Each year, the Yakima Union Gospel Mission’s medical clinic has over 10,000 patient visits — making it the largest free medical clinic in the state measured by clinic visits, directors say.

Among those, about 40% are urgent-care visits; the remainder are with patients who use the clinic as primary care, visiting four times a year on average.

The clinic is a crucial resource for the people it serves, even more so amid the pandemic.

These clients are usually low-income, don’t have medical insurance, or have insurance with extremely high deductibles that they can’t afford to foot, said Mike Johnson, executive director of the mission.

“Our typical patient demographic is working in the agricultural industry,” said Johnson. “So we have some folks that we see who are outside of working age. But most of our patients are of working age, they’re employed, they’re agriculture-based.”

The true cost of each visit to the clinic is about $42. But it’s free to clients, with donations encouraged. Over the past three years — since the clinic was revamped and expanded — donations from clients of $5, $10 or $20 have grown from a collective of roughly $25,000 a year to $100,000, supporting one-fourth of the donation-based clinic’s budget, said Johnson. This year, Virginia Mason Memorial hospital matched that dollar amount, he said.

The clinic is run by six dedicated staff members: a doctor who graduated from Yakima’s Pacific Northwest University of Health Sciences, a physician assistant and four medical office staff. It also gets an immense amount of donated physician time from local retired practitioners and support from Virginia Mason Memorial, which provides all labs and imaging for the clinic for free.

“It’s just been a really great thing to keep folks healthy, keep folks working,” he said of the clinic’s impact over the years on the community it serves.

He said the mission believes a significant portion of its clientele is undocumented, which is part of why some don’t have access to health care. But the clinic doesn’t ask.

“That isn’t our job. Our job isn’t to find out who is here with immigration papers and who isn’t. Our job is to give people care in the name of a loving God who has a great plan for their life, and we want to see them thrive,” he said. “Care is why we’re here.”

The toll of the pandemic

When the COVID-19 pandemic arrived in Yakima, the clinic saw a dive in clinic visits as people were told to stay home. At the same time, essential work in the Valley continued, and the agriculture industry was particularly vulnerable as the virus struck packing plants.

The clinic staff stepped up, said Johnson, rolling out drive-up COVID-19 testing and care for clinic patients. Over time, clientele began returning for regular visits as well, following precautions like masking and regular clinic sanitation. Clinic visits have returned to 85% to 90% of what they were pre-pandemic, Johnson said.

“This is keeping our (agriculture) industry safe and healthy, and it’s keeping people at work,” he said. What’s more, he said: “It’s good to see people coming back and getting the medical care they need.”

Dulce Chavez, 43, of Sunnyside was among the patients who returned for care. She’s been going to the mission’s Yakima clinic for a handful of years for treatment for diabetes and a serious back injury that keeps her out of work. She’s loyal to the clinic in part for its affordability, but primarily for the high-quality care she said she couldn’t find elsewhere.

When the pandemic hit, she was worried about being able to continue to receive care as well as about becoming infected, since her diabetes makes her more vulnerable to COVID-19.

But Chavez was able to continue telemedicine through the clinic and has since returned to regular chiropractic care at the office.

“The doctors here,” she said. “They take the time and they really listen to you so they can help you.”

Little by little, Chavez said her mobility is improving. The care, she said, “it’s just amazing.”

Coordinating for better service

Medical clinic staff also have worked closely with the Yakima Health District to understand and implement COVID-19 safety and cleaning protocols that have allowed the mission’s shelter and transitional housing recovery program to remain open, even while some other area resources for those experiencing homelessness have shuttered.

They continued to be involved in COVID-19 oversight, training staff along the way, and began offering clinic hours at the shelter, rather than bringing residents into the clinic to limit potential exposure.

As of late November, the Union Gospel Mission shelters had seen fewer than 20 cases of COVID-19 — with no recent cases and no deaths, something Johnson proudly attributes to the collaboration between shelter staff and the clinic’s medical staff.

This growing relationship across the two organizations also spurred a new screening of patients: asking about housing status. Already, this has led to one shelter referral of a clinic patient, which Johnson hopes to see continue and grow.

“One of the things that has surprised us and delighted us has been the way that COVID has helped us all work as a much more integrated and holistic team,” he said. “And while that’s been very hard at times, it’s made us better for it.”