Renna Khuner-Haber (center), who coordinates LifeLong Medical's testing sites in Richmond and San Pablo, talks with staff, as a registered nurse (right) talks with a patient at LifeLong's Brookside San Pablo Health Center on Jan. 19, 2022. (Beth LaBerge/KQED)
Alejandra Felix, a house cleaner and grandmother from Richmond, had a cough and a sore throat. So she did the responsible thing in COVID times and called in sick.
Her symptoms were mild, but she wanted to get tested for COVID before she went back to work, so as not to spread the virus. She works for herself, and wants to keep her clients' trust.
"First I need to know that I've taken all the precautions. I need to be sure it's only a flu," she says.
Felix had spent all morning driving around to pharmacies in Richmond and surrounding cities, looking for rapid antigen tests. There were none to be found.
The COVID testing site at her neighborhood clinic, LifeLong Medical Care, was fully booked. She called and called but waited so long on hold that she got discouraged and hung up. For Felix, a week with no work means losing up to $800 in income.
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"That's a lot because I need it to pay the bills," she says with a nervous laugh. "I feel desperate because I have to cancel all my work this week. If they give me an appointment it'll be tomorrow or the next day, so I have to cancel everything."
Across the country, the spread of omicron has people scrambling to get tested for COVID. The lines are long, appointments get scooped up fast, and rapid antigen tests are hard to find. This problem is hitting essential workers — often people of color — particularly hard. Unlike many office workers, they can't work from home, and their companies haven't stockpiled tests. The result is lost wages, or risking infecting co-workers or family members.
Renna Khuner-Haber, who coordinates LifeLong Medical's testing sites in the East Bay, including the Richmond facility, says the people who most need convenient home tests can't get them. The disparity is glaring, especially in the Bay Area, where tech companies send boxes of rapid antigen tests to workers who have the option to work from home in a surge.
"Rapid tests — they're not cheap. If you have a family of 10 people and everyone needs a rapid test and they're each $10, that's $100 right there. To test everyone twice, that adds up," she says.
Program manager Renna Khuner-Haber (center) speaks with medical assistant Jenna Tran at a COVID-19 vaccination clinic outside LifeLong Medical Care's health center in San Pablo on Jan. 19, 2022. (Beth LaBerge/KQED)
Community testing sites try to fill the gaps
One solution that’s filling in the gaps is small neighborhood clinics like LifeLong Medical’s three testing sites in Richmond, San Pablo and East Oakland, which specifically serve lower-income communities, including Medi-Cal patients, Spanish-speaking immigrants, and essential workers who risk COVID exposure at their jobs.
Since the beginning of the year, the demand for testing at the Richmond clinic has ballooned.
LifeLong’s COVID hotline also is getting about 1,000 COVID calls daily, up from about 250 in the fall.
José Castro was one of those callers. His whole family had the sniffles, so he brought his wife and three children, ages 3, 5, and 14, to get tested. He works as a house painter and spent the previous day driving all the way to San Francisco, trying to find a test.
"I waited about an hour or 90 minutes on the phone [with LifeLong] and finally got through to get an appointment. I need to have a negative test to be confident that I'm not positive so I don't transmit it to anyone at the job site," he says in Spanish. "Also, my oldest son needs a test to go back to school."
Another LifeLong patient, Victoria Martin, works as a dental hygienist and was worried about being exposed after someone tested positive at work. She was frustrated to have caught a cold — hopefully not COVID — even after she canceled holiday plans.
"It's very scary. I came here yesterday and made an appointment for today," she says. "You try to stay safe by staying in a close circle and not going out, and then someone in your bubble gets it and what can you do?"
Reaching underserved communities, but struggling to scale up
LifeLong's Richmond site can test only 60 people daily and can't scale up. Compare that to a county site a 15-minute drive away in Berkeley run by a private lab, which can do up to 1,000 tests per day.
During the surge, these smaller clinics have been swamped, struggling to keep up with demand. Yet public health officials say the small scale is by design — a feature, not a flaw.
Luciana Suelzle tests a family for COVID-19 at LifeLong Medical Care's William Jenkins Health Center in Richmond on Jan. 19, 2022. (Beth LaBerge/KQED)
"It's not always about quantity. But if we're reaching those who have no other way to access testing resources, then we're achieving our goal," says Dr. Jocelyn Freeman Garrick, who leads COVID testing for Alameda County's public health department.
With demand up 400% at county testing locations, Freeman Garrick says these smaller sites do what larger ones can't: serve marginalized neighborhoods.
"We found at those smaller sites, their percent positivity rate was much higher than the general population. So the number [of tests] may be small, but that's a pivotal role," in serving people whose jobs and living situations put them at risk, Freeman Garrick says.
Another group in San Francisco's Mission district, called Unidos en Salud, also provides COVID testing and vaccinations to undocumented people, essential workers, recent immigrants and the uninsured, through a partnership with UCSF and the Latino Task Force.
"These sites are for communities who don't have health care and where people might not trust other sites," says Dr. Carina Marquez, who founded the partnership. Still, she adds: "Size does matter when you're in a surge."
At Unidos's Mission testing site, the number of daily tests rose from about 200 in early December to about 980 in early January as omicron hit and people spilled over from private and county-run sites in better-resourced parts of the city.
Her organization has decided not to require appointments, even though it's a challenge to manage the line that stretches around the block.
Health care worker Olga Duran tests a patient for COVID-19 at an Unidos En Salud testing site on 24th and Mission streets in San Francisco on Nov. 30, 2020. Unidos en Salud (United in Health) is a collaboration between UCSF and the Latino Task Force to help working class, immigrant families through COVID-19. (Beth LaBerge/KQED)
At LifeLong, after a lull in demand since late summer, it's been hard to meet the community's testing needs.
"We're in a moment in the surge where demand is through the roof. We don't have staffing and we were never built to do that," Khuner-Haber says. "It's so hard to prioritize. Everyone is coming because they were exposed, symptomatic or needing to return to work or school. Everybody is top priority."
With some of her employees calling in sick, Khuner-Haber has struggled to stay fully staffed and hire culturally competent, Spanish-speaking staff, who are essential to building trust with patients.
Strapped for resources
Andie Martinez Patterson, a vice president with the California Primary Care Association, says mission-minded health clinics need more resources so they can hire more staff.
"The point for health centers is that we are open-door access for anybody and in particular for vulnerable and underserved, disenfranchised populations," she says. "It is the moral imperative in the mission of why community health centers exist."
