Collaborations with Community Health Workers (CHWs)
Collaborations Toolkit, Community Partnerships to Address the Consequences of the COVID-19 Pandemic Among Residents of Public Housing
The CHW Place-based Approach to Health (CHW PATH) is a collaboration between the U.S. Department of Health and Human Services (HHS), Office of Minority Health (OMH), and the U.S. Department of Housing and Urban Development (HUD). The goal of CHW PATH is to create Community Health Worker (CHW) job opportunities for residents of public housing and to assess the benefits of embedding CHWs within their own public housing communities to provide peer-to-peer support for health and social needs. CHW PATH is a pilot within the Jobs Plus program and aims to develop novel CHW positions that are informed by existing CHW models/roles (e.g., care coordinator/navigator, health educator, cultural mediator, community organizer, promotores de salud) while tailored for the unique needs and contexts of public housing settings.
Collaboration on Flu Vaccinations
Flu LEAD Webinar Series
The Flu LEAD (Linkages to End Access Disparities) project’s goal, which is no longer active, was to increase influenza vaccination coverage among residents of HUD-assisted communities and improve community health and resilience by fostering partnerships between HUD-assisted communities and local HRSA-funded health centers.
To improve vaccination rates, health center staff provided flu shots through curbside services, door-to door, mobile units, transportation, and virtual follow ups through telemedicine. They prioritized the elderly and disabled.
Overall, around 30% of the individuals vaccinated in the Flu-LEAD project became patients at the health center. The keys to the success of the program are communication within the health center and with local housing staff and residents using multiple methods of contact and promotion. Health centers also utilized student nurses to administer vaccine as well as CHWs to act as a liaison between the housing agency and residents and patients.
Collaboration on Health Education and Outreach
Health Center 101: Building Housing/Health Partnerships
Greater Meridian Health Clinic (GMHC) and Meridian Housing Authority (MHA) engage in joint marketing to improve outreach by collaborating on MHA’s newsletter; MHA website updates; and mass emails to employees. They engage in door-to-door flyer distribution by MHA team members, utilize an MHA summer intern to conduct surveys and access Resident Opportunities and Self-Sufficiency (ROSS) Coordinators and Public Housing Self Sufficiency Coordinators to promote health education.
Collaboration to Address COVID-19 Vaccine Confidence and Accessibility
Health Center 101: Building Housing/Health Partnerships
Greater Meridian Health Clinic (GMHC) and Meridian Housing Authority (MHA) leveraged their networks and relationship to improve vaccine hesitancy for COVID-19. They utilized Resident Advisory Board Support (RAB), public figure endorsements, addressed concerns about vaccination with residents during RAB meetings, and provided vaccine education through ROSS and Public Housing Coordinators. To improve COVID-19 vaccine accessibility, MHA team members set up tents on each site to accommodate residents and coordinated schedules with GHMC’s mobile unit to vaccinate residents.
The key to their successful collaboration is establishing resident buy-in. The RAB’s President provides positive testimony on GMHC services, RAB’s building captains promote COVID-19 vaccination, and MHA’s grounds crew assist with mask distribution.
Collaboration to Address COVID-19
Health Center 101: Building Housing/Health Partnerships: Miami-Dade Homeless Trust and Good Shepherd Health Center
Good Shepherd Health Center and the Miami-Dade Homeless Trust collaborated to address COVID-19 testing and vaccination for homeless individuals in Miami-Dade county. The Trust created five full service quarantine and isolation sites, that included meals, telehealth, case management, and security for homeless individuals. The health center provided consultation on quarantine and isolation protocols and ongoing engagement at all sites. There was a total of 4,912 total intakes over the course of the pandemic.
Health Center 101: Building Housing/Health Partnerships: San Ysidro Health
The goal of the partnership between San Ysidro Health (SYH) and the San Ysidro Housing Authority was to expand the health center’s reach into low-income housing properties to be able to provide Program of All-Inclusive Care for the Elderly (PACE) services to residents to ensure quality health care. SYH worked with housing sites to add a mobile clinic for on-site COVID-19 testing. SYH also offered vaccination appointments for seniors and arranged transportation and follow up. During phases of vaccine shortage, the partnership helped vulnerable seniors gain access to needed COVID-19 vaccination.
Collaboration to Improve Access to Care
Health and Housing Partnerships Report: TCA Health and Chicago Housing Authority
Illinois issued special funding to community Health Center Programs to help individuals and families enroll into affordable health insurance plans. TCA Health Inc. (TCA), a health center in Chicago, had previously experienced challenges reaching public housing residents in their service area. TCA contacted the Chicago Housing Authority (CHA) to find ways to educate public housing residents about healthcare coverage and services available, particularly those in the Riverdale, Altgeld/Murray community.
