Federally-qualified health centers (FQHCs) care for many underserved individuals, including children. But since COVID-19, these centers have seen a significant decline in visits, due in part to stay and safe at home orders. This decline has not only left many FQHCs struggling financially, but it also has negative impacts on children who have missed regularly-scheduled well visits and immunizations.
This decline has not only left many FQHCs struggling financially, but it also has negative impacts on children who have missed regularly-scheduled well visits and immunizations.
Since the onset of COVID-19, CMS has reported 22% fewer immunizations, 44% fewer outpatient mental health services, 44% fewer child screening services, and 69% fewer dental services among children enrolled in Medicaid. And while only 34% of children enrolled in Medicaid are up-to-date on their immunizations, compared to 55% of children not enrolled in Medicaid, many families are still delaying rescheduling missed appointments. Because FQHCs serve many Medicaid-enrolled children, it is more critical than ever to support these centers and ensure they can continue providing services.
Well-child visits and immunizations critical to healthy development
Children covered by Medicaid have access to comprehensive and preventive health services, including a series of standard well-child visits from the time they are born to age 21. This benefit, commonly referred to as Early and Periodic Screening, Diagnostic and Treatment (EPSDT), includes everything from developmental, vision, hearing and chronic disease screenings to immunizations and physical exams, including laboratory testing and specialist referrals.
As children grow, these appointments monitor key milestones to gauge whether a child is developing within a healthy zone. It’s during these well visits that a child’s care provider can identify gross motor, fine motor, social, problem-solving and communication delays and help guide an intervention. The earlier these interventions take place, the more possibility there is to correct an issue and mitigate further development delays that could impact the child’s ability to grow into a healthy adult.
The earlier these interventions take place, the more possibility there is to correct an issue and mitigate further development delays that could impact the child’s ability to grow into a healthy adult.
Maryland health centers utilize funding to improve children’s health
Shortly after the onset of COVID-19, UnitedHealthcare Community & State created the FQHC Transformation Investments Program, which deployed funding to FQHCs across the nation to help them remain operational and build capacity. Of the nearly 300 centers that received the funding, nine were located in Maryland.
One of the state’s FQHCs used the funds to expand their already established telehealth program to provide virtual prenatal visits for pregnant women, which included a kit that allowed expecting mothers to take their own blood pressure and tape measure to measure and record their fundal height from home during virtual visits. Another rural community health center focused on community outreach to encourage patients, including children, to come in to receive scheduled immunizations.
Now that health centers are slowly resuming more of their daily operations, many of these FQHCs are focusing funds on infection control to make in-person visits as safe as possible for both patients and providers. This includes educating patients on preventive care and the importance of regular immunizations for their children. Some FQHCs have used their funding for community-based COVID-19 testing events. And others have developed or further expanded their telehealth capacity to continue care services without in-person contact.
Helping FQHCs serve their communities
FQHCs have faced significant strain as a result of the public health emergency. Having the ability to offer testing events has been immensely helpful for these FQHCs, many of which are located in diverse communities where individuals may not have access to alternative care sites. This focus has also helped elevate awareness of FQHCs in local communities and has helped these community health centers engage with their communities in new ways.
Since FQHCs have expanded their telehealth services, providers and their patients have become more accustomed to utilizing this care delivery channel to treat and manage conditions. Providers are also beginning to change how they interact with electronic medical records (EMR) and are able to accommodate patient schedules more easily. This could improve care access for families and improve well-child visit attendance.
As time goes on, FQHCs will require continued support to remain operational during the public health emergency, especially as they experience decreased visits in primary care and well-child appointments.
As time goes on, FQHCs will require continued support to remain operational during the public health emergency, especially as they experience decreased visits in primary care and well-child appointments. This support will include supporting continued telehealth services and addressing new needs as they emerge so that they can continue to serve the community and our members, including children, and communicate the importance of regular care.
Read more from Dr. Kirk