Martinez Patterson says neighborhood clinics have stepped into testing and vaccination as part of their role as primary care providers.
But because these clinics primarily serve recipients of Medi-Cal — California's Medicaid program — they're not reimbursed at the same rates as other testing centers, many of which negotiated large contracts with county health departments.
"We are not reimbursed anywhere close to what we're reimbursed for in the typical primary care setting. So you, in effect, take staff, you lose money immediately to achieve the moral imperative," she says. If Medi-Cal reimbursed more, she says, clinics could hire more staff and serve more people.
The state provides tests and vaccines to these sites, but she argues that the current payment structure in a fee-for-service environment means clinics lose money when providing life-saving vaccines and COVID tests.
COVID is a chance to restart the policy conversation about how health centers get paid, so they can be part of the response to public health disasters in the future, Martinez Patterson says.
COVID Resources
Easy testing access and follow-up care are critical
There's a big need for easy access to testing in the neighborhoods served by community clinics because the mostly lower-income Latino immigrant families who live there are more likely to live in multigenerational households, where one sick family member could expose more vulnerable ones.
That was Alejandra Felix's situation. There are seven people living in her home, including her daughter, and a grandson who's too young to get vaccinated.
"There's a baby in my house. That's why I'm worried. I wear gloves and a mask in my own home, because I want to protect the baby," she says. When she got sick, she stopped cooking for her family and sent her husband to sleep on the living room couch.
Says Marquez from Unidos en Salud, "Easy walk-up access to testing is critical. You want a situation where you can bring the whole family down and get tested. ... Testing should be low-barrier, easy to access, with no online registration, where people can wait in line and get results quickly. Then they need to get linked to care."
Griselda Ramirez-Escamilla (center right), who runs LifeLong Medical's urgent care center, speaks with medical assistant Jenna Tran in Richmond on Jan. 19, 2022. Ramirez-Escamilla says this surge is taking an emotional toll on her small staff. (Beth LaBerge/KQED)
Unidos also provides follow-up care to people who test positive, offering financial assistance, food, cleaning supplies and more medical care when appropriate.
"Sometimes people need guidance on how to isolate in crowded households, when they can go back to work and what to do on Day Five. Vulnerable workers and families want to prevent transmission, but a positive test has so many implications for them," says Marquez.
To improve testing access, Marquez sees potential in the promotora model, where community members are trained to conduct rapid antigen tests and counsel people, then can be called in to help deal with surges.
Primary care providers, schools and clinics also can be proactive in distributing at-home tests to their patients.
Meanwhile, staff at small community clinics are just trying to keep up with the surge. At LifeLong Medical, Griselda Ramirez-Escamilla, who runs the clinic's urgent care center, says this surge is taking an emotional toll on her small staff.
"We get tired and we just got to step aside, take a breath. There are times where we cry a little," she says, tearing up. "It's hard! And we show up every morning. We have times where we do break down, but it's just the nature of it. We have to lift our spirits and keep moving."
Gaby Perez, a 24-year-old Richmond resident, knows how COVID can endanger multigenerational households — she lives with her 6-year-old son and her parents.
"Once somebody tests positive, it's like there's no way of getting away from it, unless you go to another home, but everyone you know has older relatives or little kids there, too," she says. "You got to use the same bathroom, same bedroom, same kitchen. There's not really a way around it."
After her father got COVID last summer, Perez says she was inspired to switch careers to serve her community. She's now a medical assistant at LifeLong Medical, with plans to become a nurse.
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So she did the responsible thing in COVID times and called in sick.\u003c/p>\n\u003cp>Her symptoms were mild, but she wanted to get tested for COVID before she went back to work, so as not to spread the virus. She works for herself, and wants to keep her clients' trust.\u003c/p>\n\u003cp>\"First I need to know that I've taken all the precautions. I need to be sure it's only a flu,\" she says.\u003c/p>\n\u003cp>Felix had spent all morning driving around to pharmacies in Richmond and surrounding cities, looking for rapid antigen tests. There were none to be found.\u003c/p>\n\u003cp>The COVID testing site at her neighborhood clinic, LifeLong Medical Care, was fully booked. She called and called but waited so long on hold that she got discouraged and hung up. For Felix, a week with no work means losing up to $800 in income.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"That's a lot because I need it to pay the bills,\" she says with a nervous laugh. \"I feel desperate because I have to cancel all my work this week. If they give me an appointment it'll be tomorrow or the next day, so I have to cancel everything.\"\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Renna Khuner-Haber, program manager, LifeLong Medical Care\"]'Demand is through the roof. We don't have staffing ... [and] it's so hard to prioritize. Everyone is coming because they were exposed, symptomatic, or needing to return to work or school. Everybody is top priority.'[/pullquote]Across the country, the spread of omicron has people scrambling to get tested for COVID. The lines are long, appointments get scooped up fast, and rapid antigen tests are hard to find. This problem is hitting essential workers — often people of color — particularly hard. Unlike many office workers, they can't work from home, and their companies haven't stockpiled tests. The result is lost wages, or risking infecting co-workers or family members.\u003c/p>\n\u003cp>Renna Khuner-Haber, who coordinates LifeLong Medical's testing sites in the East Bay, including the Richmond facility, says the people who most need convenient home tests can't get them. The disparity is glaring, especially in the Bay Area, where tech companies send boxes of rapid antigen tests to workers who have the option to work from home in a surge.\u003c/p>\n\u003cp>\"Rapid tests — they're not cheap. If you have a family of 10 people and everyone needs a rapid test and they're each $10, that's $100 right there. To test everyone twice, that adds up,\" she says.