Op-Ed: Already Cash-Strapped Community Clinics Struggle to Access Enough COVID-19 Tests

At the periphery of the healthcare industry are community health centers, the safety net for vulnerable populations and the uninsured, many of whom are racial and ethnic minorities with multiple serious health issues.

Yet these centers are struggling to maintain equitable access for the people they serve.

When a patient comes into a health center like ours and is presenting with COVID-19 symptoms, they cannot be tested at our facilities. Instead they must be referred to the already impacted Santa Clara County-run hospitals.

But the referral to a county hospital is not due to a protocol, per se. It is because community health centers have been wait-listed by companies that sell the test kits.

In one instance, a San Jose health center was scheduled to begin testing on March 19, only to be informed their test kits had been pulled and sent elsewhere. In an instant, patients who rely on Medi-Cal and Medicare and those who are uninsured were relegated to the back of the line. Their access to COVID-19 testing was denied.

A quarter of a million people seek healthcare at community healthcare centers like ours. Most will not seek care in the emergency rooms, or, if they do, it will be when disease progression is severe enough to cause critical illness or death. Community health centers must be given access to testing for their vulnerable patients.

On behalf of 250,000 Santa Clara County residents who are already vulnerable, we ask that you join our plea and help us prioritize community health centers and our patients.

This is not a hospitals-versus-community health centers battle. On the contrary, this simply means that testing needs to be equitable in its distribution. Our health centers can help identify patients so that they get early intervention and treatment and do not end up in the emergency departments when it’s already too late.

The lack of access to major capital investments by corporations and foundations into our community health centers and our patients exacerbates the situation for us in real-time. The lack of resources makes it hard to secure personal protective equipment and testing kits as we scramble to provide adequate care to the impoverished as well as racial and ethnic minorities while trying to keep our staff safe and healthy.

We need an immediate change in mindset as to how testing is distributed in our communities. We cannot allow for this to be yet another social injustice. Our vulnerable and undocumented populations also need to be prioritized. We are important, too.

Dolores Alvarado is an experienced healthcare executive, whose diverse career in health spans over 40 years, including working in a community health center, family planning clinic, county hospital, and university-affiliated adolescent clinic. Most recently, she served as executive manager in the Santa Clara County Public Health Department. Maribel Montanez has leveraged her development expertise over the last 18 years in the fields of education, cancer research and leads the development efforts at Gardner Health Services, a federally qualified health center in San Jose, California. 

Opinions are the author’s own and do not necessarily reflect those of San Jose Inside. Send op-ed pitches to [email protected].


  1. “In an instant, patients who rely on Medi-Cal and Medicare and those who are uninsured were relegated to the back of the line. Their access to COVID-19 testing was denied.”

    What a load of self-serving crap – and an insult to all healthcare workers. All hospitals are prohibited by law to discriminate based on ability to pay or citizenship.

    As the authors well know, we are in a triage situation. Testing and treatment is based upon medical need – not hypochondria. Even those with private health insurance don’t get tested unless approved by a MD.

    Instead, Alvarado and Montanez want to cut in line to benefit their interests at the expense of everyone else.

  2. The reason why community health clinics have been waitlisted is because they are not equipped to treat serious conditions. This is not their role. This is why you typically refer those people needing more robust treatment to VMC or other hospitals. Thus, if you really want justice for these individuals, send them where they can actually receive the treatment they need.

  3. Hey Maribel Montanez, if you are really interested in social justice, you should talk to your employer Gardner about not discriminating workers. It is my understanding Garner is currently in the settlement process of a discrimination case, gender, national origin… you cannot ask for that you do not give to others. The most concerning part is that this is a pattern at Gardner not an isolated Bx.

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