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COVID-19 Pandemic Exacted a Toll on Community Health Center Workforce; Nurses Account for Highest Loss for Health Centers on the Frontlines

Fighting a global pandemic on the frontlines of underserved communities has decimated the health center workforce with unprecedented rates of attrition.  A new survey by the National Association of Community Health Centers (NACHC) reveals that 68% of health centers report a loss of workforce of up to 25 % in the last 6 months alone. Health centers are losing nurses more than any other staff, a trend that has brought into focus a worsening national crisis and an immediate challenge to future pandemic readiness.

“The future of the Community Health Center workforce and our readiness to meet public health challenges is uncertain,” said Rachel Gonzales-Hanson, interim President and CEO of the National Association of Community Health Centers (NACHC).  “We must immediately invest in policies that will retain current health center staff, broaden the pipeline for the future workforce and foster creative strategies at the community level for short and long-term solutions. There are programs that will augment the health center workforce to ensure we can meet the demand for care, as well as provide boosters, testing, and treatment if another COVID surge in the pandemic is ahead.”

Community Health Centers, which serve nearly 30 million people nationwide, have played a central role throughout the pandemic, protecting populations and essential workers who have suffered disproportionately higher rates of infection and death from COVID-19.  To date, they have administered more than 21 million vaccines and conducted 18 million tests as the linchpin of the Biden Administration’s strategy for health equity.  The health center vaccination program is a documented success: there are fewer COVID-19 deaths and infections in areas of the country where a health center is located, according to  findings from NACHC and the Morehouse School of Medicine’s National COVID-19 Resiliency Network (NCRN).  

The frontline work of health centers has exacted a high toll in terms of staff exhaustion and attrition.  Although health centers reported losing nurses more than other staff, other areas vital to health center operations are also hard-hit, including administrative, behavioral health, and dental staff.

Salary competition from other employers and stress from the pandemic are the most common reasons for staff departures. For immediate relief, NACHC is proposing a host of policy initiatives and support for programs, including continued support for National Health Service Corps (NHSC) and the Teaching Health Center Graduate Medical Education (THCGME) and the Nurse Corps Scholarship Program. The report also highlights as a solution expanding the list of billable providers on integrated care teams as well as extending the Federal Tort Claims Act for Volunteer Health Professionals.

The NACHC report comes as the status of financial resources to fight the pandemic is uncertain. Congressional lawmakers are debating COVID relief measures and the Biden Administration warns that “without funding, the United States will not have enough additional boosters or variant specific vaccines, if needed, for all Americans.”  Health centers were also recently notified that the federal COVID-19 Uninsured Program will stop accepting claims for vaccinating, testing, and treating COVID patients who do not have the means to pay their medical bills.

In a letter to Congressional appropriators, NACHC has raised the need for flexible and sustained funding in the fight against COVID because, as “federally supported nonprofit, community-directed provider clinics, health centers operate on thin margins and cannot absorb pandemic-related costs without federal assistance.”



About National Association of Community Health Centers

Established in 1971, the National Association of Community Health Centers (NACHC) serves as the national voice for America’s Health Centers and as an advocate for health care access for the medically underserved and uninsured.