Already Strained Community Clinics Prepare for Swine Flu

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(Sacramento, CA)
Thursday, April 30, 2009

The poor and uninsured can get free or discounted care at community health clinics. And lately a lot more of them are showing up. Carmela Castellano-Garcia is the CEO and president of the California Primary Care Association. It represents about 800 clinics around the state, they serve four million patients a year. She says during this recession many clinics are seeing 25 percent more patients. And, now she says there’s the H1N1 or swine flu outbreak.

“Some of our clinics have reported a 25-30 percent increase in their patient influx, this past week alone, and we believe that this is solely due to this outbreak.” 

Castellano-Garcia says clinics in Los Angeles and Santa Clara counties are especially seeing a jump in patient load with the swine flu outbreak. And as more patients come in, she says clinics are having trouble getting supplies to help prevent the spread of the virus.

“Some of them are not well equipped enough to have the personal protective equipment such as the appropriate masks or gloves that not only their staff need but we also need to provide patients as we send them out back into the community and our waiting rooms.” 
At one clinic in West Sacramento Dr. David Katz is trying to get ready for the flu outbreak. He’s the medical director of CommuniCare Health Centers in Yolo County. He says they’re feeling the stress of more demand and fewer resources.

“At the same time that we’re being asked to respond to a national health crisis and a local health crisis by providing more services our financial resources have been diminishing.” 

Katz says a lot of factors are coming to a head. He rattles off a few: state budget cuts…county budget cuts…and of course there’s the recession. Katz says CommuniCare clinics have lost a million dollars in funding. They’ve laid-off several staff and one of his clinics is open fewer hours. And he says this is happening across the state.

“Well it’s stressful for our doctors and it’s stressful for our clinic staff to have people come and we’re not able to get them in as quickly as we want.” 
Sounds of waiting room
Diane Mosley knows all about that. She’s uninsured and in the waiting room at the Salud Clinic in West Sacramento. She needs a follow-up visit for a hernia surgery. She’s been here before and says it’s not uncommon to wait up to five hours to see a doctor. Mosley wonders what would happen if she did have swine flu.  

“I think they need more people working here. It’s scary cause uh you might have the flu and you might be really sick before you can even be seen.” 
And while they’re waiting all those hours …they could spread the virus. That’s according to Jeff Levi, the executive director of Trust for America’s Health, a public health advocacy group in Washington D.C. He says the bottom line is if swine flu reaches pandemic proportions, it’ll be ugly.

"Clinics are already operating at the margins, if you layer on a huge spike in demand related to the flu it may be very hard for clinics to stay afloat.”
Levi says if community clinics do start going under California could step in and provide some relief like staff support and medical supplies. At a recent hearing at the state Capitol health officials said that’s the goal. But they acknowledged they’ll have to ramp up communications with health care providers to make that happen.