\u003c/p>\n\u003cfigure id=\"attachment_11902203\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-11902203\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53220_037_Richmond_LifelongCOVIDClinic_01192022-qut.jpg\" alt=\"masked woman facing camera gestures with hands while masked woman with pink hair facing away from camera listens\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53220_037_Richmond_LifelongCOVIDClinic_01192022-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53220_037_Richmond_LifelongCOVIDClinic_01192022-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53220_037_Richmond_LifelongCOVIDClinic_01192022-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53220_037_Richmond_LifelongCOVIDClinic_01192022-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53220_037_Richmond_LifelongCOVIDClinic_01192022-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Program manager Renna Khuner-Haber (center) speaks with medical assistant Jenna Tran at a COVID-19 vaccination clinic outside LifeLong Medical Care's health center in San Pablo on Jan. 19, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Community testing sites try to fill the gaps\u003c/h3>\n\u003cp>One solution that’s filling in the gaps is small neighborhood clinics like LifeLong Medical’s three testing sites in Richmond, San Pablo and East Oakland, which specifically serve lower-income communities, including Medi-Cal patients, Spanish-speaking immigrants, and essential workers who risk COVID exposure at their jobs.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"José Castro, LifeLong Medical patient\"]'I need to have a negative test to be confident that I don't transmit it to anyone at the job site. Also, my oldest son needs a test to go back to school.'[/pullquote]Since the beginning of the year, the demand for testing at the Richmond clinic has ballooned.\u003c/p>\n\u003cp>LifeLong’s COVID hotline also is getting about 1,000 COVID calls daily, up from about 250 in the fall.\u003c/p>\n\u003cp>José Castro was one of those callers. His whole family had the sniffles, so he brought his wife and three children, ages 3, 5, and 14, to get tested. He works as a house painter and spent the previous day driving all the way to San Francisco, trying to find a test.\u003c/p>\n\u003cp>\"I waited about an hour or 90 minutes on the phone [with LifeLong] and finally got through to get an appointment. I need to have a negative test to be confident that I'm not positive so I don't transmit it to anyone at the job site,\" he says in Spanish. \"Also, my oldest son needs a test to go back to school.\"\u003c/p>\n\u003cp>Another LifeLong patient, Victoria Martin, works as a dental hygienist and was worried about being exposed after someone tested positive at work. She was frustrated to have caught a cold — hopefully not COVID — even after she canceled holiday plans.\u003c/p>\n\u003cp>\"It's very scary. I came here yesterday and made an appointment for today,\" she says. \"You try to stay safe by staying in a close circle and not going out, and then someone in your bubble gets it and what can you do?\"\u003c/p>\n\u003ch3>Reaching underserved communities, but struggling to scale up\u003c/h3>\n\u003cp>LifeLong's Richmond site can test only 60 people daily and can't scale up. Compare that to a county site a 15-minute drive away in Berkeley run by a private lab, which can do up to 1,000 tests per day.\u003c/p>\n\u003cp>During the surge, these smaller clinics have been swamped, struggling to keep up with demand. Yet public health officials say the small scale is by design — a feature, not a flaw.\u003c/p>\n\u003cfigure id=\"attachment_11902211\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-11902211\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53202_018_Richmond_LifelongCOVIDClinic_01192022-qut.jpg\" alt=\"nurse clothed in full PPE administers COVID test through a car window while just the mouth and nose of a vehicle occupant are visible\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53202_018_Richmond_LifelongCOVIDClinic_01192022-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53202_018_Richmond_LifelongCOVIDClinic_01192022-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53202_018_Richmond_LifelongCOVIDClinic_01192022-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53202_018_Richmond_LifelongCOVIDClinic_01192022-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53202_018_Richmond_LifelongCOVIDClinic_01192022-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Luciana Suelzle tests a family for COVID-19 at LifeLong Medical Care's William Jenkins Health Center in Richmond on Jan. 19, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"It's not always about quantity. But if we're reaching those who have no other way to access testing resources, then we're achieving our goal,\" says Dr. Jocelyn Freeman Garrick, who leads COVID testing for Alameda County's public health department.\u003c/p>\n\u003cp>With demand up 400% at county testing locations, Freeman Garrick says these smaller sites do what larger ones can't: serve marginalized neighborhoods.\u003c/p>\n\u003cp>\"We found at those smaller sites, their percent positivity rate was much higher than the general population. So the number [of tests] may be small, but that's a pivotal role,\" in serving people whose jobs and living situations put them at risk, Freeman Garrick says.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Dr. Carina Marquez, co-founder, Unidos en Salud\"]'These sites are for communities who don't have health care and where people might not trust other sites.'[/pullquote]Another group in San Francisco's Mission district, called \u003ca href=\"https://unitedinhealth.org/\">Unidos en Salud\u003c/a>, also provides COVID testing and vaccinations to undocumented people, essential workers, recent immigrants and the uninsured, through a partnership with UCSF and the Latino Task Force.\u003c/p>\n\u003cp>\"These sites are for communities who don't have health care and where people might not trust other sites,\" says Dr. Carina Marquez, who founded the partnership. Still, she adds: \"Size does matter when you're in a surge.\"\u003c/p>\n\u003cp>At Unidos's Mission testing site, the number of daily tests rose from about 200 in early December to about 980 in early January as omicron hit and people spilled over from private and county-run sites in better-resourced parts of the city.\u003c/p>\n\u003cp>Her organization has decided not to require appointments, even though it's a challenge to manage the line that stretches around the block.\u003c/p>\n\u003cfigure id=\"attachment_11902230\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-11902230\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS46108_016_KQED_SanFrancisco_COVIDTesting_11302020-qut.jpg\" alt=\"nurse in full PPE prepares to swab man wearing a mask facing away from camera, outside in sunlight\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS46108_016_KQED_SanFrancisco_COVIDTesting_11302020-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS46108_016_KQED_SanFrancisco_COVIDTesting_11302020-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS46108_016_KQED_SanFrancisco_COVIDTesting_11302020-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS46108_016_KQED_SanFrancisco_COVIDTesting_11302020-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS46108_016_KQED_SanFrancisco_COVIDTesting_11302020-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Health care worker Olga Duran tests a patient for COVID-19 at an Unidos En Salud testing site on 24th and Mission streets in San Francisco on Nov. 30, 2020. Unidos en Salud (United in Health) is a collaboration between UCSF and the Latino Task Force to help working class, immigrant families through COVID-19. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At LifeLong, after a lull in demand since late summer, it's been hard to meet the community's testing needs.\u003c/p>\n\u003cp>\"We're in a moment in the surge where demand is through the roof. We don't have staffing and we were never built to do that,\" Khuner-Haber says. \"It's so hard to prioritize. Everyone is coming because they were exposed, symptomatic or needing to return to work or school. Everybody is top priority.