Community health centers (CHCs) provide comprehensive healthcare services to medically underserved populations. If you’re thinking, “Don’t all healthcare organizations, in some ways, do that?” Of course! But there are some key differences between CHCs and traditional hospitals, ERs, and clinics. For instance, CHCs:
- Serve all — the uninsured, the underinsured, non-English speakers, rural dwellers, everyone
- Are patient-centered — their approach is based on the needs of the community they serve
- Don’t only provide healthcare — they provide other services too, like transportation, case management, and education
- Are representative — federally qualified health centers (FQHCs) must have a board of trustees made up of 51% patients who have received care at the center
- Make their mission simple — improve care, access, and health equity in underserved and impoverished communities
As you can see, CHCs hold a special place in our healthcare system, and they are a reason why CLI attended and exhibited at Minnesota’s Many Faces of Community Health Annual Conference. While the venue changed from last year because of the pandemic, the spirit of and devotion to CHCs remained ever present.
We weren’t able to attend all the sessions, but what we were able to catch was incredibly insightful (summarized below).
Authentic Leadership for Times of Change
Sarah Horst, MA, CPHQ, at Institute for Clinical Systems Improvement (ICSI)
The pandemic, along with the civil unrest inflamed by the murder of George Floyd, has accelerated change, especially in Minnesota. When we’re met with change, Sarah Horst explained how we tend to fall back on what we know. But this type of change, what we’re experiencing now, is different. We’re unable to rely on what we know and what we viewed early in 2020 as “normal.” So what did we do? We set limits and created a new path, a new standard of doing things. We adapted. We improvised.
If our histories truly do shape our present, Ms. Horst has this on lockdown. She’s currently team lead at ICSI, but her background is in improv (amongst other, more distinguishable achievements, of course!)
She used this experience to develop the Quality Improv(e) Framework, an approach to quality management that blends traditional quality improvement methods with those of improv. She discussed the five rules of improvisation and shared how they can be applied to help leaders be more nimble, resilient, and authentic:
- Concept: Play the scene you’re in, not the one you wish you’re in.
- How to apply it: Say yes, and . . .
- Concept: Believe you are enough
- How to apply it: Fire the judge
- Concept: Tolerate uncertainty
- How to apply it: Create the space for something to emerge
- Concept: Bring a brick, not a cathedral
- How to apply it: Remember that you don’t have to do it alone; it’s OK not to have all the answers
- Concept: Reflection
- How to apply it: Check in with yourself and debrief
Collaboration through Two Pandemics: Racism & COVID-19
The People’s Center and CUHCC, two community health centers that serve diverse communities in Minneapolis, delivered a joint presentation on how they partnered to deliver COVID-19 testing and education to the highly diverse neighborhood of Cedar-Riverside. Their goal was to increase testing, identify positive cases (and help them self-isolate), and increase education and awareness.
Traditionally, this west Minneapolis neighborhood has a rich history of immigration dating back to WWII. To get a better idea of the makeup of the Cedar-Riverside community, Jokho Farah provided some statistics from Minnesota Compass:
- Out of the 10,000 people who live in Cedar-Riverside, 4,000 are from 67 countries and speak 93 languages
- 65% are persons of color; two-thirds are African/African American
- 22% have a high school diploma; 9% have a bachelor’s degree
- 57% use public transportation, bike, or walk to work or school
Like many minority communities across the U.S., Cedar-Riverside faced challenges that made navigating COVID-19 difficult:
- Officials initially only shared information in English. Translated materials were delayed, so many non-English speakers didn’t understand the virus’s severity at first.
- Many residents are frontline workers. Like translated guidelines, work safety precautions were delayed or simply not put in place.
- Many families live communally in multi-generational homes.
- There is a long history of distrust toward western healthcare among the Cedar-Riverside residents, largely because of institutional and structural racism.
- Solutions, like telehealth, aren’t accessible. A lot of the patients don’t have internet, a private space, smartphones, or a job where they can take a phone visit.
The People’s Center and CUHCC were in a unique position to help Cedar-Riverside with COVID-19 because they have the trust of community leaders, they remained open and available (they never closed) during the pandemic, they provide holistic care, and they are nimble.
Through self-education, leveraged partnerships, resource sharing, and federal and state COVID-19 funding, the two CHCs were able to set up mobile testing clinics to meet the needs of the community where and when they needed it. So far, they’ve performed an astonishing 700+ tests.
These mobile sites served a dual purpose. The first was obviously testing, but the second was more about building touchpoints to other issues. For instance, they were able to promote voter registration and educate their patients on how they can shape the future of health in their community.
Federal and State Policy Update
Danny Ackert, MPH, Minnesota Association of Community Health Centers
It’s an election year, and, if we learned anything from 2016, it’s not to trust polls. Danny Ackert echoed this sentiment several times during his presentation. So what was the first thing he did after noting the inaccuracies of polling? He showed us a poll. (He was acutely aware of the irony.)
After looking at the current polling in Minnesota, he discussed the federal laws under threat that will affect CHCs and the patients they serve. The outcome of the election will be a huge determinant in whether or not the following legislation will survive and in what capacity:
- COVID-19 stimulus: Ackert summed up the stalled bill as politics and positioning before the election.
- CHC funding: Congress supports CHCs and acknowledges they have been instrumental in pandemic response. But CHCs are still waiting for extended funding.
- Affordable Care Act (ACA): It’s on the chopping block once again. The Supreme Court will hear arguments against it beginning November 10. If abolished, 24 million people would lose their health insurance immediately.
He also discussed the 340B drug discount program, a coronavirus COVID vaccine, Minnesota-specific laws, and the increased use of telehealth.
His message: Vote like your life depends on it!
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