LANSING, Michigan — In a disadvantaged neighborhood in the Michigan capital, a health clinic is being built with about $900,000 in federal funds for pandemic relief, a project that could transform community access to care.
The clinic is located between the new, affordable apartments and the community center, and is a symbol of the rapid impact that the money has had on many local public health programs.
In Michigan and some other states, stimulus aid to cities and counties has been used up faster than billions in state-designated funds, some of which remain in legislatures deadlocked over how to spend it. And while much of the local aid goes to other priorities, many cities and counties say the rescue money has provided an opportunity to improve chronically underfunded public health systems as they recover from the pandemic, and address the entrenched health inequalities that Covid-19 has made worse. .
Here in central Michigan, where officials have warned of rising rates of violence, drug addiction and care delays during the pandemic, domestic help from last year’s stimulus bill, the US bailout, has rewrote the economic fortunes of Ingham County and the general public. Health programs – at least for now.
Of the $350 billion for states and localities in the bailout, $195 billion went to state governments, with another $130 billion directed to other cities, counties and local governments, many of which projected huge revenue losses at the start of the pandemic. Local governments have been given broad discretion over how the money is spent, and many use at least some of it to support public health.
Nearly $60 million was sent to Ingham County, home to nearly 300,000 people in Lansing and its suburbs and rural suburbs. Local officials worked quickly last year to use an initial $28 million tranche, and are ready to begin applying another $28 million that will arrive this spring, some of which could be spent on an ambitious series of public health proposals.
“We have relationships in the community and we know where they can go quickly,” said county superintendent Greg Todd.
Ingham’s Ministry of Health requested money to replace the sewage systems along the rural fringes of the county; Hiring a nurse case manager and more health providers for the new clinic and separate addiction clinic; renovation of a community dental clinic; and initiation of a harm reduction program aimed at reducing transmission of HIV and viral hepatitis. Mr. Todd said the county so far plans to use the rescue money to fund the sanitation program.
Nowhere is the money’s impact more evident than with a new clinic, the Allen Neighborhood Community Health Center, which will join a network of community health centers serving tens of thousands of patients each year. Ingham County Public Health Officer Linda Vail said that before the stimulus money arrived, her management planned to open the clinic in a “naked fashion” and withdraw staff from other community clinics, “stealing Peter to pay Paul.” The stimulus funding, $750,000 to build the clinic and $137,956 to hire staff, allowed the county to cancel that plan and speed up the schedule.
The county hopes to open the clinic by summer and serve up to twenty patients a day to start.
Roughly two miles away in the Capitol, lawmakers in the Republican-controlled legislature have yet to set aside billions in US bailout money for state use, in what some state Democrats have described as an attempt to stifle the agenda of Governor Gretchen Whitmer, a Democrat. Congress last month considered recovering unspent money from the state, including money from Michigan, to the ire of both parties.
Curtis Hertle, Jr., a Democratic senator from Ingham County, said the county’s rapid use of its stimulus money was a convenient counterexample to the state legislature’s hold on more money, which he said could already have had a tangible impact. More of them were quickly released.
“Michigan has a crippled mental health structure,” he said. “We could have saved more lives in Michigan.”
Local officials have until 2026 to spend the US bailout money. In some societies, money is beginning to flow. Everywhere, stimulus funds are proving to be an essential test of domestic priorities.
The first batch of $28 million from Ingham County went to not just public health initiatives, but infrastructure projects and hundreds of local businesses. $1 million was spent on emergency medical equipment, including new ambulances and training. The county also spent $150,000 to repair public storm drains, and $450,000 to hire more behavioral health professionals in a local mental health program, with a focus on teen mental health.
Resources have extended far beyond public health. Small business grants of more than $8 million have helped mitigate some of the business downturn that Lansing has experienced during the pandemic. Nikki Thompson Frazier, who owns Sweet Encounter Bakery and Café in downtown Lansing, said her $5,000 grant allowed her to buy more mixers, produce more pastries, and hold more baking lessons. She said the money doubled to turn into more growth, which allowed her to hire workers.
“Sometimes you just need a little push,” she said.
The Allen Clinic employs a small staff that it hopes to expand gradually, if more funding materializes: two front-office staff, a nurse, two paramedics, a behavioral health specialist and a physician assistant. Local officials hope to eventually hire a doctor and another paramedic.
The clinic will have a pharmacy that offers free or low-cost prescriptions to its patients, and a blood drawing lab.
The neighborhood the clinic serves has a population of more than 17,000 residents, and about 20 percent are black, 12 percent Hispanic, 60 percent white and 3 percent Asian, according to Joanne Nelson, who runs a community center next to the clinic. future health. She said nearly 25 percent of the community lives below the poverty level, and 20 percent of families don’t own cars. A new bus stop has recently been added outside the center to help patients reach the clinic.
Dr. Adenike Shoyinka, medical director of the county health department, described the investment in the Allen complex as a “model” for how to reshape Lansing’s public health programs.
The community center next door includes a pantry that distributes over 1,000 pounds of baked goods each week and has a year-round farmers market, gardening classes, and a community-supported agricultural program. The center also enrolls low-income residents in Medicare and Affordable Care Act coverage. But Ms Nelson said her staff often had to refer people to outlying community clinics, a position it would not have once the clinic opened nearby.
Ms. Phil, the county health official, said the influx of stimulus funds had helped renew the focus on primary care in the district. She said they served a different purpose than vaccines, tests, treatments and personal protective equipment, but they were just as important.
“Recovering from the pandemic requires investment and money, not just responding to the pandemic,” she said.
Ms Vail added that the new resources could help reflect trust in local public health departments, some of which are working to restore their reputations after they have become a target of people angry at the restrictions imposed on the outbreak.
“I think we have a big job to do to restore confidence,” she said. “Unless people trust us, they will not continue to come to us for all the things we can provide for them,” including “vaccinations, nurse-at-home programs that prevent mothers from losing their babies before they are a year old” and a food assistance program for women and infants and children, commonly known as WIC.
U.S. Representative Elisa Slotkin, a Democrat whose county includes Ingham County, recently traveled to Lansing to announce a federally funded project that will add social service workers to the Lansing Police Department for mental health calls.
Ms Slotkin said she was concerned that the benefits of federal stimulus aid for Covid-19 could be fleeting in a state where there is only one public health official in some counties.
“The entire healthcare system is being supported by Covid money,” she said in an interview, referring to stimulus funds passed under the Trump and Biden administrations. “What are they going to do to take some of these temporary gains and turn them into a strategic change in the country in terms of public health and mental health?”
The next day, several miles north at another community health center, staff prepared strips of Suboxone, a drug that can help keep opioid abusers off medication, part of a program aimed at addressing Lansing’s mounting fentanyl crisis.
The clinic, which treats homeless residents in a nearby shelter, is still looking to hire more providers. Ms Phil said more money was needed for a new project to reduce drug overdoses and deaths, which have risen during the pandemic.
To the south, at the Forest Community Health Center, a federal incentive could be used to renovate dental clinic facilities, which are in huge demand. In one refugee resettlement town, the clinic treats thousands of refugees each year, including more than 300 who have recently arrived from Afghanistan.
Isabella Wakowski Norris, who supervises her, said the federal relief was initially a challenge for the clinic to use quickly. But federal and local assistance eventually helped the clinic provide protective equipment, a drive-through exoskeleton and telehealth programs, among other resources.
Ms. Wakoski Norris said she hopes to hire a psychiatrist and a dietitian soon, and build an HIV treatment program at the clinic.
“We’re here, and we’re doing our best,” she added. “But we can’t do whatever we want to do, because we’re not money-makers.”