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23 Apr 2020

Pandemic Stories: Coachella Valley Volunteers in Medicine, the Area's Only Free Health Center, Continues to Help Patients Remotely

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Dr. Stewart Fleishman, volunteer physician and board chair at CVVIM: “We have been trying to communicate that we’re still here to help the patients in the best ways we can based upon the circumstances.” Dr. Stewart Fleishman, volunteer physician and board chair at CVVIM: “We have been trying to communicate that we’re still here to help the patients in the best ways we can based upon the circumstances.”

While COVID-19 is obviously the world’s biggest current health challenge, people still have other health problems that need to be addressed in a timely fashion—and if you happen to be a low-income, uninsured resident of the Coachella Valley, one of the few options for good, quality care is Indio’s Coachella Valley Volunteers in Medicine clinic.

According to the clinic’s website: “CVVIM is a member of Volunteers in Medicine, a national nonprofit alliance with more than 90 free clinics across the U.S., whose mission is to provide healthcare services in a compassionate, caring way to our neighbors in need.” The Indio clinic opened its doors in November 2010, and is the valley’s only free health center.

However, CVVIM is not set up to directly treat COVID-19 patients like the local hospitals and the Desert AIDS Project are.

“LabCorp, our lab-service provider, (won’t) process the (COVID-19) tests from us, because they are saving the tests for the people who are needing them the most, and an ambulatory clinic (like CVVIM) that doesn’t normally see very ill patients wouldn’t qualify,” said Dr. Stewart Fleishman, a volunteer physician and the board chair at CVVIM. “So we send people to the appropriate test sites.”

The clinic’s operations have been severely impacted by the ramifications of the virus’ spread. The shelter-at-home restrictions and the threat of exposure to the coronavirus have greatly impacted the daily operations at CVVIM. In fact, the clinic stopped allowing in-person visits on March 19, when Gov. Gavin Newsom’s stay-at-home order took effect. Since then, the clinic has been communicating, diagnosing and refilling prescriptions for patients through virtual and telephonic channels every Tuesday through Friday.

“We only have a few paid staff members, and they’re all coming in,” Fleishman said. “Our volunteers are almost all over 65; maybe 75 percent of us are over 65, so it would have been very tough to ask them to come in. The rest of our volunteers are trainees from Eisenhower Medical Center, from the internal-medicine and family-practice-training programs, but they’ve been needed at the hospital. So we’ve had to change things around.

“We have medical technicians coming in, and they’re fielding all the phone calls and the faxes. They’re calling each of the providers with questions about drug (prescription) renewals, transportation, or X-ray or scan results, and then we call the patients back and give them the information. We answer any patient questions and make sure they’re OK. It’s a bit cumbersome. I am the main bilingual provider, believe it or not, with a name like Fleishman. I can operate on my own, but (the technicians) are here to help all the other providers make phone calls (to patients), because they need to have a conference call with a translator.”

Fleishman said he believes the clinic is continuing to serve its patients well, given the circumstances.

“For what we’re doing now, we have Doug (Morin), the executive director; an operations manager; a front-desk coordinator; a diabetes nurse; a med tech; and a volunteer coordinator. So, we have six people. We spread them out so that they’re not all in the same little area at the same time. We’ve really kept all of those folks employed, because we feel that’s a commitment that we want to make to them—and we need them to be the middlemen amongst all of these services and patients.”

Fleishman said many of CVVIM’s patients, in normal times, are working—but uninsured.

“Many have jobs, although some don’t have jobs now,” he said. “Luckily, most of the patients do have access to a cell phone. Since the government relaxed the rules on privacy and confidentiality, we’ve been using FaceTime and Skype to do telehealth visits. We’re not (yet using) a regular telehealth platform, (which hopefully soon) we should be getting from the national Volunteers in Medicine board.”

The one exception to the strict “no patient contact” policy: CVVIM’s Indio-based Street Medicine Team, to which one member of the clinic’s personnel is attached one night per week.

“They’ve been getting to some of the homeless people who were not being serviced by the (Coachella Valley Rescue) Mission or one of the other wonderful programs all over this valley,” Fleishman said. “These are folks living under overpasses and in small encampments. (The team) goes out on Tuesday nights with an Indio police officer, somebody from the Narrow Door (an Indio service organization) and some food. So, there’s food, clothing and medical care (being offered) to the homeless. They skipped two weeks, but they’ve started going out again.

“It’s a sad situation, but there are people congregating in small groups all over the place. Many of them have insurance—many of them have Medi-Cal, but they don’t trust the system. They feel that the system has wronged them. So, if they came to our office, by our usual rules, we wouldn’t see them, because they have insurance. But if they encounter the Street Medicine Team, then we can. Right now, a smaller team is going out, because the medical assistants are mostly needed at the Eisenhower hospital. Because the police officer is from Indio, we don’t cross the city lines into other cities. They see a number of patients every week. People trust them. They know that they’re coming, and they know there will be food and clothing with them.”

Nearly all nonprofits are dealing with financial worries due to the pandemic and the resulting economic downturn. However, Fleishman expressed limited optimism about the clinic’s future, as well as gratitude for the help that’s already come their way.

“We’ve been lucky in that before we even contacted them to let them know what our plans were, the foundations who have granted us money are being extremely understanding,” Fleishman said. “Our major fundraising event for the year, the VIMY Awards, was to be on March 21, so we’ve had to postpone that until Nov. 13. That’s a big issue.

“We have been trying to communicate that we’re still here to help the patients in the best ways we can based upon the circumstances. For the foreseeable future, yes, we are stable, but I don’t know how to quantify what ‘foreseeable’ is. Our foundations have given us latitude in how we can spend their (grant) money, because some of it was restricted to use for only certain programs. One of our funders did spontaneously send us some extra money, which was unrequested and quite lovely. But we haven’t yet (made requests for additional funding), because we wanted to see what was really happening, and figure out how long we’re going to have to operate like this.

“If we get the telehealth system from the national VIM, then I think we’ll be in a lot better shape.”

For more information on Coachella Valley Volunteers in Medicine, visit cvvim.org.

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