North Country HealthCare serves underrepresented people throughout COVID-19 and beyond
When COVID-19 first began spreading in Arizona communities, North Country HealthCare (NCHC) was ready.
The healthcare center was one of the stellar organizations that quickly responded to the crisis and assisted in guiding people to health and safety, and they have continued their much-needed care throughout the long pandemic.
“NCHC is an extremely valuable health resource in northern Arizona, providing accessible and culturally competent care to diverse communities across northern Arizona,” said Samantha Sabo, associate professor for NAU’s Center for Health Equity Research (CHER) and the Department of Health Sciences, who worked on a recent COVID-19 project with NCHC.
NCHC is a federally qualified community health center that offers comprehensive medical services to approximately 55,000 patients at 16 clinics in 12 communities across five counties in northern Arizona: Bullhead City, Flagstaff, Grand Canyon, Holbrook, Kingman, Lake Havasu City, Payson, Round Valley, Seligman, Show Low, Williams and Winslow.
NCHC provides services such as family medicine, pediatrics, obstetrics and gynecology, dental care, behavioral health services, telemedicine, health screenings, and more.
Combating COVID-19
In March 2020, CHER researchers Sabo; Ricky Camplain, assistant professor for CHER and the Department of Health Services; and Louisa O’Meara and Alexandra Samarron Longorio, senior research coordinators, began their collaboration with NCHC’s community health director Amanda Guay and education director Marica Martinic, who have both collaborated with CHER on past projects.
Together, they worked to evaluate and improve NCHC’s COVID-19 response in three areas:
- Expanding COVID-19 testing in all NCHC locations.
- Enhancing access to COVID-19 testing for gap and vulnerable populations.
- Developing and disseminating a COVID-19 Testing Employer Toolkit for small businesses and non-profits.
The project team developed an evaluation tool and questionnaire for patients who received a COVID-19 test at any NCHC location to better understand who was getting tested and why they chose to be tested or, later on, vaccinated.
CHER worked closely with NCHC to generate monthly reports and infographics over the course of 10 months, including reports on the progress of the NCHC employer outreach program.
In this unique community program for nonprofits and small businesses in Gila, Navajo, Apache, Coconino and Mohave Counties, NCHC supplied them with COVID-19 toolkits that included gloves, masks, signs and information that promoted testing for COVID-19.
NCHC used these timely reports and infographics to inform their decisions on their COVID-19 testing efforts across the five northern Arizona counties. For final reports on the project, visit CHER’s reports page.
After analyzing their findings, Camplain said that NCHC has been essential to northern Arizona during the COVID-19 pandemic.”
“They have made services, including testing and vaccines, more accessible to our communities with their multiple locations, multiple testing and vaccine events, and two mobile units,” Camplain said.
According to O’Meara, NCHC “sprang into action quickly,” establishing COVID testing in their clinics across northern Arizona in March 2020 after receiving funding through the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act to maintain and expand its COVID-19 testing program at clinic locations across its three regional hubs in northern Arizona.
“They were able to meet the needs of their clients and community, providing tests at a rate that followed the community trends through the course of the pandemic,” O’Meara said. “They were intentional in their efforts to reach underserved and gap populations, conducting wide-scale testing events open to the public, providing free testing services and PPE kits to small businesses, collaborating with local organizations such as homeless shelters and senior centers, and providing mobile testing and vaccination services once they had the equipment to do so.”
O’Meara said the research team observed that NCHC “achieved their goal of expanding testing opportunities for gap and vulnerable populations, particularly among unsheltered and low-income populations, as well as Hispanic and Native American residents.” A little more than half of surveyed patients receiving COVID-19 tests were described as low-income––qualifying for Medicaid or the NCHC sliding scale payment system. She said that in Flagstaff, NCHC partnered with Flagstaff Shelter Services to provide testing services for unsheltered individuals.
“This was a valuable service, given that people were required to get tested and receive a negative test result in order to stay in the shelter,” O’Meara said. She said that people who tested positive stayed in quarantine rooms at a local hotel.
“North Country is uniquely positioned to conduct outreach to target under-resourced communities, partner with community leadership and safety net programs, and stand up events to increase access to testing and vaccines across the region,” Guay said. “Working with CHER was remarkable because we were able to visualize our date in real time and respond with needed adjustments to our strategies to address changing demands.”
Building community partnerships for research and improved health outcomes
When Beth McManis, an assistant professor in NAU’s School of Nursing, first came to Flagstaff in 2019, she wanted to join with midwives to make a difference for perinatal and postpartum women.
Partnering with Joyce Garcia-Gonzalez, a certified nurse-midwife from NCHC Women’s Health Clinic, and Esther Ellsworth Bowers, a certified nurse-midwife and nurse practitioner in women’s health in NCHC obstetrics and gynecology, they began a project for ongoing postpartum period care at NCHC, with an emphasis on rural and underserved women, that concludes with a smooth transition from maternity care back to primary care.
Using funding through the Southwest Health Equity Research Collaborative (SHERC), their project goals are to ensure women attend their regular prenatal and post-natal appointments and to help them get the care they need in culturally sensitive manner.
One of projects they are tackling is to make sure women who are at high risk have blood pressure monitoring and have cuffs for home use.
“This improves patient health through early identification of blood pressure elevations and increased health literacy and awareness of one’s own health status,” Ellsworth Bowers said. “It also helps with logistics. With a way to monitor blood pressure at home, patients can use telemedicine rather than coming to the clinic, which allows them to keep prenatal and postpartum appointments even during the height of COVID surges, or with current challenges such as gas prices.”
They are also addressing hypertension through the American Heart Association’s Target: BP program—a national initiative to assist health care organizations to address blood pressure control.
The team will continue to address issues that prevent women from getting the regular care they need as their valuable partnership grows.
“It has been a privilege and an honor to work on this [project],” McManis said.
For more information on McManis’s Project with NCHC, watch her recent Fairness FirstX talk, “Using a Health Equity Lens to Expand Postpartum Care for Women in Underserved Communities,”through SHERC.
This research received funding from the SHERC (U54MD012388), which is sponsored by the National Institute on Minority Health and Health Disparities (NIMHD).