Free clinics in Iowa brace for pandemic effect, patient influx

CEDAR RAPIDS - As the effects of the novel coronavirus pandemic still ripple across the nation, its impact on the uninsured rates among the Cedar Rapids population still is unknown, but worrisome to local health care officials.

For those who have lost jobs that offered benefits, it probably means they've lost their health insurance, too.

That, coupled with the loss of a longtime training program for up-and-coming family physicians, could have a compounding effect on patient numbers for local free medical clinics and Cedar Rapids' Federally Qualified Health Center, all working in tandem to care for lower-income and at-risk populations.

'National and local data indicates more people are deferring care, and we are concerned,” officials from both Cedar Rapids hospitals said in a joint news release. 'We want people to seek care when they need it for emergencies and other preventive measures.

'We also believe sites of care like the Eastern Iowa Health Center and free medical clinic may experience higher volumes as people begin to seek care again.”

This past week, 1.9 million Americans filed for unemployment, bringing the pandemic-related job loss total to more than 42 million.

In the first week of June, the Iowa Workforce Development received more than 10,000 unemployment claims, bringing the total number of continuing claims in Iowa to nearly 160,000.

'The Eastern Iowa Health Center, along with other health care and community leaders, fear that more people will lose insurance as a result of the pandemic,” said Erin Langdon, chief development officer for the federally qualified health center based in Cedar Rapids.

As a result, area free medical clinics, which provide health care for those facing economic barriers, are preparing for an influx of patients down the road.

'Physicians are usually willing to refill medications and things like that for the short term, especially in this situation with the pandemic going on, but I suspect in two or three months down the road, we will see more patients,” said Dr. Cecilia Norris, medical director of the Iowa City Free Medical Clinic.

In most cases, patients at the Community Health Free Clinic in Cedar Rapids would qualify for Medicaid. Providers at free clinics only would see those patients once they are enrolled in the program, and then they would be sent to the Eastern Iowa Health Center for the long-term, said Jamie Henley, chief operating officer at Community Health Free Clinic.

As a federally qualified health center, the Eastern Iowa Health Center receives a higher reimbursement rate from federal officials to provide primary care to underserved populations - including those low-income earners who may have experienced job loss.

Program Closed

However, another factor in play within the Cedar Rapids medical community could leave the free clinics with a larger patient population in the longer term, Henley said.

As July approaches, so does the official closure date of a longtime training program for up-and-coming family physicians. The Cedar Rapids Family Medicine Residency Program, the sole family medicine residency program in Cedar Rapids, will be discontinued effective July 1 after nearly 50 years.

Of the 21 current residents, seven will graduate this summer and the remaining 14 already have found placement in programs elsewhere, officials stated.

The residents' medical home was at the Eastern Iowa Health Center, where they provided care for about 7,000 individuals. That's equivalent to three full-time doctors, said Dr. James Bell, medical director of His Hands Free Clinic in Cedar Rapids.

'The question is can they, without residents, absorb 7,000 patients?” said Dawn Brouwers, His Hands executive director.

His Hands Free Clinic is moving to a new clinic at 1245 2nd Ave. SE this month, which is expected to open to the public July 7.

The bigger space will allow the clinic to take on more patients day to day, Brouwers said.

However, given the financial hit they have taken in the midst of the pandemic, Bell said concern remains how the free clinics could absorb an increased patient volume.

'At His Hands, what can we do to help fill that gap? We don't know how we're going to answer that,” he said.

But hospital officials are confident they can meet the need. In addition to the hospitals' recruiting programs, the Eastern Iowa Health Center - established in 2006 - 'stands ready to continue serving this population,” officials said in a news release.

'In fact, Eastern Iowa Health Center has been actively recruiting providers since the Cedar Rapids Medical Education Foundation announcement and is well positioned to care for existing and new patients,” the statement reads.

'If hospital care is needed, both hospitals have hospitalists that will provide care for these patients.”

Langdon said the health center is part of a communitywide response to provide increased insurance enrollment assistance for public insurance options, such as Medicaid, and private insurance available through the federal marketplace.

'Additionally no patient is turned away at Eastern Iowa Health Center due to inability to pay,” she said. 'We provide assistance to uninsured patients on a sliding fee scale and will continue to serve patients throughout the year, despite their insurance status.”

Mercy Medical Center CEO Tim Charles said Cedar Rapids hospitals also continue to put an emphasis on robust recruiting. They hope to bring in advanced practitioners - such as physician assistants and nurse practitioners - to meet the need on the primary care side.

From the Community Health Free Clinic's perspective, bridging the gap for those patients for a longer period of time is not a concern.

'That's not new for us,” Henley said. 'We did the same thing when the Affordable Care Act came out.”

'We'll figure it out,” he added. 'That's the thing with us, we've got a lot of great partners who work with us, a lot of great volunteers, so we'll figure out ways to help patients and whatever they need and really make sure they're taken care of.

'The rest of it we'll figure out as we go along.”

Comments: (319) 398-8469; michaela.ramm@thegazette.com