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Opinion: California, Here’s How to Protect Essential Workers

Originally Published in the California Health Report

By Paula Wilson

COVID-19 is exposing a hard truth about our communities: If the low-wage workers cannot obtain decent health care, everyone else is at risk.

That’s because many of the lowest-income Californians hold essential jobs in retail and other services where they regularly interact with the public. The UC Berkeley Labor Center estimates that up to half or more of California’s workers are considered essential, and most are paid low wages. If they become ill with COVID-19, they often can’t afford time off to isolate themselves. They risk infecting those in their households and other community members as a result.
Meanwhile, California’s health care safety net wasn’t particularly robust prior to COVID-19. It will soon become more frayed. A recent Families USA report concludes 5.4 million Americans lost their job-based health insurance coverage between February and May. Extrapolating that data suggests at least 650,000 Californians have lost their job-based insurance. The Berkeley Labor Center notes that nearly a third of the state’s workforce has filed for unemployment benefits over the past five months.

Providing health care to such vulnerable groups is the reason community health centers exist. They provide comprehensive primary care, including behavioral health, dental and optometric services, regardless of one’s ability to pay. Since the COVID-19 outbreak began, the nation’s nearly 1,000 community health centers have performed more than 3 million tests for the virus. Testing aside, the nearly 200 community health centers in California treat 5 million patients annually — a number that grew 70 percent between 2010 and 2018.

In Los Angeles County, Valley Community Healthcare and other health centers serve an outsized share of low-income patients. Seventy-nine percent are working poor (with incomes below the federal poverty level, which is $24,600 for a family of four), and 95 percent rely on public insurance or are uninsured.

As a result of COVID-19’s economic fallout, Valley Community’s patient load is expected to increase by as much as 20 percent by the end of the year. Although we already serve more than 1,500 homeless patients, we anticipate hundreds more of our patients will soon lose their homes.

On top of these strains, hundreds of millions of dollars in state funding that flow to community health centers could be at risk as the state struggles to close its yawning budget deficit. All community health centers would feel that loss acutely. For Valley Community, this means attempting to close the gap with fundraising — far tougher to do in a shrinking economy.

Fortunately, community health centers have a track record of providing high-quality care in spite of economic and other challenges. For example, Valley Community has stayed on the cutting edge of community health with HIV testing and treatment, specialized teen health, integrated mental health, nutrition, and much more outside standard general medical care. Health centers also have an important role to play in the economic recovery of their communities: Most employees live nearby, creating opportunity and economic growth for the communities they serve.

Reassuringly, Southern California’s business and philanthropic communities understand the importance of the health care safety net and have stepped up to support it during a time of need. For example, the insurer Health Net awarded $100,000 to Valley Community Healthcare to install a telehealth system, part of a $4 million grant to 48 health centers in the Los Angeles area. Philanthropic organizations and small businesses have also provided critically needed resources to support COVID-19 testing and the purchasing of personal protective equipment and other items that have been difficult to secure as the medical supply chain has come under pressure.

This support is a good start, but the needs of health centers such as Valley Community will only grow in the months ahead. Health centers need investments at the federal, state and local levels to meet our mission and support our communities.

Despite the tough economic times brought about by the COVID-19 pandemic, we will continue to search for ways to maintain and expand services so we can continue to serve some of the most medically challenged, vulnerable and disproportionately impacted patients outside of hospital intensive care units.

We have no other choice in these uncertain times but to keep moving forward. Neither do our patients — and, for that matter, neither does the rest of California.

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