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

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

In Michigan and some other states, city and county stimulus funds have been deployed faster than billions in state-designated funds, some of which remain tied up in lawmakers deadlocked on how to spend them. And while much of the local aid is going towards other priorities, many cities and counties say the bailout funds have created a way to improve chronically underfunded public health systems as they recover from the pandemic and to address gridlocked health inequalities driven by Covid-19 were made worse.

Here in central Michigan, where officials have warned of rising rates of violence, drug addiction and delayed care during the pandemic, local help from last year’s stimulus bill, the American Rescue Plan, has changed the economic fate of Ingham County and its public rewritten health programs – at least for now.

Of the $350 billion for states and localities in the bailout plan, $195 billion went to state governments, with another $130 billion going to cities, counties and other local governments, many of which forecast huge revenue losses early in the pandemic . Local governments were given wide discretion about how to spend the money, and many are using 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 and its suburban and rural surroundings. Local officials worked quickly last year to use an initial $28 million tranche and are poised to request another $28 million that will arrive this spring, some for an ambitious set of proposals could be spent in the field of public health.

“We have the community connections and we know where things can go quickly,” said Gregg Todd, the county controller.

The Ingham Health Department asked for money to replace septic systems along the rural outskirts of the county; Hiring a Nurse Case Manager and other healthcare providers for the new clinic and a separate addiction clinic; renovate a group dental practice; and launch a harm reduction program aimed at reducing 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 impact of the money more evident than at 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. Ingham County Public Health Officer Linda Vail said that before the stimulus funds arrived, her department planned to open the clinic “bare-bones” and pull staff from other community clinics “to rob Peter to pay Paul.” The stimulus funding, $750,000 to build the clinic and $137,956 to hire staff, allowed the county to scrap that plan and accelerate the schedule.

The county hopes to open the clinic by the summer, initially treating up to two dozen patients a day.

Recognition…Elaine Cromie for the New York Times

Nearly two miles away in the Capitol, lawmakers in the Republican-controlled legislature have yet to allocate billions of dollars in America’s bailout funds to state uses, in what some Democrats have described as an attempt to quash Gov. Gretchen Whitmer’s agenda. a democrat. Congress last month considered withdrawing unspent federal funds, including from Michigan, in a move that caused bipartisan furor.

Curtis Hertel Jr., a Democratic senator representing Ingham County, said the county’s rapid use of its stimulus funds is a fitting counterexample to the state legislature’s grab on the larger pot of money, which he says may already have had a significant impact more of these were quickly released.

“Michigan has a broken mental health structure,” he said. “We could have saved more lives in Michigan.”

Local officials have until 2026 to spend America’s bailout money. In some communities, the money is just beginning to flow. Everywhere the stimulus funds prove to be a Litmus test of 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 repairing public storm drains and $450,000 hiring more behavioral medicine specialists in a local mental health programwith a focus on adolescent mental health.

The resources reach far beyond public health. Over $8 million Small Business Grants helped stem some of the commercial downturn Lansing has suffered during the pandemic. Nikki Thompson Frazier who owns these Sweet Encounter Bakery and Cafe in downtown Lansing, said her $5,000 grant allows her to buy more mixers, make more pastries and teach more baking classes. The money went into more growth, she said, and allowed her to hire two workers.

“Sometimes you just need that little push,” she says.

The Allen Clinic is hiring a small staff that it plans to gradually expand as more resources are made available: two front office staff, a nurse, two physician assistants, a behavioral medicine doctor, and a physician assistant. Local officials hope to eventually hire a doctor and another medical assistant.

The clinic will have a pharmacy that will provide free or low-cost prescriptions to patients and a blood collection laboratory.

Recognition…Elaine Cromie for the New York Times

The neighborhood that the clinic will serve has more than 17,000 residents and is made up of about 20 percent Black, 12 percent Hispanic, 60 percent White and 3 percent Asian, according to Joan Nelson, who runs a community center next 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. A new bus stop outside the center was recently added to make it easier for patients to get to the clinic.

dr Adenike Shoyinka, medical director for the county health department, called the investment in the Allen complex a “template” for redesigning Lansing’s public health programs.

The community center next door includes a pantry that hands out over 1,000 pounds of baked goods and produce each week, and a year-round farmer’s market, gardening classes, and a community-based agricultural program. The center also enrolls low-income residents in Medicaid and Affordable Care Act health insurance. But Ms Nelson said her staff often have to refer people to community clinics far away, a position they will no longer be in when the clinic next door opens.

Ms Vail, the county health officer, said the influx of stimulus money has helped renew the focus on primary care in the area. It serves a different purpose than vaccines, tests, treatments and personal protective equipment, she said, but one that is 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 dwindling trust in local health departments, some of which are working to restore their reputation for it became a target for humans angry about pandemic restrictions.

“I think we have a lot to do to regain confidence,” she said. “If people don’t trust us, they won’t continue to come to us for all the things we can offer them,” including “the vaccinations, the foster home visitation programs that prevent mothers from losing their babies before they’re a year old.” and the Nutrition Assistance 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 had led with federal funds that would add social workers to the Lansing Police Department for mental health-related calls will.

Ms Slotkin said she was concerned the benefits of government Covid-19 stimulus support could be fleeting in a state where some counties have only one public health officer.

Recognition…Doug Mills/The New York Times

“The entire healthcare system is supported by Covid funds,” she said in an interview, referring to stimulus funds awarded under both the Trump and Biden administrations. “What will they do to take some of these temporary gains and turn them into a strategic shift in government for public health and mental health?”

The next day, several miles north at another community health center, staffers prepared strips of Suboxone, a drug that may help opioid users wean off the drugs, part of a program aimed at tackling a spiraling fentanyl crisis in Lansing.

The clinic, which treats homeless residents of an adjacent shelter, is still looking for additional providers. More funding is needed for a new project to reduce drug overdoses and deaths, which have increased during the pandemic, Ms Vail said.

Further south, at the Forest Community Health Center, federal incentives could be used to update the dental practice’s facilities, which are in huge demand. in one refugee settlement townthe clinic treats thousands of refugees each year, including more than 300 who have recently arrived from Afghanistan.

The federal relief initially presented a challenge for the clinic to deploy quickly, said Izabela Wackowski-Norris, who oversees it. But state and local support eventually helped the clinic afford protective equipment, an outdoor drive-through structure and telemedicine software, among other things.

Ms. Wackowski-Norris said she hopes to soon hire a psychiatrist and a nutritionist and expand the clinic’s HIV treatment program.

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

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