Virginia health care safety net breaking, leaders say

RICHMOND Virginia's health care safety net is groaning under increased demand, and a simple cash infusion won't solve the problem for free clinics and community hospitals around the state, industry leaders told legislators Thursday.

More cash certainly wouldn't hurt, though. A relatively small portion of free clinic budgets comes from state coffers now, according to presentations offered up Thursday to a state Senate subcommittee.

Linda Wilkinson, who heads the Virginia Association of Free and Charitable Clinics, put the state's share at about $3.8 million out of the $35 million a year it takes to run 60 clinics around the state. Most of the budget comes from private donations, though the federal government, local governments and patients kick in, too, she said.

There's also a shortage of doctors and dentists in many parts of the state who are willing or able to volunteer their time, Wilkinson and other health care executives said Thursday.

"And forget about finding a dermatologist," Wilkinson said.

Altogether, the free clinics and community health centers that make up the state's safety net treated 235,000 uninsured Virginians in 2013, according to Deborah Oswalt, executive director of the Virginia Health Care Foundation.

"Quite an achievement," she said. "Except when you compare it to the number of people that are actually eligible. It's only about a third."

Oswalt, Wilkinson and Neal Graham, head of the Virginia Community Healthcare Association, laid out some baselines for senators in the health care debate that continues to take up a lot of the bandwidth in Richmond, even with Medicaid expansion a seemingly dead issue. Without the billions in federal funding that would have paid for health insurance for hundreds of thousands of Virginians, providers are looking for a plan B.

Some have pointed to free clinics and other quasi-charitable health care settings as the answer, but these executives assured senators Thursday they're only part of the answer. They showed pictures of long lines of people waiting for care. Even in Arlington, part of well-to-do Northern Virginia, more than a hundred people will stand in line for a lottery to get one of 20 new patient spots in an area free clinic, Oswalt said.

There is a massive call for more dental services, Wilkinson said. Some 90 percent of the calls for help her foundation receives are for dental care, she said. The need is increasing, she said, as local health departments close their dental clinics.

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Virginia health care safety net breaking, leaders say

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