Elisa Reyes has come to Plaza del Sol Family Health Center for doctor’s appointments for more than a decade. Though she moved away a while ago, the 33-year-old keeps returning, even if it means a two-hour roundtrip bus ride.
That’s because her two children see the same doctor she does. Because when she’s sick, she can walk in without an appointment. Because the staff at the Queens clinic helped her apply for health insurance and food stamps.
“I feel at home. They also speak my language,” Reyes said in Spanish. “I feel comfortable.”
Plaza del Sol is one of two dozen sites run by Urban Health Plan Inc., which is one of nearly 1,400 federally designated community health centers. One in 11 Americans rely on these to get routine medical care, social services and, in some cases, fresh food.
The clinics serve as a critical safety net in every state and U.S. territory for low-income people of all ages. But it’s a safety net under stress.
Since 2012, community health centers have seen a 45% increase in the number of people seeking care — and they’ve opened more and more service sites to expand their footprint to more than 15,000 locations.
Many centers are short-staffed and struggling to compete for doctors, mental health professionals, nurses and dentists. Leaders also told media that funding is an ever-present concern, with the months-long debate over the federal budget making it all but impossible for them to plan and hire for the long term.
Despite that, the centers are trying to improve their communities’ health and access to primary care in the face of inequities that start well before a patient steps into an exam room.
Community health centers have been around, in some form, for decades, and they are largely what remains to serve a community when urban and rural hospitals close or cut back.
Dr. Matthew Kusher, Plaza del Sol’s clinical director, said there are things that prescriptions can’t change, like stopping the spread of flu and COVID-19 when people live in apartments with one family per room and it’s impossible to quarantine.
“What we provide here is only 20% of what goes toward somebody’s health,” Kusher said. “Their health is more driven by the other factors, more driven by the poverty, and the lack of access to food or clean water or healthy air.”
Nine in 10 health center patients live at or below 200% of the federal poverty line, according to the U.S. Health Resources and Services Administration. Beyond that:
— In 2022, nearly 1.4 million health center patients were homeless.
— One in five was uninsured.
— Half were on Medicaid.
— One in four was best served in a language other than English; about 63% were racial or ethnic minorities.
“We confront these disparities head-on in the communities that need it the most,” said Dr. Kyu Rhee, president of the National Association of Community Health Centers. “We have a workforce that works nonstop, diligently and is resilient and diverse — that represents the people they serve. And that trust is so essential.”
Plaza del Sol’s specialty case manager Yelisa Sierra said she frequently fields questions about people needing clothes, food or shelter. Lately, the clinic serves many newly arrived migrants. She wishes she had a better answer to the question she hears most: Where can they find work?
“It’s not only a medical need, it’s emotion,” said Sierra, sitting in a cramped office off the bustling waiting room. “They need to have a person that listens. Sometimes, it’s just that.”
Fifty years ago, Dr. Acklema Mohammad started as a medical assistant in Urban Health Plan’s first clinic, San Juan Health Center. She has cared for some families across three generations.
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