Annette Kowal
President, Chief Executive Officer
At the heart of this story is the fact that CHCs are strong organizations that maintain the highest quality care under all circumstances, and do so to keep their patients and communities healthy. The CHC movement was founded more than 50 years ago on the idea that everyone deserves access to health care, and flourished from a few small sites scattered around the country to an integral part of America’s health care system. That same optimistic spirit still thrives in the CHC movement today, and the stories about communities staying strong during crisis are living proof
Shutdown
Americans have been called on to serve our country time and time again. You have a chance to be a hero … and to save thousands of lives by staying home.
– Governor Jared Polis, issuing a statewide shelter in place order on March 25, 2020.
A New Way of Life
With that order, Colorado began the rapid transition from bustling state to near ghost town. Schools closed. Most businesses sent their employees home to work remotely or laid off staff. Tourists cut vacations short. Even playgrounds were abandoned.
Meanwhile, an army of essential workers mobilized, providing residents with vital goods such as food, water, power and of course, health care. As the state’s largest primary care network, Colorado’s Community Health Centers played a vital role in delivering pandemic related care. With COVID-19 spreading quickly, CHC staff had to move fast to find new ways to provide services while still safeguarding employee health.
KEEPING PATIENTS INFORMED
Communicating effectively with staff and patients became crucial. MarillacHealth instituted an Incident Command Team that met daily to monitor and respond to public health advisories and implement COVID-specific operational strategies. MarillacHealth’s first actions included developing a “quick screen” for anyone entering the main clinic and creating a triage system for patients presenting COVID-19 symptoms.
Since any in-person interaction carried a great deal of risk, obtaining protective gear became a top priority for all CHCs. STRIDE Community Health Center partnered with Jefferson County Public Health and the National Strategic Stockpile to maintain supplies of masks, gloves and gowns for providers and staff. The facilities team at Valley-Wide Health System made at least 800 masks for staff and their families and had enough extras to provide masks to patients and others in the community.
Community Health Centers also served as key conduits of information during the early days of the pandemic, offering resources on their websites and social media channels about how to stop the spread and how to distinguish symptoms of COVID-19 from other illnesses.
CONTRIBUTING TO THE CAUSE
Some providers contributed to the effort to develop effective COVID-19 treatments. Dr. Makenzie Lewis, a physician at Clinica Family Health, developed antibodies after contracting COVID-19 in late March. She donated her plasma to help others in Colorado recover from the disease.
Maintaining Access to Care
Although there were times when we couldn’t be physically connected with our patients, our care team made sure that our hearts were connected and our patients felt cared about
– Ben Wiederholt, former CEO, STRIDE Community Health Center
TeleHealth
Once CHCs worked through the initial crisis of the pandemic, maintaining access to primary care became the top priority. Many expanded telehealth services, created outdoor care spaces, and provided enhanced call center support. Others created entirely new outreach and care programs. No amount of creativity was off-limits.
For example, Colorado Coalition for the Homeless equipped backpacks with telehealth gear for nurses to use on-site with patients staying in housing programs. This enabled nurses to help patients visit with a provider remotely. Tepeyac Community Health Center provided blood pressure monitors, glucometers, lancet test strips, and pulse oximeters to patients, in coordination with a phone or video visit with their provider, for self-managed support.
Northwest Colorado Health pivoted to online paperwork systems, including an online process for patients to check-in from home or from their car. High Plains Community Health Center set up a screening system via telephone at their front door. Based on the screening, patients were either allowed to enter the Community Health Center, or providers would don personal protective equipment and visit the patient outside by their car.
Sheridan Health Services partnered with bilingual nursing students to help Spanish-speaking patients. The nurses helped patients manage concerns about privacy, get comfortable using Zoom, have their questions answered, and feel reassured. The result was a nearly 50 percent increase in Sheridan’s telehealth appointments by May, 2020.
