Basalt clinic cares for the ‘lost community’ during COVID-19 crisis
A midvalley medical clinic that helps uninsured people deal with COVID-19 is experiencing a surge in requests for tests as the economic reopening unfolds.
Midvalley Family Practice performed 108 tests in El Jebel on June 25 at a special event coordinated with an Eagle County aid program called the MIRA bus. Since then, the clinic’s staff has tested between 10 and 17 people per day at its facility in Basalt. That’s more requests for tests than they fielded even in the early days of the coronavirus crisis.
Dr. Glenn Kotz and his team at the clinic founded a nonprofit called Healthy All Together to raise funds to provide care for what they believe is a growing uninsured population in the region. The need for services threatens to dwarf their current resources.
“We’ve started to talk about this as a lost community because we don’t know how many people are uninsured because they have just stayed out of the picture,” Kotz said. “Through the MIRA bus and through our offering of the services, every day there are new people coming out of this lost community to say, ‘Hey, I’m sick and I don’t have insurance and I haven’t seen a doctor in years.’”
Midvalley Family Practice has an open-door policy when it comes to COVID-19 testing. They don’t turn away the uninsured. As a designated testing site in the state, it receives a limited number of tests for free.
However, the care they provide doesn’t simply consist of ramming a cotton swap far up the nose of patients for what’s known as a PCR test. The nurses of the clinic perform a medical assessment of the people and sometimes find issues that have been unaddressed for years. High blood pressure, for example, is a common finding.
“It’s a total evaluation,” said Lisa Robbiano, a nurse at the clinic. “Many of the uninsured haven’t been to a doctor for years.”
One recent incident stuck out for the Midvalley Family Practice team. An entire family came in and all tested positive for COVID-19.
The father is in his 40s and didn’t have any underlying medical conditions when he became infected. He was winded just walking into the clinic’s isolated section for COVID-19 testing. He also had a high fever. Midvalley sent him to Valley View Hospital, which sent him to a hospital in Denver where, at last word, he was still on a ventilator.
It’s a prime example of how COVID-19 shouldn’t be shrugged off, the clinic’s staff said.
“I don’t think we in the medical field know exactly why that happens yet, which makes it more scary to us,” Ashley Burke, a nurse at the clinic, said about the severe symptoms of the man in his 40s. “I think sometimes the general population, some people anyway, like to throw it off like, ‘Oh well, the flu kills more people.’ But we kind of understand the flu. The flu has been around. This is new. We don’t understand it and people are dying and getting ill that are really young.”
While testing and assessing health, they regularly find people who are going hungry because they are unemployed or unable to pay rent because they are out of money. They steer those families or individuals toward resources in the Roaring Fork Valley.
HAT executive director Jarid Rollins also is a mental health provider at the clinic and has been counseling people since the coronavirus outbreak.
“Initially when this all started there was this great coming together. (Some) people were freaking out but people were also thankful that there was this respite where they could relax for a little bit,” Rollins said. “There was a plethora of resources. People were getting unemployment. The counties were supporting their residents as well. As this has dragged on, people are getting exhausted, they’re more anxious, the resources are fewer because not everyone is in crisis mode, people are back to work, but those who can’t go back to work or who have been exposed or are positive, they’re really feeling the effects of this.”
Rollins said the uninsured rate among Roaring Fork Valley residents was about 16% pre-coronavirus crisis, according to best available data. He believes the percentage is significantly higher now because of all the people who lost jobs that provided health insurance.
That swelling of the ranks of unemployed spurred the Midvalley Family Practice team to form the nonprofit to provide care.
“There was a need being presented in the valley that we needed to fill,” said Lisa O’Neil, a nurse at the clinic.
Federal guidelines advised medical clinics early in the coronavirus crisis to stop seeing patients in person and do tele-conferences. Midvalley Family Practice found almost immediately that people wanted face-to-face contact, so it started seeing people for the coronavirus in their vehicles in the parking lot.
The cold and snow interfered with the equipment as well as comfort of the sick. Next, they set up a tent in the parking lot. More recently they created a secured section of their office called the COVID Corner that has its own entrance.
Word of the free tests has spread throughout the region.
“Early on in the process we started seeing people from an hour to an hour-and-a-half away,” Kotz said. “Anywhere from Parachute to Meeker and Gypsum.”
Many of their patients come from Basalt, El Jebel and Carbondale. They exceeded 500 tests by the end of last week.
“Our positivity rate, which means out of those 500, how many are positive, is 11, 12 percent,” Robbiano said. The clinic is doing more tests, she said, but the positivity rate also is going up. In other words, the positive tests aren’t simply due to more testing.
The state average is a 10% positive rate.
People can’t just get tested because they want to know if they have COVID-19. They must call the clinic in advance at 970-927-4666 and explain if they have been exposed or are feeling symptomatic.
Early in the crisis, most of the people they tested exhibited symptoms. Since the second week of June, the vast majority of people they see are requesting tests because they were exposed to someone who tested positive.
Robbiano said between five and 10 of the patients they tested have been hospitalized, though the staff believes a higher number probably should have been.
There is no sign that the requests for tests will drop anytime soon. June 20 was “insane” at the clinic, said Imelda De La Torre, who staffs the front desk. She had to turn away or reschedule nearly 15 patients.
Based on their experience, the overwhelming message from the clinic staff is precautions need to be taken seriously. That means wearing face coverings, maintaining social distancing and avoiding large gatherings. A person who feels they have been directly exposed to someone who tested positive must quarantine and get tested as quickly as possible. And people who get tested must avoid contact with others while waiting for their test result and isolate if the result is positive.
“If you’re going to ask for a test, it’s almost like you are signing a contact that I will change my behaviors and my risk to others,” nurse Maria McHale said.
Healthy All Together received grants from the Colorado COVID Relief Fund, Caring for Community Fund and the William H. Hurt Foundation. It has about $48,000 remaining from the initial grants.
Donations can be made by contacting Jarid Rollins at firstname.lastname@example.org or calling 970-927-4666.
“We will run out of funding well before the epidemic or pandemic is over,” Kotz said.
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