In one Michigan county, stimulus funds are overhauling public health programs

LANSING, Michigan — In an underserved neighborhood of Michigan’s capital, a health clinic is being built with nearly $900,000 in federal pandemic relief funds, a project that could transform access to the community in care.

Wedged between new affordable apartments and a community center, the clinic is a symbol of the rapid effect the funds have had on many local public health programs.

In Michigan and some other states, stimulus aid for cities and counties has been used faster than billions in state-designated funds, some of which remain tied up in legislatures deadlocked over how to spend them. And while much of the local aid goes to other priorities, many cities and counties say the bailout funds have provided an opening to improve chronically underfunded public health systems as they struggle. are recovering from the pandemic, addressing the entrenched health disparities that Covid-19 has exacerbated.

Here in the middle of Michigan, where officials have warned of soaring rates of violence, substance abuse and delayed care during the pandemic, local relief from last year’s stimulus bill , the US bailout, has rewritten the economic fortunes of Ingham County and its public health programs — at least for now.

Of the $350 billion earmarked for states and localities in the bailout, $195 billion went to state governments, and another $130 billion was directed to cities, counties and other local governments. , many of which anticipated huge revenue losses at the start of the pandemic. Local governments have been given wide discretion over how to spend the money, and many are using at least some of it to bolster public health.

Nearly $60 million was sent to Ingham County, home to nearly 300,000 people in Lansing and its suburban and rural environs. Local officials worked quickly last year to use a first tranche of $28 million and are ready to start applying an additional $28 million that will arrive this spring, part of which could be spent on an ambitious series of development proposals. public health.

“We have connections in the community and know where this can go fast,” said Gregg Todd, the county comptroller.

The Ingham Health Department requested money to replace septic systems along the county’s rural fringes; hire a nurse case manager and other health care providers for the new clinic and a separate addictions clinic; renovate a community dental office; and launching a harm reduction program that would aim to reduce the transmission of HIV and viral hepatitis. So far, the county plans to use the bailout money to fund the septic program, Mr Todd said.

Nowhere is the effect of the money clearer than with the new clinic, the Allen Neighborhood Community Health Center, which will join a network of community health centers that serve tens of thousands of patients each year. Linda Vail, public health officer for Ingham County, said before stimulus money arrived, her department had planned to open the clinic in a “bare bones” fashion and pull staff out of the clinic. other community clinics, “robbing Peter to pay Paul”. Stimulus funding, $750,000 to build the clinic and $137,956 to hire staff, allowed the county to scrap that plan and accelerate the timeline.

The county hopes to open the clinic by the summer and have it serve up to two dozen patients a day to start.

Almost two miles away on Capitol Hill, lawmakers in the Republican-controlled Legislature have yet to allocate billions of US bailout funds earmarked for the state, in what some Democrats in the described as an attempt to stifle the agenda of Governor Gretchen Whitmer, a Democrat. Last month, Congress considered resuming unspent state funds, including from Michigan, prompting howls from both sides.

Curtis Hertel Jr., a Democratic state senator who represents Ingham County, said the county’s rapid use of its stimulus funds was a fitting counterexample to the government’s legislature’s grip. The report on the biggest pot of money, which he says could have already had a significant impact had more of it been released quickly.

“Michigan has a broken 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 communities, the money is just starting to come in. Everywhere, stimulus funds are proving to be a litmus test of local priorities.

Ingham County’s first $28 million went to not only public health initiatives, but also 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 sewers and $450,000 to hire more behavioral health specialists in a local mental health program, focusing on teen mental health.

The resources go far beyond public health. More than $8 million in small business grants helped stem some of the business downturn Lansing suffered during the pandemic. Nikki Thompson Frazier, owner of the Sweet Encounter Bakery and Café in downtown Lansing, said her $5,000 grant allowed her to buy more mixers, produce more baked goods and run more classes. of pastry. The money snowballed into more growth, she said, allowing her to hire two workers.

“Sometimes you just need a little push,” she said.

The Allen Clinic is hiring a small staff that it hopes to gradually expand, if more funding materializes: two front desk staff, a nurse, two medical assistants, a behavioral health specialist and a medical assistant. Local officials hope to eventually hire a doctor and another medical assistant.

The clinic will have a pharmacy that provides free or low-cost prescriptions to its patients, and a laboratory for blood sampling.

The neighborhood served by the clinic has more than 17,000 residents and is made up of about 20% black, 12% Hispanic, 60% white and 3% Asian, according to Joan Nelson, who runs a community center in next to the future health clinic. About 25% of the community lives below the poverty line and 20% of families do not own a car, she said. A new bus stop has recently been added outside the center to help patients get to the clinic.

Dr. Adenike Shoyinka, medical director for the county health department, called the investment in Allen’s complex a “model” for how to reshape public health programs in Lansing.

The community center next door includes a food pantry that distributes more than 1,000 pounds of baked goods and produce each week and has a year-round farmers’ market, gardening classes and a gardening program. community supported agriculture. The center also enrolls low-income residents for Medicaid and Affordable Care Act coverage. But Ms Nelson said her staff often have to refer people to distant community clinics, a position they will no longer be in after the nearby clinic opens.

Ms Vail, the county health worker, said the influx of stimulus money has helped renew the focus on primary care in the area. It served a different purpose than vaccines, tests, treatments and personal protective equipment, she said, but one that was just as important.

“It takes investment and money to recover from a pandemic, not just to respond to a pandemic,” she said.

The new resources, Ms Vail added, could help reverse the loss of faith in local public health departments, some of which are struggling to restore their reputations after becoming targets of people angry at pandemic restrictions.

“I think we have a big job to do to regain trust,” she said. “Unless people trust us, they won’t keep coming to us for everything we can offer them,” including “vaccinations, nurses’ home-visiting programs that prevent mothers from losing their baby before he’s ‘re a year old’ and the food assistance program for women, infants and children, known as WIC.

United States Representative Elissa Slotkin, a Democrat whose district includes Ingham County, recently visited Lansing to announce a project she spearheaded with federal funds that will add social workers to the Department of Lansing police for calls related to mental health.

Ms Slotkin said she fears the benefits of federal Covid-19 stimulus assistance will be fleeting in a state in which some counties have only one public health official.

“The whole health system is 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 strategic change in the state in public health and mental health?”

The next day, several miles north of another community health center, staff prepared strips of Suboxone, a drug that can help wean opioid users, as part of a program to dealing with a growing fentanyl crisis in Lansing.

The clinic, which treats homeless residents at a nearby shelter, is still looking to hire other providers. More funds are needed for a new project to reduce drug overdoses and deaths, which have increased during the pandemic, Ms Vail said.

Further south, at Forest Community Health Center, federal stimulus could be used to revamp facilities at the dental practice, which is in huge demand. In a refugee resettlement town, the clinic treats thousands of refugees every year, including more than 300 recently arrived from Afghanistan.

Federal aid was initially a challenge for the clinic to use quickly, said Izabela Wackowski-Norris, who oversees it. But federal and local aid eventually helped the clinic afford protective gear, an outdoor drive-thru structure and telehealth software, among other resources.

Ms Wackowski-Norris said she hoped to hire a psychiatrist and dietitian soon, and expand the clinic’s HIV treatment programme.

“We are here and we are doing our best,” she added. “But we just can’t do everything we want to do, because we’re not made of money.”

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