hypertension and diabetes and mental health issues,” Weniger said. “They specifically rely on the clinic for low cost or free medications. And it’s just a big loss for our community.
Clinic staff will spend the rest of the year helping its 400 patients transition to new providers and providing them with a 90-day supply of medications and a 30-day written prescription. According to a Wednesday press release, the clinic expects to complete that transition by November 20, at which point the Harrisonburg Community Health Center will be prepared to take Free Clinic patients.
“I’m hoping that we can help as many patients as possible get settled into practices like the Community Health Center, or in some of the private Sentara practices around town,” Adamson said. “It’s going to be tough because the timeline is really tight. But I know that there are several of us that want to make sure that patients don’t get sort of left in the lurch and want to make sure we can continue their medications and prescriptions until they can get placed or receive care somewhere else.”
After transitioning patients to other providers, the clinic’s 14 paid staffers will take the final steps to close by December 30. Hale said that while he and everyone else involved with the decision are sad to see it end, he believes it will have left Harrisonburg in a better place than when it started.
“I think that we have lived our mission,” Hale said. “We provided healthcare for the uninsured and primarily through volunteer resources, and I think we need to celebrate the fact that we’ve done that for 30 plus years.”
However, he doesn’t believe that the spirit behind The Free Clinic is going anywhere.
“I think there’s always a need for some sort of healthcare in communities that’s very multifaceted, and healthcare is changing,” Hale said. “So whether that’s in the form of a free clinic or something else, I certainly think that we all want our communities want to be as healthy as they can be. So I think everybody strives to get there and there always will be collaboration.”
As it turns out, that effort is already underway, as a group comprising several healthcare providers, including Adamson, are discussing plans for a possible successor to The Free Clinic. Weniger is also part of that effort.
“It’s a group of local physician assistants, nurse practitioners, and physicians who have already banded together and met and are pursuing, a 401c3 nonprofit to perhaps start their own free clinic here in town very soon,” he said. “They’d like to see this population of patients not fall through the cracks and perhaps to have a continuity of care here.”
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