\"\u003c/p>\n\u003cp>With some of her employees calling in sick, Khuner-Haber has struggled to stay fully staffed and hire culturally competent, Spanish-speaking staff, who are essential to building trust with patients.\u003c/p>\n\u003ch3>Strapped for resources\u003c/h3>\n\u003cp>Andie Martinez Patterson, a vice president with the California Primary Care Association, says mission-minded health clinics need more resources so they can hire more staff.\u003c/p>\n\u003cp>\"The point for health centers is that we are open-door access for anybody and in particular for vulnerable and underserved, disenfranchised populations,\" she says. \"It is the moral imperative in the mission of why community health centers exist.\"\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Andie Martinez Patterson, vice president, California Primary Care Association\"]'We are not reimbursed anywhere close to what we're reimbursed for in the typical primary care setting. So in effect ... you lose money immediately to achieve the moral imperative.'[/pullquote]Martinez Patterson says neighborhood clinics have stepped into testing and vaccination as part of their role as primary care providers.\u003c/p>\n\u003cp>But because these clinics primarily serve recipients of Medi-Cal — California's Medicaid program — they're not reimbursed at the same rates as other testing centers, many of which negotiated large contracts with county health departments.\u003c/p>\n\u003cp>\"We are not reimbursed anywhere close to what we're reimbursed for in the typical primary care setting. So you, in effect, take staff, you lose money immediately to achieve the moral imperative,\" she says. If Medi-Cal reimbursed more, she says, clinics could hire more staff and serve more people.\u003c/p>\n\u003cp>The state provides tests and vaccines to these sites, but she argues that the current payment structure in a fee-for-service environment means clinics lose money when providing life-saving vaccines and COVID tests.\u003c/p>\n\u003cp>COVID is a chance to restart the policy conversation about how health centers get paid, so they can be part of the response to public health disasters in the future, Martinez Patterson says.\u003c/p>\n\u003cp>[aside label='COVID Resources' tag='coronavirus-resources-and-explainers']\u003c/p>\n\u003ch3>Easy testing access and follow-up care are critical\u003c/h3>\n\u003cp>There's a big need for easy access to testing in the neighborhoods served by community clinics because the mostly lower-income Latino immigrant families who live there are more likely to live in multigenerational households, where one sick family member could expose more vulnerable ones.\u003c/p>\n\u003cp>That was Alejandra Felix's situation. There are seven people living in her home, including her daughter, and a grandson who's too young to get vaccinated.\u003c/p>\n\u003cp>\"There's a baby in my house. That's why I'm worried. I wear gloves and a mask in my own home, because I want to protect the baby,\" she says. When she got sick, she stopped cooking for her family and sent her husband to sleep on the living room couch.\u003c/p>\n\u003cp>Says Marquez from Unidos en Salud, \"Easy walk-up access to testing is critical. You want a situation where you can bring the whole family down and get tested. ... Testing should be low-barrier, easy to access, with no online registration, where people can wait in line and get results quickly. Then they need to get linked to care.\"\u003c/p>\n\u003cfigure id=\"attachment_11902233\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-11902233\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53191_004_Richmond_LifelongCOVIDClinic_01192022-qut.jpg\" alt=\"masked woman stands looking down at another masked nurse seated at a portable table, under tents at an outdoor COVID vaccination clinic\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53191_004_Richmond_LifelongCOVIDClinic_01192022-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53191_004_Richmond_LifelongCOVIDClinic_01192022-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53191_004_Richmond_LifelongCOVIDClinic_01192022-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53191_004_Richmond_LifelongCOVIDClinic_01192022-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53191_004_Richmond_LifelongCOVIDClinic_01192022-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Griselda Ramirez-Escamilla (center right), who runs LifeLong Medical's urgent care center, speaks with medical assistant Jenna Tran in Richmond on Jan. 19, 2022. Ramirez-Escamilla says this surge is taking an emotional toll on her small staff. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Unidos also provides follow-up care to people who test positive, offering financial assistance, food, cleaning supplies and more medical care when appropriate.\u003c/p>\n\u003cp>\"Sometimes people need guidance on how to isolate in crowded households, when they can go back to work and what to do on Day Five. Vulnerable workers and families want to prevent transmission, but a positive test has so many implications for them,\" says Marquez.\u003c/p>\n\u003cp>[aside postID=news_11860883 hero='https://ww2.kqed.org/app/uploads/sites/10/2021/02/SanJose_COVIDTesting-1038x576.jpg']To improve testing access, Marquez sees potential in the \u003ca href=\"https://www.kqed.org/news/11860883/trusted-leaders-are-fighting-covid-19-vaccine-fears-in-black-and-latino-communities\">promotora model\u003c/a>, where community members are trained to conduct rapid antigen tests and counsel people, then can be called in to help deal with surges.\u003c/p>\n\u003cp>Primary care providers, schools and clinics also can be proactive in distributing at-home tests to their patients.\u003c/p>\n\u003cp>Meanwhile, staff at small community clinics are just trying to keep up with the surge. At LifeLong Medical, Griselda Ramirez-Escamilla, who runs the clinic's urgent care center, says this surge is taking an emotional toll on her small staff.\u003c/p>\n\u003cp>\"We get tired and we just got to step aside, take a breath. There are times where we cry a little,\" she says, tearing up. \"It's hard! And we show up every morning. We have times where we do break down, but it's just the nature of it. We have to lift our spirits and keep moving.\"\u003c/p>\n\u003cp>Gaby Perez, a 24-year-old Richmond resident, knows how COVID can endanger multigenerational households — she lives with her 6-year-old son and her parents.\u003c/p>\n\u003cp>\"Once somebody tests positive, it's like there's no way of getting away from it, unless you go to another home, but everyone you know has older relatives or little kids there, too,\" she says. \"You got to use the same bathroom, same bedroom, same kitchen. There's not really a way around it.\"\u003c/p>\n\u003cp>After her father got COVID last summer, Perez says she was inspired to switch careers to serve her community. She's now a medical assistant at LifeLong Medical, with plans to become a nurse.