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Column: Good Neighbor clinics respond to COVID-19

Published: 7/31/2020 10:20:15 PM
Modified: 7/31/2020 10:20:11 PM

When the novel coronavirus hit the Upper Valley, the Good Neighbor Health Clinic, like every other health care facility, needed to respond to the threat. In order to assure the safety of our patients, volunteers and staff, we had to change how we delivered medical and dental care. In doing this, we also needed to remain true to our mission of providing free medical and dental care to people in the Upper Valley who are in need and who do not have the means to pay.

Our vision of a community where people have access to the health resources they need to reach their full potential for mental, physical and social well-being remains a priority.

The Good Neighbor Health Clinic is unique — no two free clinics are alike — in that it relies on a combination of volunteer providers, medical and dental students and paid staff in both its medical and dental clinic.

Ironically, volunteers, staff and students often fit the profile of individuals who seemed to be disproportionately contracting COVID-19.

In order to provide free health care, the clinics first of all had to find a way to provide care safely.

We did not know how the virus was transmitted. Was it spread by aerosol or droplets? What kind of personal protective equipment would we need? Would we also need a highly efficient ventilation system, which we currently do not have?

It was apparent that we would have to make changes.

Initially, we stopped seeing patients face-to-face in both the medical and dental clinic. In the medical clinic, established patients with chronic conditions were cared for remotely. Pre-screening for COVID-19 was done over the phone with referrals being made as necessary.

The Red Logan Dental Clinic was more problematic in that, by its very nature, dental providers are potentially exposed to infected oral droplets.

On June 1, when Vermont Gov. Phil Scott opened up dental offices on a limited basis (with adequate PPE, along with requiring staff and patient screening protocols), the dental clinic saw 104 patients and provided 124 exams, cleanings and extractions. This level of dental care continued through the end of July, at which time the dental clinic closed for a planned renovation in August.

Upper Valley Strong has generously funded us $4,400 for the purchase of two surgical air scrubbers in the dental clinic. The organization has asked that this be a challenge grant so that two additional pieces of equipment may be purchased.

Our current plans for providing health care include: a continuation of our partnership with The Haven to reach homeless people in need of care, an expansion of a partnership with Dartmouth College to bring consultative psychiatric services to patients remotely (we will provide tablets and Wi-Fi access in our parking lot at 70 N. Main St. in White River Junction), as well as hiring an assistor to work with Vermonters who need help enrolling in Vermont Health Connect insurance and other programs such as fuel assistance, filling out tax forms, or 3-Squares for those who are food insecure.

As always, Good Neighbor health care focuses on helping patients by paying attention to those social factors that play an important role in determining people’s health — such as housing, food security and household income — and not just on their medical needs.

During this time of economic uncertainty, with the potential loss of employer-based medical insurance for many in our community, it is more important than ever for the services provided by the Good Neighbor Health Clinic and the Red Logan Dental Clinic to be accessible to those in need.

Paul Manganiello is co-medical director, Dana Michalovic is executive director, and Craig River-Westling is board chair of the Good Neighbor Health Clinic and the Red Logan Dental Clinic. Donations may be made at or by mail to P.O. Box 1250, White River Junction Vt. 05001.

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