CURBSIDE CARE
To overcome the challenges of social distancing, increased demand for care, and known risks of indoor transmission, many CHCs offered services outdoors. Sunrise Community Health set up drive-through dental screenings. Salud Family Health offered curbside pick-ups for all medications. Uncompahgre Medical Center rented large tents with wrap-around walls and propane heaters, converting their ambulance bay into a COVID-19 testing site. Summit Community Care Clinic set up an outdoor tent to treat patients who showed symptoms of COVID-19.This essential outdoor area started as two tents from people’s backyards, put together in 24 hours, and grew to a more permanent and widely-used structure.Across the state, CHCs organized drive-through COVID-19 testing in parking lots and curbside, so that patients could get tested without having to leave their cars.
TRANSPORTATION
Transportation, a known barrier to care, was especially limiting for patients early in the pandemic. Valley-Wide Health Systems,Inc. serves a nearly 8,000-square-mile area of farmland and natural open spacein the San Luis Valley. In August 2020, Valley-Wide launched the Valley-Wide Ride program, giving patients the ability to book a free ride to health care appointments, the gym, grocery store, library, laundromat, or wherever they needed to go.Other CHCs got innovative as well. Salud partnered with local businesses to provide transportation and mobile care for migrant workers. Denver Health’s Community Health Services brought a new mobile Community Health Center into service, prioritizing COVID-19 services
Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s standard dummy text ever since the 1500s, when an unknown printer took a galley of type and scrambled it to make a type specimen book. It has survived not only five centuries, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more recently with desktop publishing software like Aldus PageMaker including versions of Lorem Ipsum.
Testing
We’re building this car as we’re driving
– Governor Jared Polis, May 2020
As COVID-19 cases, hospitalizations, and deaths continued to mount, Colorado health officials increased community testing from 2,000 to 10,000 people per day. Community Health Centers became a critical partner in the effort to test Coloradans and prevent community spread
COMMUNITY TESTING SITES
In April 2020, Pueblo County opened a COVID-19 drive-through testing site,and Pueblo Community Health Center, Inc. employees were among those staffing the site. Peak Vista Community Health Centers set up drive-through testing sites in Colorado Springs. STRIDE Community Health Center set up mobile testing sites in coordination with Front Range businesses, school districts, and public health agencies. MarillacHealth, Salud, and many other Colorado CHCs partnered with local schools, businesses, and shopping centers to coordinate free drive-through testing sites.
Rural CHCs like Uncompahgre used radio, newspapers, and social media to get urgent messages out in English and Spanish about free COVID-19 testing locations. Despite the cold Colorado weather, Mountain Family Health Centers set up outdoor testing. Staff and volunteers at every CHC got creative to make sure they had adequate supplies of personal protective equipment (PPE) and testing materials. In fact, when Clinica Family Health experienced an extreme shortage of testingequipment, they worked with Quest Diagnostics, their lab partner, to create their ownCOVID-19 test kit. The collective effort of Colorado CHCs to provide COVID-19 testing was nothing short of monumental.
HONORING EMPLOYEES AND VOLUNTEERS
It is hard to come up with adequate language to express how inspired I am by the people who work at Colorado Community Health Centers. They have risen to the challenge in communities across the state
– Annette Kowal, CCHN President & CEO
Throughout 2020, the public recognized frontline workers and healthcare professionals as heroes, who worked extra-long hours to keep their communities safe. Even now, it’s hard to comprehend the endurance, dedication, compassion, and courage they demonstrated during those long, dark, and often hopeless days.
EXPRESSING GRATITUDE
Many of thehealth careworkers, especially those who stepped in at the very beginning, were volunteers. Nancy Carlson, for example, was a retired pediatrician who responded to the dire need for masks and PPE by raising money for healthcare organizations, including Clinica. Nancy’s GoFundMe page raised $1,650 in 36 hours to help the CHC buy masks and reusable gowns.