TCA Health and CHA collaborated on a grant proposal to improve outreach and enrollment. As part of the grant application, each organization provided a letter of support defining the initiative and outlining the terms of the collaboration. With shared resources, TCA and CHA were able to hire and train two public housing residents to conduct outreach and enrollment activities. TCA worked with CHA’s property managers to enroll public housing residents into health insurance when they came in to pay their rent, at CHA laundromats, and at local advisory council meetings and other events hosted by CHA. Together, the organizations were able to maximize opportunities to reach residents and enroll them into affordable health insurance.
Health Center 101: Building Housing/Health Partnerships: Quality of Life Health Center and Greater Gadsden Housing Authority
The Quality of Life Health Center’s (QOLHC) leadership worked with the leadership of the Greater Gadsden Housing Authority (GGHA) to open a primary health care program for public housing residents. GGHA leased facilities to QOLHC and helped identify new residents for outreach purposes. The lease agreement between GGHA and QOLHC outlined the purpose of the relationship, defined the roles and responsibilities of each party, identified the selected services provided in the donated space, and clarified the communication and reporting requirements. Primary care sites were located in two areas designed to service residents of seven housing developments and persons living within a one-mile radius of these developments. The Project called “ProCare” focused on family health care through education and counseling, preventative care, and promotion of healthy living practices.
Collaboration for Seniors
Health and Housing Partnerships Report
A number of collaborative efforts illustrate the partnership of PHA and PHMC such as smoking cessation and outreach and enrollment efforts incorporated into public housing sponsored events. The most recent collaborative effort of these two institutions involves the administration of an early childhood education program into a community development initiative. Funding comes from PHA for the first two years with subsequent funding contingent on performance of the program. Benefits from the PHMC and PHA partnership include but are not limited to the improved accessibility to services and programs to improve the health and well-being of residents and employment opportunities in the community.
Collaboration on Senior Health Initiative
Developing Cross-Sector Partnerships
Casa Maravilla, a 73-unit senior housing building in Chicago, is a great example of a public and private partnership between Alivio Medical Center, The Resurrection Project, and the City of Chicago Department of Family and Support Services Area Agency on Aging. The Resurrection Project is a nonprofit organization that purchased land from Alivio Medical Center to build the senior housing project. Alivio Medical Center allowed the sale of the land with the caveat that affordable units be set aside for seniors. The Resurrection Project agreed and leases out 7,000 square feet of the first floor to the City of Chicago free of cost for a Senior Center, which is managed by Alivio Medical Center.
The senior center has monthly wellness programs. A nurse, registered dietician, and a pharmacist provide health education presentations for the seniors. Seniors and outreach and enrollment staff are housed at the site. The senior center also operates as a Benefits enrollment center to help people with SNAP, Medicare, Medicaid, Medicare Savings Program, Low Income Subsidy, and some local programs. They also work with local school programs to allow students to work or volunteer at the senior center, which is beneficial for both age groups. The partners routinely evaluate the quality of care delivered to the seniors in the community and strive to improve it where possible. One of the unique characteristics of the community is its diversity. The area is multilingual and multicultural, and the staff of the Senior Center has evolved to reflect those changes. Agencies that serve limited-English speakers must have appropriate staff to provide culturally competent care, beyond just language translation. The staff of Casa Maravilla is not only bilingual, but bicultural.
Health and Housing Partnerships Report: Zufall Health and Madison Housing Authority
The relationship between Zufall Health Center and Madison Housing Authority (MHA) began in 2012 when MHA received a 3-year Resident Opportunities and Self-Sufficiency (ROSS) Program grant from HUD. The funding was used to assess the needs of residents of conventional public housing and coordinate available resources in the community to meet those needs.
The program utilized public and private resources for supportive services and resident empowerment activities. These services enabled participating families to increase earned income, reduce or eliminate the need for welfare assistance, make progress toward achieving economic independence and housing self-sufficiency or, in the case of elderly or disabled residents, help improve living conditions and enable residents to age-in-place. Age-in-place is the ability of older adults to continue living their lives in their homes and communities without having to re-locate to an assisted living facility.
Collaboration to Improve Care for Seniors
Senior Case Study
Community Health Initiatives, Inc. in Brooklyn provides a health education series called the Senior Club. The president of Carroll Gardens Senior Citizen Housing, a 101-unit building for low-income elderly, is also a member of the Board of Directors at Community Health Initiatives, Inc. Under her leadership, the Senior Club has organized regular onsite health education discussions with various specialists and primary care providers. For example, a podiatrist discusses foot care and diabetes, and nurses provide food security screenings.
