NE Piedmont News

North Carolina has 39 federally-qualified health centers where many of the state’s poor, rural and uninsured residents get health care. 

However, COVID-19-related restrictions have made it more difficult to serve the state's vulnerable population as the centers shifted more to telemedicine. 

According to a report in the Carolina Journal, approximately 50% of patients at the health centers do not have internet access, making it nearly impossible for them to participate in online health care. Added to the problem, if doctors treat patients over the phone, the centers are not eligible for reimbursement, which also impacts paying staff members. 

“That handicaps those of us where only 50% of our patients can do a virtual visit,” Roanoke Chowan Community Health Center CEO Kim Schwartz told the Carolina Journal for its April 27 report. “That’s using the assumption that everyone has access to a virtual visit — but the only access they have is a phone visit.”

In one rural area of eastern North Carolina, an 87-year-old doctor set up a “hotspot” in a parking lot to treat patients who could not do virtual visits, according to the publication. He ran into another issue for North Carolina’s poor: one in four has access to reliable transportation.

When the pandemic shut down medical offices in North Carolina, the state quickly changed the rules to allow compensation for telemedicine visits. Payments were increased for online visits but not for telephone visits, the publication reported. A consultation that usually paid the clinic $140, now pays $30.

“Not being able to get a telephone visit paid for like I got an in-person visit paid for a month ago, that’s eventually going to catch up with us,” Schwartz told the Carolina Journal. “That’s the scary part.”

Congress allocated $35 million to the 39 federal health centers in North Carolina, but the clinics have little financial reserves and federal funding will not make up for the shortfalls, Brendan Riley, policy director for the North Carolina Community Health Center Association, told the Carolina Journal. 

“Federal cash won’t replace losses,” he told the publication. 

Federally qualified community health centers form a safety net for North Carolina’s poorest residents that stretches across the state. The pandemic has created a crisis for providers, Schwartz told the publication. “No one expected this and the grave effect it’s going to have." 

Things are still worse for the clinics that meet the same standards and serve the same patient population as the federally qualified centers but don’t receive federal aid. 

“Everybody is struggling. Patients aren’t coming to the office,” Dr. Lee Ann Amann, CEO of Black River Family Practice in Pender County, told the Carolina Journal. “We’re a nonprofit, so we’re OK. We’re getting by, but if we have to keep this up for another couple more weeks, we’ll be in trouble,” Amann said.