In the COVID-19 response, partnerships are essential to reach underserved communities, maximize resources, reduce duplicating efforts, and improve the delivery of services and resources. Federally-Qualified Health Centers (FQHCs) and local health departments (LHDs) share goals to improve community health, particularly among disproportionately impacted populations. Collaboration allows limited federal, state, and local resources to be targeted and allocated to areas that need the resources most. Likewise, it is also essential to provide information and services via channels that community members actively use and trust.
Reaching Communities Through FQHC Partnerships
FQHCs are community-based health care providers that receive federal funds to provide primary care services to underserved populations and communities. They offer comprehensive care, including preventive health, dental, mental health, and substance abuse services, hospital and specialty care, and even transportation services related to patient care, all on a sliding fee scale. They may be community health centers, migrant health centers, healthcare for the homeless, or health centers for public housing residents. FQHCs are often deeply rooted in their communities and are uniquely positioned to bridge cultural and linguistic knowledge gaps for health departments.
Health departments partner with FQHCs to address COVID-19 impacts by offering pop-up and clinic testing sites, community-based interpreters, and access to resource coordinators. Together the partnerships are successfully implementing multilingual education to prepare community members for the next steps and help identify social support needs.
Partnering with Community-Based Organizations and Culturally Matched Patient Navigators in Colorado
Denver Health Refugee Clinic, Colorado Department of Public Health and Environment (CDPHE), and a non-profit organization, Immunize Colorado, partnered to outreach a cohort of refugee arrivals to provide missed vaccinations. Funding for outreach was provided by a local family foundation. The concern was that baseline barriers to receive health care, including vaccinations, was exacerbated by the COVID-19 pandemic. A culturally matched refugee patient navigator initially outreached refugee families to link them to appointments to receive any needed vaccinations at the FQHC. Barriers, including transportation, access to appointments, and any questions about the need for vaccinations or safety to come to the clinic during the pandemic were addressed and tracked through standard scripting in the FQHC’s electronic medical record. Outreach incorporated education on influenza vaccination and linkage to influenza vaccine clinics. Currently, outreach has focused on linking RIM populations identified in the Denver Health and Hospitals EMR to COVID-19 vaccinations.
Partnering with FQHCs in Washington
HealthPoint in King County, Washington, collaborates with Seattle and King County Public Health Departments to improve access and equity in their RIM communities. Before COVID-19, they worked together to conduct outreach and operate vaccination and school-based clinics. Since COVID-19, they initiated biweekly COVID Response and Racial Equity conference calls that include other community health centers to review community needs and develop plans. As a result of these collaborations, they have created easy access to indoor testing at primary care clinics and high-volume outdoor testing centers open to their community members. People who are positive for COVID-19 will have access to FQHC patient access coordinators/patient navigators to connect clients with support services and quarantine facilities through the health department.
When COVID-19 affected the migrant worker community in Washington, Columbia County Public Health reached out to Columbia Valley Community Health, who formed a mobile outreach team comprised of medical assistants, a nurse, and a provider to offer testing and education in migrant work camps. The partnership allows public health to communicate COVID-19 responses between the health department and the clinic so the outreach team can mobilize quickly and go on-site with their mobile clinic for testing or CICT. Since the members of this team are from the FQHC, they are familiar with the community and have the trust of their clients
Partnering with FQHCs in New York
To meet their need for multicultural and multilingual CICT staff, the Erie County Department of Health in Buffalo, NY, reached out to Jericho Road Community Health Center. The health department recruited the FQHC's interpreting staff to aid in contact tracing efforts. Hiring from within the community and offering linguistically appropriate messages can help build trust and increase community members' willingness to share information.
Partnering with FQHCs in California
The Marin Department of Health and Human Services leveraged their partnership with Marin Community Clinics to support COVID-19 response in their community. The clinics offer daily drop-in community testing run by the county but staffed by the clinic. Because of the clinic's relationship with the community, they have found that people often feel more comfortable sharing personal information for case investigation and contact tracing (CICT) activities. An online form is used to collect data such as preferred language and shared with the county to facilitate CICT. The clinic's nurses also help clients navigate services such as the county food delivery program, pop-up food banks, and temporary quarantine/isolation housing by providing bilingual resource sheets to help with social support needs.
Partnering with FQHCs in Connecticut
The Connecticut Department of Public Health serves their vulnerable communities through collaboration with the FQHC, Fair Haven Community Health Care. Together they host pop-up clinics in residential spaces with higher COVID-19 prevalence and utilize the trusted school-based health centers and staff (since schools are remote) for additional community-based testing events. The testing events are open to all community members and allow the FQHC to screen residents for food insecurity and social support needs. They found about 70 percent of their patient population identifies food insecurity as a significant issue. They acquired grant funding to partner with one local grocery store and a local cab company to deliver a large box of produce and other basic groceries within a week of having their COVID-19 test to meet this need. "We're not under any illusion that that's healing food insecurity, but at least it can help mitigate those needs during that isolation period for people who may otherwise need to go to the corner store or the grocery store," says Ben Oldfield, Chief Medical Officer, Fairhaven Community Healthcare.
Partnering with FQHCs in Maryland
To better serve their migrant worker population, The Somerset County Health Department in Maryland conducts tristate meetings with FQHCs and community-based organizations (CBOs) to monitor COVID-19 outbreaks among workers moving along the coast. The Routine Multiagency Migrant Meetings led by the public health department include East Coast Head Start, Social Services, FQHCs, and the summer schools for migrant children. The health department leverages the relationships with these groups that interact face to face with their migrant community. The FQHCs and CBOs share available services and support public health initiatives with their community. Specifically, the FQHCs help communicate testing information and provide transportation for the workers.