Harrisonburg's Free Clinic Will Close, But Is An Alternative On The Horizon?

Oct 12, 2020

Credit Calvin Pynn

The Harrisonburg-Rockingham Free Clinic will close at the end of the year, after serving uninsured adults in the area for more than three decades. Staff and volunteers are spending the final months making sure the clinic’s patients won’t be left behind. WMRA's Calvin Pynn reports.

The clinic got hit by a double-whammy.  It lost patients when Virginia expanded Medicaid eligibility last year, and then restrictions on volunteer staffing due to the coronavirus also disrupted operations.  The clinic also lost funding from the City of Harrisonburg this year, and the board of directors decided its operation was no longer sustainable.  Josh Hale is the Board’s president.

Josh Hale is president of the board of directors for the Harrisonburg-Rockingham Free Clinic.
Credit Josh Hale

JOSH HALE: There were a few factors and I wouldn’t say any one really outweighed the other. I think all aspects of the funding is in there for sure, but many different things make that up.

The city’s current budget, which was adopted several months into the pandemic, allocated $5,500 for the clinic – less than half of the annual funding it has received in years past.

The pandemic also challenged the Free Clinic’s care model which relies on volunteers – many of whom are retired healthcare providers at risk of infection. Susan Adamson is a nurse practitioner who has volunteered there for more than 20 years. She said the staff took those challenges in stride.

SUSAN ADAMSON: After having been through many transitions and challenges over the years, I was really proud of how the Free Clinic responded. We had an outpouring of community support. So many of our volunteers have been standing behind us and wanting to come in, but for about three months, we really had to pare down our services to keep everybody safe.

That included pivoting to a telemedicine model and only opening one day per week for patients who needed to be seen in person.

Nurse practitioner Susan Adamson (right) works with a JMU PA student (left) and a patient at the Free Clinic.
Credit JMU Physician Assistant program

ADAMSON: So we really flexed very quickly, and I'm proud of how hard everybody worked to make sure that we didn't have any gaps in patient services, even though they looked different. We didn't let any patients down during that time. We maintained services. It just had a different look to it.

The Free Clinic returned to a normal schedule in July when the Board of Directors met to determine its future. They spent the next couple months exploring ways to keep the Clinic open, but unanimously voted in September to close.

The Clinic’s volunteers were notified on Tuesday and for Adamson, it came as a surprise.

ADAMSON: So, it was about five weeks ago, I think all of us sort of realized that something was going to have to change. We didn't know that it was going to be a closure of the clinic, we weren't aware of that. And we certainly didn't know that this timeline that would be so aggressive would happen.

Helping the Free Clinic’s 400 patients transition to new providers will be the staff’s priority through November, and patients will leave the clinic with a 90-day supply of medications along with a 30-day written prescription. The Harrisonburg Community Health Center will be prepared to see patients from the clinic after it closes.

ADAMSON: It’s going to be tough because the timeline is really tight. But I know that there are several of us that want to make sure that patients don't get sort of left in the lurch and want to make sure we can continue their medications and prescriptions until they can get placed or receive care somewhere else.

From that point, the Clinic’s 14 paid staff members will take the next steps to close by December 30. Board president Hale said he believes the clinic will leave Harrisonburg in a better place than when it started.

HALE: I think that we have lived our mission. We provided healthcare for the uninsured and primarily through volunteer resources. And I think we need to celebrate the fact that we've done that for 30 plus years.

The closure will also mark the end of a four-year partnership between the Free Clinic and James Madison University through a Health Resources and Services Administration grant that has allowed students in JMU’s Physician Assistant program to train there. Jerry Weniger is the program’s director.

JERRY WENIGER: Over the last four years, we have gotten a very clear indication from our students who have completed this experience that it was valuable to them, and they feel like they learned a lot about cultural competence working with a diverse population of patients that come through the Free Clinic.

Once the clinic is gone, though, he expects that the loss will hurt the community more than it will the program.

WENIGER: There's a significant population of people in our community that are vulnerable and rely on the Free Clinic for care of chronic conditions like hypertension and diabetes and mental health issues. And they specifically rely on the clinic for low cost or free medications, so it’s just a big loss for our community.

This may not be the end, however. A group of local providers – including Adamson – are discussing plans for a successor to the Free Clinic. Weniger is also contributing to those conversations.

WENIGER: It’s a group of local physician assistants, nurse practitioners, and physicians who have already banded together and met and are pursuing a 401c3 nonprofit to perhaps start their own free clinic here in town very soon. They'd like to see this population of patients not fall through the cracks and perhaps to have a continuity of care here.