Community Health Centers found small but meaningful ways to thank their staff and volunteers. Axis Health System’s Integrated Healthcare Clinics created a series of “Who’s Behind the Mask?” messages to honor their healthcare heroes and connect with their patients. Salud issued Certificates of Appreciation. Many CHCs shared team photos on social media and received handwritten notes from patients thanking their healthcare heroes. It was a genuine team effort.
COPING WITH COVID
Getting through COVID means being here for each other, and for our communities. You are not alone. We’re here to lend a helping hand to you and your family.
– The Team at Salud Family Health
As the pandemic wore on, stress, exhaustion, and despair wereinevitable. Stories of nurses and doctors leaving the profession became common. Burnout became a serious threat to healthcare organizations. Resistance to mask mandates, remote learning, and stay-at-home orders manifested as frustration aimed at public health officials and healthcare workers.
You Are Not Alone
CHCs responded with messaging to address mental health, including offering coping strategies for staff and patients alike. Some set up mental health hotlines. Others provided tips for stress management or how to help older neighbors who live alone. Rural CHCs like River Valley Family Health Centers and Axis expanded outreach to migrant workers and other high-risk populations. Axis created a specific campaign focused on mental health services. Colorado Coalition for the Homeless developed four lodging contracts to provide 700 rooms, primary and behavioral health care, and essential social services to houseless Coloradans. Many CHCs offered links to resources for individuals who lost their jobs or health insurance. Working as a community, CHC staff were a force to be reckoned with.
Vaccination
There are things we can’t ever capture in numbers. Grandmothers who asked to hug us because they could now see their grandchildren after an entire year. Teenagers who were thrilled because it meant they could go to prom. Entire families who showed up to get a vaccine and enjoy some green chili and music. There are no other words to describe taking a drink out of a firehose except one: life-changing
– Mitzi Moran, Sunrise Community Health CEO
Mobilization
In December 2020, when frontline healthcare workers were among the first in Colorado to receive the new COVID-19 vaccine, we finally saw the light at the end of the tunnel. Relying heavily on CHCs as part of Colorado’s efforts to stop the spread, Governor Polis tasked Colorado Community Health Centers with vaccinating 15 percent of eligible Coloradans. Throughout 2021, Community Health Centers mobilized to vaccinate as many people as they could reach.A year later, Colorado CHCs had administered over 615,900 doses.
Outreach
Communicating effectively with staff and patients became crucial. MarillacHealth instituted an Incident Command Team that met daily to monitor and respond to public health advisories and implement COVID-specific operational strategies. MarillacHealth’s first actions included developing a “quick screen” for anyone entering the main clinic and creating a triage system for patients presenting COVID-19 symptoms.
Since any in-person interaction carried a great deal of risk, obtaining protective gear became a top priority for all CHCs. STRIDE Community Health Center partnered with Jefferson County Public Health and the National Strategic Stockpile to maintain supplies of masks, gloves and gowns for providers and staff. The facilities team at Valley-Wide Health System made at least 800 masks for staff and their families and had enough extras to provide masks to patients and others in the community.
Community Health Centers also served as key conduits of information during the early days of the pandemic, offering resources on their websites and social media channels about how to stop the spread and how to distinguish symptoms of COVID-19 from other illnesses.
Moving forward
Community Health Centers are founded on the idea that health care should be available to everyone, regardless of their income or what community they live in. CHCs take that commitment seriously – in fact, the majority of the members of everyCHC board of directors are patients of that CHC. “Community” has always been the underlying spirit of CHCs.
The COVID-19 pandemic has required high levels of flexibility, courage, and most of all, love of our communities. Throughout the pandemic, the individuals who work at Colorado Community Health Centers took their love of their patients and communities to new levels. They learned new skills, took on new tasks, supported each other in personal and professional upheaval, all while caring for their patients and their own families.
As COVID-19 moves from a pandemic to an endemic, CHC staff will continue to care for their communities. They already knew about innovation and resiliency; and will add what they have learned and created to their ongoing care and preparation for the future. They embody the spirit of community. We all benefit from that unwavering commitment, and we are deeply grateful.