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n","disqusIdentifier":"11902149 https://ww2.kqed.org/news/?p=11902149","disqusUrl":"https://ww2.kqed.org/news/2022/01/21/community-covid-clinics-fill-crucial-need-in-underserved-communities-but-are-strapped-for-resources/","stats":{"hasVideo":false,"hasChartOrMap":false,"hasAudio":false,"hasPolis":false,"wordCount":2281,"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"iframeSrcs":[],"paragraphCount":51},"modified":1644019330,"excerpt":"Clinics like LifeLong Medical in Richmond provide crucial services to lower-income communities, including immigrants and essential workers who risk COVID exposure at work. But they're overwhelmed, and reimbursed at a far lower rate than other providers.","headData":{"twImgId":"","twTitle":"","ogTitle":"","ogImgId":"","twDescription":"","description":"Clinics like LifeLong Medical in Richmond provide crucial services to lower-income communities, including immigrants and essential workers who risk COVID exposure at work. But they're overwhelmed, and reimbursed at a far lower rate than other providers.","title":"Community COVID Clinics Fill Crucial Need in Underserved Communities — But Are Strapped for Resources | KQED","ogDescription":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"Community COVID Clinics Fill Crucial Need in Underserved Communities — But Are Strapped for Resources","datePublished":"2022-01-21T05:01:26-08:00","dateModified":"2022-02-04T16:02:10-08:00","image":"https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53217_034_Richmond_LifelongCOVIDClinic_01192022-qut-1020x680.jpg","isAccessibleForFree":"True","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"},"author":{"@type":"Person","name":"Raquel Maria Dillon","jobTitle":"Journalist","url":"https://www.kqed.org/author/rdillon"}},"authorsData":[{"type":"authors","id":"11495","meta":{"index":"authors_1716337520","id":"11495","found":true},"name":"Raquel Maria Dillon","firstName":"Raquel Maria","lastName":"Dillon","slug":"rdillon","email":"rdillon@kqed.org","display_author_email":false,"staff_mastheads":[],"title":null,"bio":"Raquel Maria Dillon was a reporter and host for KQED News. Previously, she produced the daily statewide California Report, edited newscasts, and covered health and education stories. Before returning to the Bay Area in 2016, she worked in Los Angeles as a wire reporter and one-woman-band video journalist for the Associated Press, where she shot, edited and reported breaking news and features across the West. Her work has appeared online and in print around the globe, and also on NPR’s Morning Edition, All Things Considered, Here and Now, Marketplace, On The Media, and Studio 360. She previously edited and mentored up-and-coming reporters at KALW, produced social videos for Timeline.com, and was a local TV news videographer for KTVU and digital producer for KNTV. She got her start as a Radio News Trainee at KQED, produced a weekly public affairs roundtable show for OPB, and covered health and politics at New Hampshire Public Radio. She has a BA in political science from Barnard College and a MA in video journalism from UC Berkeley, where she was awarded the Faith Fancher Scholarship and a Student Emmy. She has received numerous local awards from the Associated Press and the Society of Professional Journalists.","avatar":"https://secure.gravatar.com/avatar/b8e02ae982913d0950df605910267c1b?s=600&d=blank&r=g","twitter":"RaquelMDillon","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"news","roles":["subscriber"]},{"site":"stateofhealth","roles":["editor"]},{"site":"science","roles":["editor"]},{"site":"forum","roles":["editor"]}],"headData":{"title":"Raquel Maria Dillon | KQED","description":null,"ogImgSrc":"https://secure.gravatar.com/avatar/b8e02ae982913d0950df605910267c1b?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/b8e02ae982913d0950df605910267c1b?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/rdillon"}],"imageData":{"ogImageSize":{"file":"https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53217_034_Richmond_LifelongCOVIDClinic_01192022-qut-1020x680.jpg","width":1020,"mimeType":"image/jpeg","height":680},"ogImageWidth":"1020","ogImageHeight":"680","twitterImageUrl":"https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53217_034_Richmond_LifelongCOVIDClinic_01192022-qut-1020x680.jpg","twImageSize":{"file":"https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53217_034_Richmond_LifelongCOVIDClinic_01192022-qut-1020x680.jpg","width":1020,"mimeType":"image/jpeg","height":680},"twitterCard":"summary_large_image"},"tagData":{"tags":["California","coronavirus","coronavirus testing","covid testing","essential workers","featured-news","Health","health care","Medi-Cal","Richmond","San Pablo"]}},"guestAuthors":[],"slug":"community-covid-clinics-fill-crucial-need-in-underserved-communities-but-are-strapped-for-resources","status":"publish","audioUrl":"https://traffic.omny.fm/d/clips/0af137ef-751e-4b19-a055-aaef00d2d578/ffca7e9f-6831-41c5-bcaf-aaef00f5a073/a2f822fc-ad3a-409c-8257-ae16010539f5/audio.mp3","excludeFromSiteSearch":"Include","path":"/news/11902149/community-covid-clinics-fill-crucial-need-in-underserved-communities-but-are-strapped-for-resources","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Alejandra Felix, a house cleaner and grandmother from Richmond, had a cough and a sore throat. So she did the responsible thing in COVID times and called in sick.\u003c/p>\n\u003cp>Her symptoms were mild, but she wanted to get tested for COVID before she went back to work, so as not to spread the virus. She works for herself, and wants to keep her clients' trust.\u003c/p>\n\u003cp>\"First I need to know that I've taken all the precautions. I need to be sure it's only a flu,\" she says.\u003c/p>\n\u003cp>Felix had spent all morning driving around to pharmacies in Richmond and surrounding cities, looking for rapid antigen tests. There were none to be found.\u003c/p>\n\u003cp>The COVID testing site at her neighborhood clinic, LifeLong Medical Care, was fully booked. She called and called but waited so long on hold that she got discouraged and hung up. For Felix, a week with no work means losing up to $800 in income.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"That's a lot because I need it to pay the bills,\" she says with a nervous laugh. \"I feel desperate because I have to cancel all my work this week. If they give me an appointment it'll be tomorrow or the next day, so I have to cancel everything.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"'Demand is through the roof. We don't have staffing ... [and] it's so hard to prioritize. Everyone is coming because they were exposed, symptomatic, or needing to return to work or school. Everybody is top priority.'","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Renna Khuner-Haber, program manager, LifeLong Medical Care","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>Across the country, the spread of omicron has people scrambling to get tested for COVID. The lines are long, appointments get scooped up fast, and rapid antigen tests are hard to find. This problem is hitting essential workers — often people of color — particularly hard. Unlike many office workers, they can't work from home, and their companies haven't stockpiled tests. The result is lost wages, or risking infecting co-workers or family members.\u003c/p>\n\u003cp>Renna Khuner-Haber, who coordinates LifeLong Medical's testing sites in the East Bay, including the Richmond facility, says the people who most need convenient home tests can't get them. The disparity is glaring, especially in the Bay Area, where tech companies send boxes of rapid antigen tests to workers who have the option to work from home in a surge.\u003c/p>\n\u003cp>\"Rapid tests — they're not cheap. If you have a family of 10 people and everyone needs a rapid test and they're each $10, that's $100 right there. To test everyone twice, that adds up,\" she says.