Calgary Refugee Health Clinic could shut down with majority of funding pulled, doctor warns

A Calgary medical clinic that provides health care to thousands of refugees a year may soon have to close its doors due to funding cuts.

The Calgary Refugee Health Clinic, based in the city's northeast, has a roster of 2,500 patients and sees a steady influx as newcomers arrive in the city.

But, according to the clinic's medical director, a large portion of its operational funding will be cut off in a matter of months.

"We're frustrated. We're anxious," said Dr. Rachel Talavlikar, who is also a family physician at the clinic.

"We're not understanding why a health system would create more issues when we're already in crisis." 

The clinic receives approximately $1.6 million a year from the Mosaic Primary Care Network to help with operational costs, according to Talavlikar.

But staff members have been informed that funding will stop at the end of March, she said.

In addition, efforts to secure funding through the provincial government have failed, despite meetings with Alberta Health officials.

"These people arrive at a time of crisis," she said. "These patients are resilient … but they need and deserve that initial support."

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According to Talavlikar, the clinic is the only one of its kind in Calgary, providing intensive multi-disciplinary health care to refugees when they arrive and helping them through the resettlement process.

And it takes in between 1,000 and 1,500 refugees a year, she said.

"We respond to international crises and surges in arrivals."

The team of more than two dozen doctors includes family physicians, infectious disease specialists, psychiatrists and internal medicine physicians. Other service providers include nurses, patient navigators, psychologists and social workers. 

The clinic provides key stabilizing services for refugees, including initial health assessments and screening tests, treatment for acute health concerns and chronic health conditions in addition to other services such as immunization.

With translation services in place, the team helps patients access social services and settlement agencies and, after some time, it helps them transition to permanent care in the community.

"It's really backwards thinking if we take that away," she said.

Talavlikar said doctors will try to help as many patients as they can with basic care, if the multi-disciplinary clinic shuts down, but the impact could be significant.

"I think we will see an increased strain on our emergency rooms as well as our other community walk-in services," she said.

"Or, more devastatingly, we will see people who arrive, and perhaps have unmet health needs, and then sadly they show up in the ICU in liver failure or heart failure or a situation that did not need to happen."

After initially declining to comment on the operational funding changes, the Mosaic Primary Care Network shared a statement with CBC News on Friday afternoon, through a public relations firm.

"Over time, patient volume and complexity of care have grown significantly, surpassing the capacity of Mosaic's PCN's mandate," the statement reads in part.

"We have been working closely with the physician leaders since November 2023 on a long-term sustainability plan to better serve refugee patients within the system."

It said funding will continue until the end of March. After that, it appears the PCN expects care will shift to its 400 family physician members in the community.

"Our PCN refugee and newcomer program provides services in partnership with our committed members and will continue to do so beyond March 2025, supporting their smooth transition into long-term medical homes."

Government response

When asked about the situation at a Thursday news conference, Health Minister Adriana LaGrange said provincial funding for programs such as this typically flows through primary care networks. 

"This would be a relationship between the primary network and that particular clinic. So I would encourage them to continue having those conversations" she said.

Talavlikar said that when it became clear the Mosaic funding would end, her team had several meetings with Alberta Health officials to ask for grant money, including one meeting with the assistant deputy minister of health, but their request was refused.

When asked if she's concerned about the impact the funding cuts could have on newcomers, LaGrange acknowledged there are questions.

"I'm certainly worried about anyone — refugee or otherwise — who comes to Alberta and requires care. We want to make sure that everyone is looked after," she said.

"I'm not familiar with the particulars of this particular case, so I will look into it and see if more can be done. But this is a primary care network that has been funding this particular situation," she said.

A statement from the health minister's office said the decision to cut funding was an "independent board decision" within the primary care network, and Alberta Health has no authority over that decision.

"Alberta Health has had discussions with the Mosaic Refugee Health Clinic and the Mosaic PCN and will be meeting with both groups in the coming weeks to facilitate a discussion and work towards a meaningful solution," the emailed statement said.

According to Talavlikar, the total cost to operate the Calgary Refugee Health Clinic is approximately $2 million a year.

In addition to the money traditionally provided by the Mosaic PCN, doctors contribute $350,000 annually to the operational funding budget.

None of the physicians work full time at the clinic. They're paid by the province for seeing patients through an alternative relationship plan and, in some cases, on a fee-for-service basis.

"The reality is that a specialized outpatient service for a very vulnerable population cannot be operated on overhead alone," Talavlikar said.

Meanwhile a non-profit society has been set up and doctors have started fundraising in an effort to keep some services running.