RICHMOND, Va. -- Before her medical credential hung on the walls, Dr. Rachel Waller volunteered her time and efforts to what was then the Fan Free Clinic.
“Richmond’s, actually, Virginia’s oldest free clinic," Dr. Waller said during an interview in her office where she now serves as Medical Director of Health Brigade. "Those experiences over time formed who I am.”
Now, Dr. Waller is in charge of leading care for an influx of patients Health Brigade and other free clinics across Virginia haven't seen in recent years.
“I think across the board, we’ve seen about a 30% increase in requests for services," Waller said.
Those numbers are a little higher than what free and charitable clinics — who provide health care services to vulnerable populations without insurance across the state — have reported in recent years.
The 50 clinics that are part of the Virginia Association of Free and Charitable Clinics served 75,000 patients in 2022, a 19% increase over 2021 when 63,000 patients received care.
"Feedback from our members shows that the demand for free and charitable clinics is rapidly growing due to changes in Medicaid coverage and rising living costs,” said Rufus Phillips, VAFCC CEO. “Free clinics have never been more vital to the health of communities as they work to provide quality and compassionate care to patients. While clinics will never waver in their support of Virginians, these nonprofits need the support of the community more than ever.”
Dr. Waller remains a supporter of Medicaid expansion in Virginia a few years ago, but she said it has changed the type of patients they've seen coming through their doors, especially out of the pandemic and the economic climate that followed.
“We are actually getting clients who may be a little older and may have more chronic medical conditions. We’re definitely seeing clients who don’t have English as their first language," Dr. Waller said.
Both of those populations require more resources to provide the quality care Health Brigade seeks to provide every client.
"In trying to see as many people as possible, when we have more patients who have chronic needs, that takes up time we would have otherwise used to see new patients. We want to provide not just care but quality care and our patients are needing to come in for more visits than they did previously," Dr. Waller said. "The need for good interpretation services and bilingual staff has definitely been new for us. It also leads to longer visits, but it’s so important for people to get care in a language they understand. It’s absolutely integral to providing good and safe care.”
All of this leads to increased staffing needs at a time when the healthcare industry is facing challenges nationwide.
Health Brigade utilizes donations and grant funding to pay their full-time staff. Other funding sources, like state resources, go directly to patient services, Dr. Waller said.
“Of course, we have wonderful volunteers. We’re very grateful to them, but they can’t always fulfill all the needs that we have, especially in patients who are chronically ill and need a lot of navigation," Dr. Waller said.
VAFCC members are seeing major increases in dental needs and patients who need prescription medication. Clients seeking mental health care is up 10% across Virginia, VAFCC said.
“Our clients are under a lot of stress. They’re already folks who are struggling to make ends meet, and I really think it's helpful for them to know there’s a place to go where they can start to feel better and find safe paths through their lives," Dr. Waller said.
Dr. Waller used to work for a larger health system in the city. Her days of doing volunteer work grew into why she loves the mission Health Brigade tackles daily - "To really just provide good medical care without having to think about insurance companies and prior authorizations and things like that can make commercial insurance so challenging.”
In order to provide quality care to the growing number of neighbors who rely on Virginia's free clinics, Dr. Waller said more funding is critical.
"That is critical to maintaining a healthy Virginia. Is that giving good primary care and give good solid care for chronic conditions to keep people out of the emergency rooms and back engaged in their lives," she said.
”We really just try to make sure we are mindful of how we utilize the money and resources that are given to us so that we really direct as much of the services to our patients as possible."
In the state budget negotiations underway, VAFCC is seeking a $5 million increase each year in state funding over what they already receive.
That works to about $100,000 on average for each free clinic in Virginia. The latest draft of the state budget comes out Sunday.
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