OPINION: ESRH employee discusses the importance of federally funded health centers

By Joan Lingen, M.D., Chief Medical Officer, Eastern Shore Rural Health Systems, Inc.

Shortly after Doris Brown moved into her new home in Accomack County, she had to take her 4-year-old daughter for her wellness visit. Brown went to the same health provider that she had visited since she was a teen: Eastern Shore Rural Health System Inc., the only federally qualified health center (FQHC) on Virginia’s Eastern Shore.

At that time, Brown’s daughter would at times appear lethargic and without an appetite, signs – since she wasn’t ill – that Brown chalked up to her daughter being four and a picky eater.

Although it was a routine wellness visit, the doctor decided to further investigate why the little girl wasn’t herself. Tests revealed that she had alarmingly high levels of lead in her bloodstream, alerting Brown that her new home was overrun with lead-based surfaces. Lead poisoning in children can have severe consequences, including developmental delays, brain damage and even death.

“We immediately made renovations to our house to better control the lead levels,” said Brown, a small business owner. “My daughter is now 13 and her lead levels are closely monitored and we’ve been able to protect them from getting worse. She hasn’t had those same symptoms in the past nine years and I owe that to Eastern Shore Rural Health’s excellent care. It was another reminder of why I’ve continued to go to Eastern Shore Rural Health for my family’s care.”

Brown said she would have to travel across state lines to find a new primary care practice if Eastern Shore Rural Health System, which was founded in 1976, didn’t exist.

“I’d have to start from scratch to look for a doctor,” Brown said. “I wouldn’t know where to start.”

It’s a legitimate worry among many patients who access care at FQHCs right now – not just on the Eastern Shore but across the entire Commonwealth of Virginia.

As both Virginia’s delegation addresses federal funding for health programs and as Virginia’s legislature looks for ways to save money, it’s crucial to prioritize FQHCs and to avoid any cuts to their Medicaid funding. More than 400,000 Virginians rely on FQHCs for vital, cost-efficient and life-saving care.

Cutting either FQHC or Medicaid funding would disproportionately impact the people who need healthcare most, further entrenching existing health disparities. If FQHCs are underfunded or closed, patients will lose primary care providers and rely on overcrowded emergency rooms or urgent care centers, which can’t offer the same personalized, long-term care. This would worsen the financial strain on the healthcare system – creating longer wait times at emergency departments and increasing the number of people who need to be hospitalized – as untreated conditions often require more expensive care. Local and state governments will be forced to raise taxes as a result.

The Importance of FQHCs

FQHCs are essential community-based healthcare providers serving over 30 million US citizens, with services offered on a free or on a sliding cost scale to those who qualify for discounts based on household size and income. In Virginia, they are often the only healthcare option.

Virginia FQHCs are non-profit, independent health centers that offer multiple services under one roof, from primary care to dentistry and behavioral health. They are essential for underserved populations facing health disparities due to financial, transportation, and discrimination barriers. These centers provide preventive care for various conditions, ensuring cost isn’t a barrier, and offer a lifeline for individuals experiencing homelessness.

In addition, FQHCs are more than primary care providers – they also are vital sources of health education, community outreach and health advocacy. They bridge knowledge gaps and ensure patients have resources for effective health management. The benefits of maintaining FQHCs extend beyond individuals to entire communities, creating healthier environments and reducing the burden on the healthcare system.

The Path Forward

Protecting FQHCs during reauthorization and shielding them from Medicaid cuts is about ensuring the well-being of Virginians. Our Virginia lawmakers must recognize that FQHCs are pillars of community health, especially in areas with limited healthcare options. If Congress passes Medicaid cuts to the states, approximately 600,000 Virginians could lose Medicaid coverage, according to a Virginia “trigger” law that automatically cuts Medicaid to hundreds of thousands if the federal government pushes more costs to state budgets and state taxpayers.

Preserving FQHCs is a matter of preserving access to care. Everyone, regardless of income, race, or geography, deserves access to quality care. Protecting these centers invests in our state’s health and affirms our commitment to equality and fairness. Now is the time to act and ensure FQHCs’ critical services remain available to all who need them.

Joan Lingen, M.D., serves as the Chief Medical Officer for Eastern Shore Rural Health System, Inc., a Federally Qualified Health Center (FQHC) located in Eastern Shore, VA and a member of Virginia Community Healthcare Association, the primary care association representing Virginia’s FQHCs