Collaboration on Oral Health Care
Health and Housing Partnerships Report: Zufall Health Dental Services
Transportation was an issue for public housing residents, so Zufall Health delivered dental services through a mobile dental health van. First time patients were given free dental services, which included fluoride treatment, dental exam, X-rays of problem areas, and oral-cancer screening. In order to streamline the administration process, staff from Zufall would pre-register patients prior to the van’s arrival, which reduced wait times and allowed providers to see more patients. The goal of the first visit was to encourage patients to access additional dental services at the health center; however, staff noted that many patients preferred the mobile van. As a result, a follow-up visit offering a full dental exam was made available through the dental van for a modified fee of $20.
Collaboration to Address Community Violence
Addressing Violence in Public Housing Communities
Genesee Health Systems (GHS) operates in the Flint area in Genesee County, MI. GHS established a partnership with the Public Housing Commission to build a Health Center site directly in an 800-unit public housing development in Flint. Health Center leadership assumed that the proximity and the improved access to primary care services would be viewed positively in the community. However, they found that it took almost a year to gain trust and acceptance from residents.
One of the strategies they used to build a rapport in the community was through fun, family-oriented activities and fairs, giveaways, food, and other games and raffles. They also worked thoroughly to ensure a safe environment at GHS. There is a security guard on site and an armed Genesee County Sherriff patrols all of the health center site locations. The presence of law enforcement provides an added sense of safety to both patients and staff at the health center. According to the Director of Operations, knowing the officer is there helps individuals from acting aggressively and decreases the risk of a violent situation.
In addition, all Health Center staff receive crisis intervention training to learn de-escalation techniques. Providing training to everyone, rather than a select few, allows the health center staff to attend to the needs of the patients immediately in the event of an acute crisis. The Director of Business Operations also recommends having a separate room available to move individuals when a conflict erupts. A separate space can create a calming effect but can also prevent a potentially violent episode from spreading to the common waiting areas at the health center and affecting other patients, families, and staff.
Collaboration to Address Lead Exposure
Health and Housing Partnerships Report: Circle of Care
San Diego Housing Commission (SDHC) identified La Maestra Community Health Centers (LMCHC) as a key community stakeholder who could help engage residents of public housing to educate them around lead hazards and encourage them to test their children. LMCHC was identified as an essential partner in this initiative in large part because of its “Circle of Care” approach.
The Circle of Care encourages a holistic, solution-based approach to providing programs and services and was created because LMCHC believes that complete family wellness requires more than just medical services. Every staff member at LMCHC Community Health Centers from receptionist to physician is trained in the Circle of Care approach and to guide the patient towards treatment, education, training and ultimately, self-sufficiency. The Circle of Care involves a network of integrated services provided at LMCHC in addition to community resources like SDHC. SDHC refers residents to LMCHC, for various services, including blood-lead testing. SDHC partnered with LMCHC and several key stakeholders to conduct blood test events. Testing was offered on site of the housing complexes by staff at LMCHC. The test rate increased from 3% (prior to LMCHC’s engagement) to 29%. LMCHC led the way to host targeted testing at various community sites around San Diego, such as elementary schools, parks and community centers. Through their family self-sufficiency program, LMCHC had greater access to their target population. This collaboration allowed LMCHC to better understand and address challenges the families who lived in San Diego Housing Commission sites had; whatever they needed to become self-sufficient or improve their quality of life, including education, job search or job training, or health.
Collaboration to Address Weatherization
Health and Housing Partnerships Report: Weatherization
The San Diego Housing Commission (SDHC) and La Maestra Community Health Centers (LMCHC) had established a partnership to address lead hazards within the home. The LMCHC and SDHC partnership eventually expanded to the Metropolitan Area Advisory Committee on Anti-Poverty MAAC Project around weatherization for seniors and low-income families.
This collaboration allowed several key stakeholders to conduct blood test events where testing was offered on site of the housing complexes by LMCHC staff and at health center sites. Through this partnership, LMCHC also led the way to host targeted testing at various community sites around San Diego, such as elementary schools, parks, and community centers. Through their family self-sufficiency program, La Maestra had greater access to their target population. Collaborating allowed LMCHC to better understand and address challenges the families who lived in San Diego Housing Commission sites had; whatever they needed to become self- sufficient or improve their quality of life, including education, job search or job training, or health.