Embedding Equity throughout the COVID-19 Response Organizational Structure

To reach communities that are most impacted by inequities during the COVID-19 pandemic, it is essential to integrate considerations for these communities of focus into all aspects of the response efforts. When equity work is sequestered to one area of the response, there are often siloes in the work and equity considerations can become reactive instead of proactive.

Background

For the COVID-19 response, the Minnesota Department of Health (MDH) stood up an Incident Command System (ICS) to resource, coordinate, and manage activities related to the public health emergency. The ICS functions as an organizational chart and reporting structure that allocates staff to different areas of the response. The standard ICS model is flexible to meet the needs of a wide range of emergencies, but the standard structure includes Operations, Planning, Logistics, and Finance sections. The plan was built upon the existing All-Hazards Response and Recovery Plan for Minnesota. 

Organizational Overview 

Systemically embedding a focus on refugee, immigrant, and migrant (RIM) communities throughout the ICS has been a promising approach to ensuring that these communities’ needs are met during the response. Multiple teams throughout MDH have integrated considerations for these communities into their work and structure. This approach recognizes that RIM communities cannot have their emergency needs met by just one person or one team but rather by many areas of the response practicing processes that promote equity. 

A hub of this work in the MDH ICS is the Cultural, Faith, and Disability Communities (CFD) Branch, which falls within the Local/Tribal/Community Health/Partners Section, under the Operations Bureau.

The CFD Branch encompasses the following teams and responsibilities: 

  • The Seasonal and Agricultural Workers team has collaborated with COVID-19 testing workgroups, the Department of Employment and Economic Development, and local public health to address worksite outbreaks and migrant worker needs. 
  • The Community Liaison team has MDH employees who work as trusted messengers with specific cultural and ethnic communities in Minnesota, such as African communities, Asian and Pacific Islander communities, Latino communities, and recently arrived refugees. 
  • The Communications, Media, and Materials team coordinates translation and dissemination of COVID-19 educational materials in 14 languages spoken by Minnesotans. In addition, this team leads an initiative to share stories of community partnership during the COVID-19 response. 
  • The Contracts team manages relationships with Diverse Media Vendors and Community-Based Organizations that are working to share messaging about COVID-19 to diverse communities and provide input from communities back to MDH. 
  • COVID-19 Community Coordinators are community-based organizations that connect Minnesota's diverse communities to COVID testing and resources. A team of lead coordinators at MDH manage these grants. 
  • The Disability team works in partnership with other state agencies, community-based organizations and advocates to address the needs and concerns of people with disabilities and special health needs and conducts regular outreach, including monthly community calls. 
  • The Faith team conducts outreach and ongoing relationship building with faith-based organizations throughout Minnesota to provide relevant COVID-19 information, listens to community needs and questions, develops and disseminates guidance, shares resources, and promotes consistent messaging in collaboration with faith leaders and local public health.  

Cross-Agency Collaboration for Impact 

A key aspect of promoting equity for RIM communities in the COVID-19 response has been explicitly including equity considerations across the response. The CFD Branch has coordinated across areas of the response to ensure that equity is embedded in all activities. The CFD staff informs actions of other teams and advocates for change when needed in key areas. A few examples of this include: 

Case Investigation and Contact Tracing (CICT) 

  • The agency tapped bilingual/bicultural staff at MDH to conduct interviews. MDH also worked with a hiring agency to recruit more multilingual interviewers. Both approaches improve the timeliness of CICT interviews. 
  • The CICT interview forms were reviewed and adapted to improve plain language. For example, the Tennessen warning script section was revised multiple times with CICT staff representing various refugee and immigrant communities. 
  • Data collection includes race/ethnicity with improved disaggregation, preferred language, sexual orientation, and gender identity 
  • Efforts to collect preferred language at registration (community testing) 
  • Training offered to CICT staff on how to ask sexual orientation and gender identity questions, with specific framing and language that is culturally specific 
  • Community engagement efforts have included campaigns to encourage community members to “accept call from MDH or local public health” 
  • Videos were created with community input to address fears about CICT 
  • Establishment of a community advisory committee on CICT – members include refugee, immigrant, and migrant community organization representatives  
  • Staff from across the agency continually elevated and addressed issues as they arose 

Testing 

  • Collected community input on how to improve accessibility of testing sites 
  • Advocacy for language access, transportation assistance, educational material development, and trusted community site locations 
  • Linked community leaders interested in hosting testing sites with the state and local partners to help stand up sites 
  • Advocated for testing sites in specific communities of focus as needed 
  • Connected community partners with opportunities to tour testing sites and provide feedback 

Vaccination access, allocation, and distribution 

  • Collaborated with the communications team and vaccine experts to create a Vaccine 101 presentation that can be used for community presentations 
  • Formed a diverse team of Vaccine Ambassadors to respond to culturally-specific vaccine speaking requests received by MDH and have community-specific spokespeople well versed on vaccine-related messaging   
  • Represented the CFD branch and RIM communities on the COVID-19 Vaccine Allocation Advisory Group to advocate for equity in vaccine allocation 
  • Coordinated with the Vaccine Equity and Engagement Team. This team serves as a team solely focused on planning and engagement on vaccination efforts, working closely with the Cultural, Faith, and Disability branch of the response.  The team consists of staff who serve as Vaccine Outreach Directors, planning community vaccination sites, collaborating on plans for mobile vaccination clinics, and messaging with local partners and leaders about updates and development in vaccine rollout.
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