At the end of October, the public health state of emergency for COVID-19 will officially end for Washington state and the city of Seattle. In many ways, that is good news. We have collectively come far in our understanding of the virus. Public health experts and researchers continue to find and improve upon tools that each of us can use to protect ourselves and our communities, allowing us to go on with our daily lives.
But the end of the state and city orders and the impending end to the federal COVID-19 public health emergency may have impacts that could set back individuals and families furthest away from society’s benefits.
First, the “end of the emergency” will inevitably lead some to believe that COVID-19 is no longer a threat. This can create a disconnect between what people are hearing in the news and the steps health care providers are encouraging patients to take to protect themselves, such as staying up to date on COVID-19 vaccinations/boosters, wearing masks, improving airflow in crowded indoor spaces, and testing and isolating when sick.
As we enter the colder months and flu season — one that is poised to make a big comeback after two years of being mild — this disconnect puts many in our community at higher risk, particularly those who traditionally have trouble accessing health care and are likely under-vaccinated.
On Seattle’s end of the public health emergency status change, some protections around evictions will be phased out. This could push more of our neighbors into housing insecurity at a time when inflation and rent are skyrocketing. As we have seen at Neighborcare Health, homelessness further complicates a person’s ability to care for their health and well-being, leaving them more vulnerable to all kinds of illnesses and health conditions.
Perhaps some of the largest impacts on our patients will come later. Telehealth services and Medicaid coverage that are contingent on the federal COVID-19 public health emergency order hang in the balance. That was recently extended to Jan. 11, 2023.
When the pandemic struck in 2020, Neighborcare Health and many of our fellow community health centers quickly ramped up to provide telehealth services — particularly phone visits — to keep staff and patients safe. Some state and federal rules were temporarily relaxed to allow us to provide these services, which we were not allowed to do prior to the public health emergencies.
While many of our patients prefer in-person care, providing care by phone, which does not require high-speed internet, a computer or smartphone with enough data — things not always available to many in our community — has proven to be an excellent option for our patients who face multiple challenges to getting the health care they need. Once the federal public health emergency ends, telehealth medical services by phone may not be allowed in the same way by Medicaid and Medicare or will be so limited as to make it unfeasible for community health centers like ours to continue offering them.
Phone visits have also allowed Neighborcare Health and other organizations to lower barriers to access life-saving and life-changing medications to treat opioid use disorders. Before the pandemic, patients had to see an approved medical prescriber in-person before they could get a prescription for buprenorphine, a medication that can help manage opiod cravings and withdrawal.
Now, Neighborcare Health nurses in the community can connect patients with those providers by phone to get them started on the path to recovery as soon as they are ready, without waiting for or finding a way to get to an in-person appointment. While advocates are working to make this exception permanent, this practice could revert to previous in-person requirements, making it harder for people to access critical addiction treatment services.
Lastly, in 2020, when public health emergencies were declared and people across Washington state lost their jobs and their health insurance, thousands enrolled in Apple Health/Medicaid programs for low-cost or no-cost coverage. Approximately 387,000 more people enrolled in the state’s program from March 2020 to July 2022. In order to ensure enrollees could keep coverage during the tumult of the pandemic, the federal government allowed people to stay continuously enrolled instead of requiring annual re-enrollment.
Leading up to the end of the federal public health emergency, community health centers, managed care organizations, the state Health Care Authority and others will need to embark on the huge task of urging patients to make sure their contact information is up-to-date and to promptly respond to requests related to their coverage. Many should not see any change, if they act. Those who do not act, or who no longer qualify, may be left without access to health care or burdened with a bill they may be unable to pay.
For the past two and a half years, we all have adjusted and readjusted to meet the ever-changing status of the pandemic. If we have learned anything, it should be that getting back to “normal” or the way things “used to be” may not be the best choice for a healthy community. We will need to work more collaboratively with stakeholders and partners to develop new and innovative approaches to address critical needs and to improve the quality of life within our communities.
Rashad Collins is the CEO of Neighborcare Health. Collins has been in community health for more than a decade. Learn more about Neighborcare Health at neighborcare.org
Read more of the Oct. 26-Nov. 1, 2022 issue.