The role of a federally qualified health center during a pandemic

ABSTRACT

The COVID-19 pandemic has caused a signicant loss of life and dramatically upended the livelihood of communities across the world. However, as with other health crises, the pandemic has hit low-income communities particularly hard. Epidemiological data have shown that individuals in poorer communities are not only at a higher risk for severe COVID-19 illness and fatality, but are also at a heightened risk of suffering long-term economic and social consequences as indirect effects of the pandemic, highlighting the need for community-wide interventions. As community-based institutions, whose primary role is to provide primary care and divert patients from emergency care, Federally Qualied Health Centers (FQHCs) have a particularly important role to play. The purpose of this presentation is to describe the efforts of a FQHC located in the South Bronx, to prevent the disruption of health care services during the COVID-19 pandemic, and to facilitate critical continuity of care for medically and socially vulnerable patients in an eeffort to mitigate adverse health outcomes. Our FQHC mobilized a COVID-19 response to address two primary goals 1) to prevent disruption inprimary care during a pandemic and shelter-in-place mandate through targeted outreach and telehealthservices to medically and socially vulnerable populations, and 2) to identify and address the increased socialneeds of families adversely impacted by the pandemic through referrals to in-house and communityresources. Our data team compiled lists of patients for outreach based on the aforementioned goals anddistributed them to clinical teams. Priorities for outreach included patients who rely on continuous clinicalcare and families at increased economic and social risk, such as newly-arrived immigrant families and familiesexperiencing homelessness. Telehealth and in-person visits were systematically prioritized to include infants 0to 2 years for well-child visits and vaccinations, children with persistent asthma, and adolescents withcontraceptive needs (e.g. depo provera). Additional outreach was done to patients at heightened risk ofadverse outcomes from a disruption of clinical care, specically pregnant women, patients 70 years of age andolder, and patients with comorbid medical conditions. Social needs were addressed through the expansion ofan existing emergency food pantry to offer household cleaning supplies, personal hygiene products, facemasks, and health education material, and through referrals to community resources. Contactless delivery ofthese supplies was provided for homebound patients. As this work is ongoing, future analysis will describe theextent of need during the COVID-19 pandemic and the impact of our efforts through analysis of clinicaloutcomes including timely immunizations, asthma outcomes, and adherence to reproductive healthtreatments. Lessons learned in our systematic response to this pandemic may be valuable for other healthcenters in planning for how to provide care for children and families during this, and future crises.