LANSING, Michigan — In a deprived 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 community access to care.
The clinic, sandwiched between new affordable apartments and a community center, is a symbol of the rapid effect the funds have had on many local public health programs.
In Michigan and some other states, stimulus to cities and counties has been used faster than billions in state-designated funds, some of which remain tied up in the legislature stuck on how to spend it. And while much of the local aid is moving toward other priorities, many cities and counties say the rescue funds have provided an opening to improve chronically underfunded public health systems as they recover from the pandemic, by addressing deep-seated health disparities that Covid-19 has exacerbated.
Here, in central Michigan, where officials have warned of escalating violence, drug addiction and delayed care amid the pandemic, local aid from last year’s stimulus bill, the American Rescue Plan, has helped the economic fate of Ingham County and its audience rewritten. health programs — at least for now.
Of the $350 billion for states and localities in the bailout, $195 billion went to state governments, and another $130 billion to cities, counties and other local governments, many of which anticipated huge revenue losses as the pandemic began. Local governments have been given wide 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’s suburban and rural areas. Local officials worked quickly last year to use an initial tranche of $28 million, and are poised to apply another $28 million due to arrive this spring, some of which could be spent on an ambitious set of proposals. for public health.
“We have the relationships in the community and know where it can go quickly,” said Gregg Todd, the county controller.
The Ingham Health Department requested funds to replace septic systems along the rural fringe of the county; hire a nurse case manager and more caregivers for the new clinic and a separate addiction clinic; renovate a communal dental practice; and initiate a harm reduction program that aims to reduce the transmission of HIV and viral hepatitis. So far, the county plans to use the rescue money to fund the septic program, Mr. todd.
Nowhere is the effect of the money more apparent than in the 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. Linda Vail, the Ingham County public health officer, said that before the stimulus funds arrived, her department planned to open the clinic in a “bare-bones” manner and withdraw staff from other community clinics, “robbing Peter to pay Paul.” The incentive funding, $750,000 to build the clinic and $137,956 to hire staff, allowed the county to scrap that plan and speed up the timeline.
The province hopes to open the clinic by the summer and thus be able to serve as many as two dozen patients a day.
Nearly two miles away, at the Capitol, lawmakers in the Republican-controlled legislature have yet to allocate billions of U.S. bailout funds to be used by the state, in what some state Democrats have described as an attempt to disrupt Governor Gretchen’s agenda. Whitmer, a Democrat. Congress last month considered taking back unspent state money, including from Michigan, to cheers from both sides.
Curtis Hertel Jr., a Democratic state senator who represents Ingham County, said the county’s rapid use of the stimulus funds was a fitting counterexample to the state legislature’s hold on the bigger pot of money, which he says is already making a meaningful impact. could have had. more of it was released soon.
“Michigan has a broken mental health structure,” he said. “We could have saved more lives in Michigan.”
Local officials have until 2026 to spend money on the US bailout plan. In some communities, the money is just starting to flow. Everywhere, the stimulus funds are proving to be a litmus test for local priorities.
Ingham County’s first $28 million tranche went not only to public health initiatives, but also to infrastructure projects and hundreds of local businesses. A million dollars 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 specialists for a local mental health program, with a focus on adolescent mental health.
The resources extend far beyond public health. More than $8 million in small business grants helped curb some of the commercial decline Lansing had suffered during the pandemic. Nikki Thompson Frazier, owner of the Sweet Encounter Bakery and Café in downtown Lansing, said her $5,000 grant could buy more mixers, produce more pastries, and teach more baking classes. The money fueled more growth, she said, allowing her to hire two workers.
“Sometimes you just need that little push,” she says.
The Allen Clinic is hiring a small staff that she hopes to gradually increase as funding increases: two front office workers, a nurse, two medical assistants, a behaviorist, and a physician assistant. Local officials hope to eventually hire a doctor and another medical assistant.
The clinic will have a pharmacy that dispenses free or inexpensive prescriptions to its patients, and a laboratory for blood draws.
The neighborhood that the clinic will serve has more than 17,000 residents and is approximately 20 percent black, 12 percent Hispanic, 60 percent white and 3 percent Asian, according to Joan Nelson, who runs a community center adjacent to the future health clinic. About 25 percent of the community lives below the poverty line and 20 percent of families don’t own cars, she said. Recently a new bus stop was added outside the center to help patients to the clinic.
dr. Adenike Shoyinka, medical director of the county’s health department, called the investment in the Allen complex a “template” for reshaping 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 products each week and has a year-round farmer’s market, gardening classes, and a community-supported farming program. 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 community clinics far away, a position they will no longer have after the clinic next door opens.
Ms. Vail, the county health officer, said the influx of stimulus funds had contributed to a renewed 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 respond to a pandemic,” she said.
The new agents, Ms Vail added, could help reverse dwindling trust in local public health departments, some of which are working to rebuild their reputations after being targeted by people angry about pandemic restrictions.
“I think we have a big job to do to regain confidence,” she said. “Unless people trust us, they won’t keep coming to us for all the things we can provide for them,” including “the vaccinations, the nurses’ home visit programs that prevent mothers from losing their babies before they’re a year old.” and the Food Aid Program for Women, Infants and Children, known as WIC.
United States Representative Elissa Slotkin, a Democrat whose district includes Ingham County, recently traveled to Lansing to announce a project she led with federal funds that will add social workers to the Lansing Police Department for calls. related to mental health.
Ms. Slotkin said she was concerned that the benefits of federal Covid-19 stimulus could be fleeting in a state where some counties have only one public health officer.
“The entire healthcare system is being propped up by Covid money,” she said in an interview, referring to stimulus funds provided under both the Trump and Biden administrations. “What are they going to do to take some of those temporary gains and turn them into strategic change in the state in public health and mental health?”
The next day, several miles north at another community health center, employees prepared strips of Suboxone, a drug that may help kick opioid users off the drugs, part of a program that aims to tackle a rapidly growing fentanyl crisis in Lansing. to take.
The clinic, which treats homeless residents of an adjacent shelter, is still looking for more caregivers. More funds are needed for a new project to reduce overdoses and deaths, which have increased during the pandemic, Ms Vail said.
Further south, at the Forest Community Health Center, a federal incentive could be used to renew the dental office facilities, which are in huge demand. In a refugee resettlement city, the clinic treats thousands of refugees each year, including more than 300 who have recently arrived from Afghanistan.
Federal aid was initially challenging for the clinic to use quickly, said Izabela Wackowski-Norris, who oversees it. But federal and local aid eventually helped the clinic afford protective equipment, an outdoor drive-through structure, and telehealth software, among other things.
Ms Wackowski-Norris said she hoped to soon hire a psychiatrist and dietitian and build out the clinic’s HIV treatment program.
“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 up of money.”