\u003c/p>\n\u003cfigure id=\"attachment_11902203\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-11902203\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53220_037_Richmond_LifelongCOVIDClinic_01192022-qut.jpg\" alt=\"masked woman facing camera gestures with hands while masked woman with pink hair facing away from camera listens\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53220_037_Richmond_LifelongCOVIDClinic_01192022-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53220_037_Richmond_LifelongCOVIDClinic_01192022-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53220_037_Richmond_LifelongCOVIDClinic_01192022-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53220_037_Richmond_LifelongCOVIDClinic_01192022-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53220_037_Richmond_LifelongCOVIDClinic_01192022-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Program manager Renna Khuner-Haber (center) speaks with medical assistant Jenna Tran at a COVID-19 vaccination clinic outside LifeLong Medical Care's health center in San Pablo on Jan. 19, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Community testing sites try to fill the gaps\u003c/h3>\n\u003cp>One solution that’s filling in the gaps is small neighborhood clinics like LifeLong Medical’s three testing sites in Richmond, San Pablo and East Oakland, which specifically serve lower-income communities, including Medi-Cal patients, Spanish-speaking immigrants, and essential workers who risk COVID exposure at their jobs.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"'I need to have a negative test to be confident that I don't transmit it to anyone at the job site. Also, my oldest son needs a test to go back to school.'","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"José Castro, LifeLong Medical patient","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>Since the beginning of the year, the demand for testing at the Richmond clinic has ballooned.\u003c/p>\n\u003cp>LifeLong’s COVID hotline also is getting about 1,000 COVID calls daily, up from about 250 in the fall.\u003c/p>\n\u003cp>José Castro was one of those callers. His whole family had the sniffles, so he brought his wife and three children, ages 3, 5, and 14, to get tested. He works as a house painter and spent the previous day driving all the way to San Francisco, trying to find a test.\u003c/p>\n\u003cp>\"I waited about an hour or 90 minutes on the phone [with LifeLong] and finally got through to get an appointment. I need to have a negative test to be confident that I'm not positive so I don't transmit it to anyone at the job site,\" he says in Spanish. \"Also, my oldest son needs a test to go back to school.\"\u003c/p>\n\u003cp>Another LifeLong patient, Victoria Martin, works as a dental hygienist and was worried about being exposed after someone tested positive at work. She was frustrated to have caught a cold — hopefully not COVID — even after she canceled holiday plans.\u003c/p>\n\u003cp>\"It's very scary. I came here yesterday and made an appointment for today,\" she says. \"You try to stay safe by staying in a close circle and not going out, and then someone in your bubble gets it and what can you do?\"\u003c/p>\n\u003ch3>Reaching underserved communities, but struggling to scale up\u003c/h3>\n\u003cp>LifeLong's Richmond site can test only 60 people daily and can't scale up. Compare that to a county site a 15-minute drive away in Berkeley run by a private lab, which can do up to 1,000 tests per day.\u003c/p>\n\u003cp>During the surge, these smaller clinics have been swamped, struggling to keep up with demand. Yet public health officials say the small scale is by design — a feature, not a flaw.\u003c/p>\n\u003cfigure id=\"attachment_11902211\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-11902211\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53202_018_Richmond_LifelongCOVIDClinic_01192022-qut.jpg\" alt=\"nurse clothed in full PPE administers COVID test through a car window while just the mouth and nose of a vehicle occupant are visible\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53202_018_Richmond_LifelongCOVIDClinic_01192022-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53202_018_Richmond_LifelongCOVIDClinic_01192022-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53202_018_Richmond_LifelongCOVIDClinic_01192022-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53202_018_Richmond_LifelongCOVIDClinic_01192022-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53202_018_Richmond_LifelongCOVIDClinic_01192022-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Luciana Suelzle tests a family for COVID-19 at LifeLong Medical Care's William Jenkins Health Center in Richmond on Jan. 19, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"It's not always about quantity. But if we're reaching those who have no other way to access testing resources, then we're achieving our goal,\" says Dr. Jocelyn Freeman Garrick, who leads COVID testing for Alameda County's public health department.\u003c/p>\n\u003cp>With demand up 400% at county testing locations, Freeman Garrick says these smaller sites do what larger ones can't: serve marginalized neighborhoods.\u003c/p>\n\u003cp>\"We found at those smaller sites, their percent positivity rate was much higher than the general population. So the number [of tests] may be small, but that's a pivotal role,\" in serving people whose jobs and living situations put them at risk, Freeman Garrick says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"'These sites are for communities who don't have health care and where people might not trust other sites.'","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Dr. Carina Marquez, co-founder, Unidos en Salud","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>Another group in San Francisco's Mission district, called \u003ca href=\"https://unitedinhealth.org/\">Unidos en Salud\u003c/a>, also provides COVID testing and vaccinations to undocumented people, essential workers, recent immigrants and the uninsured, through a partnership with UCSF and the Latino Task Force.\u003c/p>\n\u003cp>\"These sites are for communities who don't have health care and where people might not trust other sites,\" says Dr. Carina Marquez, who founded the partnership. Still, she adds: \"Size does matter when you're in a surge.\"\u003c/p>\n\u003cp>At Unidos's Mission testing site, the number of daily tests rose from about 200 in early December to about 980 in early January as omicron hit and people spilled over from private and county-run sites in better-resourced parts of the city.\u003c/p>\n\u003cp>Her organization has decided not to require appointments, even though it's a challenge to manage the line that stretches around the block.\u003c/p>\n\u003cfigure id=\"attachment_11902230\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-11902230\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS46108_016_KQED_SanFrancisco_COVIDTesting_11302020-qut.jpg\" alt=\"nurse in full PPE prepares to swab man wearing a mask facing away from camera, outside in sunlight\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS46108_016_KQED_SanFrancisco_COVIDTesting_11302020-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS46108_016_KQED_SanFrancisco_COVIDTesting_11302020-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS46108_016_KQED_SanFrancisco_COVIDTesting_11302020-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS46108_016_KQED_SanFrancisco_COVIDTesting_11302020-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS46108_016_KQED_SanFrancisco_COVIDTesting_11302020-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Health care worker Olga Duran tests a patient for COVID-19 at an Unidos En Salud testing site on 24th and Mission streets in San Francisco on Nov. 30, 2020. Unidos en Salud (United in Health) is a collaboration between UCSF and the Latino Task Force to help working class, immigrant families through COVID-19. