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Since the start of the pandemic, triage nurse Mari Morales has yet to take a break from the nonprofit clinic Health For All. Instead, she spends each day doing much of the same tasks she did before the pandemic — gathering a patient’s vital signs, checking their blood pressure, and performing a general assessment before a doctor can see them. But with social distancing due to COVID-19, drastic changes have had to be made at the clinic and to Morales’ everyday routine.
Before COVID-19, people without health insurance went to organizations like Health For All for medical care, says Liz Dickey, executive director of Health For All. Since COVID-19, the uncertainty of living without health insurance has only intensified. The uninsured can go to places like Health For All for COVID testing or to refill prescriptions they cannot afford after losing their jobs, Dickey says.
As a community-supported nonprofit, Health For All serves as a free primary-care clinic for the uninsured, she says. “I tell people to think of us like Doctors Without Borders on a local level,” Dickey says. “We use volunteer medical providers to actually see the patients and act as a safety net for people who otherwise fall through the cracks.”
Texas has the highest number of uninsured people in the country, Dickey says. Those ages 18 to 64 without insurance but make too much to qualify for government assistance are more likely to not seek preventative primary care, she says, and as a result, their conditions often worsen to the point they have to go to the emergency room.
“We provide a medical home for the uninsured so those people aren’t taxing our local ERs,” Health For All’s Community Relations Specialist Amanda Schrader says. “We are able to save our community around $3 million to $4 million annually by providing a place for the uninsured to go for basically manageable conditions.”
Health For All does a lot of chronic disease management, like diabetes and hypertension, Dickey says. Many patients say their biggest need is access to affordable medication to treat chronic conditions, she says.
“We have actually established a Class D pharmacy on site,” Dickey says. A Class D pharmacy carries a limited range of drugs for prescription drug orders such as topical drugs and vaccines, according to the Texas State Board of Pharmacy website.
“It’s pre-stocked with medication, and doctors can come and select from the ‘vending machine’ which medications they need,” Dickey says.
Health For All relies on volunteers to provide care, but COVID-19 has changed that too, says Schrader. Many of these volunteers are now considered to be high risk, or their own practices have gotten busier, she says.
“It’s been a little bit harder to get people to come volunteer at our clinic because we rely on retired providers or providers that practice somewhere else,” says Schrader.
One solution Health For All has implemented is televisits, said Morales. The downside is televisits feel less personal, says Morales.
“It has taken a mental toll,” she says. “Now, even though there’s not a physical barrier there, you have to be extra cautious.”
The personal connection is what Morales said she misses most.
“Sometimes they want to cry, they bring their concerns, they want to talk about things,” Morales says. “A lot of them want to give you a hug because they understand that we are going to help them.
“But, you kind of have to say ‘Well, I can give you my elbow,’” Morales says.
This and the high-risk environment negatively affects hands-on nurses, she added.
“That feeds into you mentally,” Morales says. “We still have to be there! We have got to show up because we’ve got to take care of our patients.”
Health For All plays only a small role in serving the uninsured in Bryan College Station. In Brazos County, around 600,000 people do not have health insurance, said Dickey. Health For All handles about 4,000 patient visits a year, according to the Health For All website.
Health For All partners with other organizations like United Way of the Brazos Valley and The Bridge Ministries to ensure everyone has access to help, whether they are dealing with chronic disease management, food insecurity, or COVID-19, says Dickey.
Poor nutrition and an inability to access health care are closely linked, says Tatiana Rivera, operations manager for The Bridge Ministries, a food pantry in Bryan. Poor nutrition can lead to diabetes or obesity, and if left unchecked, can lead to something a lot more serious, Rivera says.
“It goes back to being able to access very cheap food, and it might be fast food that is unhealthy,” she says.
The Bridge Ministries partners with the Bryan Health Department for a diabetes program, said Rivera. An 8-hour class is offered by the health department, that then partners with The Bridge Ministries to pass out food catered to a diabetic diet every third Thursday of the month, she says.
United Way of the Brazos Valley is an umbrella organization that is currently partnered with 22 nonprofits to raise funds and provide support, according to Alison Prince, president and CEO of United Way of the Brazos Valley.
Health For All is one of the health care agencies UWBV supports, says Peggi Goss, the vice president community impact of UWBV.
“We meet with them once a month to try and solve more complex issues,” says Goss.
At the start of the pandemic, it was hard for Health For All to get COVID tests. Since then, COVID tests have become more readily available, like at on-campus testing kiosks, says Greg Hartman, chief operating officer and senior vice president of the Health and Science Center at A&M.
The kiosks are not only meant for people affiliated with A&M, says Hartman, who is responsible for getting these kiosks on campus.
“If you’re at the kiosk, it can be anybody — anyone from the general public can show up,” says Hartman. “The test supply came from the Department of Emergency Management, and so they supply the tests free to the general public.”
Health For All and other nonprofits require support to continue to provide for the Brazos Valley, says Kate Barnes, development coordinator for Health For All.
“We want to make sure everybody, no matter their economic status, religion, sexual orientation or race has the opportunity to get the care they need,” Barnes says.
Monetary donations are a huge need, Dickey says. Health For All has stayed afloat, but continued donations are crucial in the coming months, especially since it is unknown how long the pandemic will last, she added.
“We are blessed to live in a community where we have a number of supporters who are very generous and are really trying to work hard to help,” Dickey says. “We are very hopeful that will continue.”
For more information, visit hlth4all.org.