Free clinics tell Senate Health and Welfare they fill widening gaps as demand rises

OLIVEA SHERROW, executive director of the Vermont Free & Referral Clinics (VFRC), told the Senate Health and Welfare Committee that the eight-clinic network cared for 12,154 patients in 2024 and relies on a legislative appropriation managed by the Vermont Department of Health that covers just over half of the network’s collective operating expenses.

That funding, Sherrow said, allowed clinics to hire staff, expand space and broaden services. “This funding allows us to keep our doors open, and it also allows us to remain the only place where patients can come where they are guaranteed not to receive a bill,” Sherrow said.

Why it matters: VFRC representatives said their clinics serve people who are uninsured, underinsured or otherwise unable to access care elsewhere; the clinics provide a safety net that clinic leaders say reduces emergency-department visits and hospitalizations.

Sherrow told senators the network’s patients face multiple barriers: about 25% of VFRC patients were uninsured in 2024, roughly 45% were underinsured, 20% lacked a primary care provider, 41% were at or below 200% of the federal poverty level, and 10% were best served in a language other than English. Sherrow said uninsured and underinsured numbers have risen in the last two years.

Dan Barlow, executive director of the People’s Health and Wellness Clinic in Barre, described how the legislative appropriation supported local expansion. “Our annual budget’s about $440,000,” Barlow said. “About 45% of that is the legislative appropriation.” Barlow said People’s Health served 658 people last year, including 229 new patients, and provided roughly 545 medical and 440 dental appointments.

Oral health emerged as a recurring concern. Barlow said a retired dental surgeon now volunteers and that, with legislative support, the clinic expanded dental-hygiene hours and purchased equipment to perform extractions; the clinic performed extractions for more than 100 people in 2024. Sherrow and Barlow said lack of affordable dental care is a major driver of delayed treatment and emergency visits.

Clinic staff described additional services targeted to vulnerable groups: wound clinics for patients injured by xylazine-tainted street drugs, mobile and pop-up oral-health clinics, LGBTQ+-appropriate care clinics and partnerships with harm-reduction providers. Barlow said his clinic runs a xylazine wound clinic and gives out wound-care kits; he described cases in which the wounds can lead to limb loss.

Speakers also raised immigration and law-enforcement concerns. Barlow said clinics are preparing internal plans in case Immigration and Customs Enforcement (ICE) appears at clinic sites and requested guidance about whether ICE can access patient records. He summarized his understanding: ICE can question patients in waiting areas but, in his view, would need a judicial warrant to compel access to protected medical records; he said clinics will consult attorneys as needed. The discussion referenced HIPAA and judicial warrants as the current rules staff are relying on.

VFRC leaders sought level funding for fiscal year 2026. Sherrow said the appropriation is “a little over $1,500,000” for the network and that funding historically has enabled clinics to serve patients who otherwise would use emergency departments. She said the VFRC wants the committee to consider maintaining the appropriation level adopted in recent years; at the committee meeting she said the network intends to request level funding for FY26.

The committee asked operational questions—whether free clinics are federally qualified health centers (FQHCs) and whether volunteers could be offered state tax credits. Sherrow and Barlow said their clinics are not FQHCs and cannot bill Medicaid or commercial insurance; clinic care is provided free, in part, because of volunteer clinicians. Sherrow said she would look into the question of volunteer tax credits and follow up with the committee.

The testimony referenced partnerships and local donations that support operations: Central Vermont Medical Center, United Way grants, donated medical equipment and clothing and local faith-based neighbors that host or support clinics. Barlow said donations of medical equipment and supplies are critical.

The witnesses closed by thanking the committee and offering to return with additional detail if the committee requested it. VFRC representatives requested that legislators “keep that in mind as we’re thinking about solutions” to system-wide pressures that increase demand on free clinics.