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At LifeLong, after a lull in demand since late summer, it's been hard to meet the community's testing needs.\u003c/p>\n\u003cp>\"We're in a moment in the surge where demand is through the roof. We don't have staffing and we were never built to do that,\" Khuner-Haber says. \"It's so hard to prioritize. Everyone is coming because they were exposed, symptomatic or needing to return to work or school. Everybody is top priority.\"\u003c/p>\n\u003cp>With some of her employees calling in sick, Khuner-Haber has struggled to stay fully staffed and hire culturally competent, Spanish-speaking staff, who are essential to building trust with patients.\u003c/p>\n\u003ch3>Strapped for resources\u003c/h3>\n\u003cp>Andie Martinez Patterson, a vice president with the California Primary Care Association, says mission-minded health clinics need more resources so they can hire more staff.\u003c/p>\n\u003cp>\"The point for health centers is that we are open-door access for anybody and in particular for vulnerable and underserved, disenfranchised populations,\" she says. \"It is the moral imperative in the mission of why community health centers exist.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"'We are not reimbursed anywhere close to what we're reimbursed for in the typical primary care setting. So in effect ... you lose money immediately to achieve the moral imperative.'","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Andie Martinez Patterson, vice president, California Primary Care Association","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>Martinez Patterson says neighborhood clinics have stepped into testing and vaccination as part of their role as primary care providers.\u003c/p>\n\u003cp>But because these clinics primarily serve recipients of Medi-Cal — California's Medicaid program — they're not reimbursed at the same rates as other testing centers, many of which negotiated large contracts with county health departments.\u003c/p>\n\u003cp>\"We are not reimbursed anywhere close to what we're reimbursed for in the typical primary care setting. So you, in effect, take staff, you lose money immediately to achieve the moral imperative,\" she says. If Medi-Cal reimbursed more, she says, clinics could hire more staff and serve more people.\u003c/p>\n\u003cp>The state provides tests and vaccines to these sites, but she argues that the current payment structure in a fee-for-service environment means clinics lose money when providing life-saving vaccines and COVID tests.\u003c/p>\n\u003cp>COVID is a chance to restart the policy conversation about how health centers get paid, so they can be part of the response to public health disasters in the future, Martinez Patterson says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"label":"COVID Resources ","tag":"coronavirus-resources-and-explainers"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch3>Easy testing access and follow-up care are critical\u003c/h3>\n\u003cp>There's a big need for easy access to testing in the neighborhoods served by community clinics because the mostly lower-income Latino immigrant families who live there are more likely to live in multigenerational households, where one sick family member could expose more vulnerable ones.\u003c/p>\n\u003cp>That was Alejandra Felix's situation. There are seven people living in her home, including her daughter, and a grandson who's too young to get vaccinated.\u003c/p>\n\u003cp>\"There's a baby in my house. That's why I'm worried. I wear gloves and a mask in my own home, because I want to protect the baby,\" she says. When she got sick, she stopped cooking for her family and sent her husband to sleep on the living room couch.\u003c/p>\n\u003cp>Says Marquez from Unidos en Salud, \"Easy walk-up access to testing is critical. You want a situation where you can bring the whole family down and get tested. ... Testing should be low-barrier, easy to access, with no online registration, where people can wait in line and get results quickly. Then they need to get linked to care.\"\u003c/p>\n\u003cfigure id=\"attachment_11902233\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-11902233\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53191_004_Richmond_LifelongCOVIDClinic_01192022-qut.jpg\" alt=\"masked woman stands looking down at another masked nurse seated at a portable table, under tents at an outdoor COVID vaccination clinic\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53191_004_Richmond_LifelongCOVIDClinic_01192022-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53191_004_Richmond_LifelongCOVIDClinic_01192022-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53191_004_Richmond_LifelongCOVIDClinic_01192022-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53191_004_Richmond_LifelongCOVIDClinic_01192022-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53191_004_Richmond_LifelongCOVIDClinic_01192022-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Griselda Ramirez-Escamilla (center right), who runs LifeLong Medical's urgent care center, speaks with medical assistant Jenna Tran in Richmond on Jan. 19, 2022. Ramirez-Escamilla says this surge is taking an emotional toll on her small staff. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Unidos also provides follow-up care to people who test positive, offering financial assistance, food, cleaning supplies and more medical care when appropriate.\u003c/p>\n\u003cp>\"Sometimes people need guidance on how to isolate in crowded households, when they can go back to work and what to do on Day Five. Vulnerable workers and families want to prevent transmission, but a positive test has so many implications for them,\" says Marquez.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"postid":"news_11860883","hero":"https://ww2.kqed.org/app/uploads/sites/10/2021/02/SanJose_COVIDTesting-1038x576.jpg","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>To improve testing access, Marquez sees potential in the \u003ca href=\"https://www.kqed.org/news/11860883/trusted-leaders-are-fighting-covid-19-vaccine-fears-in-black-and-latino-communities\">promotora model\u003c/a>, where community members are trained to conduct rapid antigen tests and counsel people, then can be called in to help deal with surges.\u003c/p>\n\u003cp>Primary care providers, schools and clinics also can be proactive in distributing at-home tests to their patients.\u003c/p>\n\u003cp>Meanwhile, staff at small community clinics are just trying to keep up with the surge. At LifeLong Medical, Griselda Ramirez-Escamilla, who runs the clinic's urgent care center, says this surge is taking an emotional toll on her small staff.\u003c/p>\n\u003cp>\"We get tired and we just got to step aside, take a breath. There are times where we cry a little,\" she says, tearing up. \"It's hard! And we show up every morning. We have times where we do break down, but it's just the nature of it. We have to lift our spirits and keep moving.\"\u003c/p>\n\u003cp>Gaby Perez, a 24-year-old Richmond resident, knows how COVID can endanger multigenerational households — she lives with her 6-year-old son and her parents.\u003c/p>\n\u003cp>\"Once somebody tests positive, it's like there's no way of getting away from it, unless you go to another home, but everyone you know has older relatives or little kids there, too,\" she says. \"You got to use the same bathroom, same bedroom, same kitchen. There's not really a way around it.\"\u003c/p>\n\u003cp>After her father got COVID last summer, Perez says she was inspired to switch careers to serve her community. She's now a medical assistant at LifeLong Medical, with plans to become a nurse.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11902149/community-covid-clinics-fill-crucial-need-in-underserved-communities-but-are-strapped-for-resources","authors":["11495"],"programs":["news_72"],"categories":["news_457","news_8"],"tags":["news_18538","news_27350","news_27646","news_29123","news_27698","news_27626","news_18543","news_683","news_30539","news_2605","news_579","news_23011"],"featImg":"news_11902175","label":"news_72","isLoading":false,"hasAllInfo":true}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. Michel Martin hosts on the weekends.","airtime":"MON-FRI 1pm-2pm, 4:30pm-6:30pm\u003cbr />SAT-SUN 5pm-6pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/All-Things-Considered-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/all-things-considered/","meta":{"site":"news","source":"npr"},"link":"/radio/program/all-things-considered"},"american-suburb-podcast":{"id":"american-suburb-podcast","title":"American Suburb: The Podcast","tagline":"The flip side of gentrification, told through one town","info":"Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. But is this once sleepy suburb ready for them?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/American-Suburb-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/news/series/american-suburb-podcast","meta":{"site":"news","source":"kqed","order":"13"},"link":"/news/series/american-suburb-podcast/","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328","tuneIn":"https://tunein.com/radio/American-Suburb-p1086805/","rss":"https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"}},"baycurious":{"id":"baycurious","title":"Bay Curious","tagline":"Exploring the Bay Area, one question at a time","info":"KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg","imageAlt":"\"KQED Bay Curious","officialWebsiteLink":"/news/series/baycurious","meta":{"site":"news","source":"kqed","order":"4"},"link":"/podcasts/baycurious","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/bay-curious/id1172473406","npr":"https://www.npr.org/podcasts/500557090/bay-curious","rss":"https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvbmV3cy9jYXRlZ29yeS9iYXktY3VyaW91cy1wb2RjYXN0L2ZlZWQvcG9kY2FzdA","stitcher":"https://www.stitcher.com/podcast/kqed/bay-curious","spotify":"https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"}},"bbc-world-service":{"id":"bbc-world-service","title":"BBC World Service","info":"The day's top stories from BBC News compiled twice daily in the week, once at weekends.","airtime":"MON-FRI 9pm-10pm, TUE-FRI 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.bbc.co.uk/sounds/play/live:bbc_world_service","meta":{"site":"news","source":"BBC World Service"},"link":"/radio/program/bbc-world-service","subscribe":{"apple":"https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2","tuneIn":"https://tunein.com/radio/BBC-World-Service-p455581/","rss":"https://podcasts.files.bbci.co.uk/p02nq0gn.rss"}},"code-switch-life-kit":{"id":"code-switch-life-kit","title":"Code Switch / Life Kit","info":"\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. 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You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED MindShift: How We Will Learn","officialWebsiteLink":"/mindshift/","meta":{"site":"news","source":"kqed","order":"2"},"link":"/podcasts/mindshift","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5","npr":"https://www.npr.org/podcasts/464615685/mind-shift-podcast","stitcher":"https://www.stitcher.com/podcast/kqed/stories-teachers-share","spotify":"https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"}},"morning-edition":{"id":"morning-edition","title":"Morning Edition","info":"\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.","airtime":"MON-FRI 3am-9am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/morning-edition/","meta":{"site":"news","source":"npr"},"link":"/radio/program/morning-edition"},"onourwatch":{"id":"onourwatch","title":"On Our Watch","tagline":"Police secrets, unsealed","info":"For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg","imageAlt":"On Our Watch from NPR and KQED","officialWebsiteLink":"/podcasts/onourwatch","meta":{"site":"news","source":"kqed","order":"1"},"link":"/podcasts/onourwatch","subscribe":{"apple":"https://podcasts.apple.com/podcast/id1567098962","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw","npr":"https://rpb3r.app.goo.gl/onourwatch","spotify":"https://open.spotify.com/show/0OLWoyizopu6tY1XiuX70x","tuneIn":"https://tunein.com/radio/On-Our-Watch-p1436229/","stitcher":"https://www.stitcher.com/show/on-our-watch","rss":"https://feeds.npr.org/510360/podcast.xml"}},"on-the-media":{"id":"on-the-media","title":"On The Media","info":"Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us","airtime":"SUN 2pm-3pm, MON 12am-1am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png","officialWebsiteLink":"https://www.wnycstudios.org/shows/otm","meta":{"site":"news","source":"wnyc"},"link":"/radio/program/on-the-media","subscribe":{"apple":"https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2","tuneIn":"https://tunein.com/radio/On-the-Media-p69/","rss":"http://feeds.wnyc.org/onthemedia"}},"our-body-politic":{"id":"our-body-politic","title":"Our Body Politic","info":"Presented by KQED, KCRW and KPCC, and created and hosted by award-winning journalist Farai Chideya, Our Body Politic is unapologetically centered on reporting on not just how women of color experience the major political events of today, but how they’re impacting those very issues.","airtime":"SAT 6pm-7pm, SUN 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Our-Body-Politic-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://our-body-politic.simplecast.com/","meta":{"site":"news","source":"kcrw"},"link":"/radio/program/our-body-politic","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/our-body-politic/id1533069868","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5zaW1wbGVjYXN0LmNvbS9feGFQaHMxcw","spotify":"https://open.spotify.com/show/4ApAiLT1kV153TttWAmqmc","rss":"https://feeds.simplecast.com/_xaPhs1s","tuneIn":"https://tunein.com/podcasts/News--Politics-Podcasts/Our-Body-Politic-p1369211/"}},"pbs-newshour":{"id":"pbs-newshour","title":"PBS NewsHour","info":"Analysis, background reports and updates from the PBS NewsHour putting today's news in context.","airtime":"MON-FRI 3pm-4pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.pbs.org/newshour/","meta":{"site":"news","source":"pbs"},"link":"/radio/program/pbs-newshour","subscribe":{"apple":"https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2","tuneIn":"https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/","rss":"https://www.pbs.org/newshour/feeds/rss/podcasts/show"}},"perspectives":{"id":"perspectives","title":"Perspectives","tagline":"KQED's series of of daily listener commentaries since 1991","info":"KQED's series of of daily listener commentaries since 1991.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Perspectives-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/perspectives/","meta":{"site":"radio","source":"kqed","order":"15"},"link":"/perspectives","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/id73801135","npr":"https://www.npr.org/podcasts/432309616/perspectives","rss":"https://ww2.kqed.org/perspectives/category/perspectives/feed/","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvcGVyc3BlY3RpdmVzL2NhdGVnb3J5L3BlcnNwZWN0aXZlcy9mZWVkLw"}},"planet-money":{"id":"planet-money","title":"Planet Money","info":"The economy explained. 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