COVID-19 forced Community Benefit programs to evolve, but the good work continues
By Claire Sykes
From charity care to parenting classes, Oregon community benefit programs improve public health and well-being throughout the state. They’re more crucial than ever now with the coronavirus. In the midst of this menace, the challenges couldn’t be greater, especially given the difficulty of delivering services during social distancing and less in-person contact.
Some community benefit programs, such as CHI St. Anthony Hospital’s health-outreach program at senior centers, have temporarily shut down due to restrictions on large gatherings and visitors at facilities. But many of Oregon’s hospitals and health systems have adapted to the urgencies and uncertainties of the coronavirus, adjusting their community benefit programs to continue serving their communities. They’ve accelerated and expanded existing programs and quickly formed new ones. Many have begun delivering care to vacant parking lots, farm fields and front doors.
Oregon’s hospitals and health systems have depended even more on forming and fostering community relationships in the COVID era. They’re building more active, ongoing and sustaining partnerships with county public health agencies as well as community organizations, school districts and other stakeholders. And they’re doing it well.
“Our hospital and health systems are engaged with and anchored in their communities, not just a place to go when you’re sick or injured. They build connections with their patients and community members through local assessments, which inform the community benefit program investments that are made. Many hospitals have identified social determinants of health as a key priority,” says Rebecca Tiel, MPH, Director of Public Policy with OAHHS.
“The future for community benefit programs is a collaborative model,” she says. “We’ll see more of a collective impact, where hospitals are working with different entities, all rowing their boats in one direction.”
Here are six hospital and health systems with oars in the water:
Outbreaks and Outreach: Samaritan Health Services
When over 120 Pacific Seafood workers in Newport tested positive for COVID-19 in June, it hit the whole town hard, especially the immigrant community. Newport was effectively handling the coronavirus when suddenly health officials were hurled into responding to a major outbreak. They rose to meet the challenge.
Lincoln County Public Health (LCPH) and Samaritan Pacific Communities Hospital (SPCH) began a collective response, but they found a significant barrier: Some of those workers are indigenous Guatemalans whose sole language is Mam, not Spanish, and they didn’t understand the meaning of their test results and instructions.
“Right away, we sent two bilingual Spanish-speaking staff members over to [LCPH], and paid their salaries,” says Dr. Lesley Ogden, CEO of Samaritan Health. Lincoln County contracted with local Mam speakers for translation.
The County also has turned to Samaritan’s experts for the content of its online COVID-19 public-service Spanish-English videos, now in Mam, too. SPCH and SNLH have made similar language changes to their call-in centers and online presence. Their enhanced social media content gives bilingual information on the science of COVID-19, prevention, testing, and treatment.
Contact tracing needed Spanish interpretation, and SPCH sought the help of the Confederated Tribes of Siletz Indians and Centro de Ayuda, a Newport nonprofit. Fortunately, one of SPCH’s employees speaks Mam and is bilingual, and was willing to be trained as a certified interpreter. “The indigenous-Guatemalan community is large enough here. We’ve got to have that commitment to them,” says Dr. Ogden.
She understands the need to offer different resources for different minority groups. “So it’s been helpful for us to meet with the Lincoln County Board of Commissioners and community stakeholders,” Dr. Ogden says. “We very much are relying on the County, which has more frequent contact with some of our minority populations, and community organizations that can help us understand what’s needed.
“When we saw the coronavirus unfolding, we viewed it as ‘We’re all in this together, and we need to move together in lockstep,” says Dr. Ogden, “because none of us will be successful on our own.”
Caring Connections: Good Shepherd Health Care System
It couldn’t be a worse time to be homeless, disadvantaged, and without a primary-care provider. That’s why Good Shepherd Health Care System (GSHCS), in Hermiston, is doing all it can to spread the word about the ConneXions program in Umatilla and Morrow counties.
Community Health Workers (CHW) connect clients to resources related to finances, health, medication management, health care coverage, food, shelter, transportation, psychological and addiction issues, along with wellness screenings and classes. If someone is COVID-19 positive with no health care provider, ConneXions gets them established with one. As the program grows, it’s proactively helping community members become more self-sufficient on their health journeys.
ConneXions is a part of GSHCS’s Education and Wellness Department, which offers dozens of mostly free classes. Now with many of these online, they’ve reached people they otherwise couldn’t.
Some can’t or won’t leave their homes, due to illness or fear of infection. “We’re making more home visits to assess their situations and link them to the right services and care,” says Juli Gregory, GSHCS’s Education Director.
Good Shepherd also shows up for local businesses. The hospital and Umatilla County Public Health created a free information packet on infection prevention and contact tracing for companies, so they can stay safe and open.
Another great service is the CareVan Medical Transportation program. It drives people for free to any medical or mental health appointment in GSHCS’s service area, and to any of their affiliated providers in Hermiston.
Gregory says, “Thanks to the collaboration between all of our partners, we’ve been able to expand our services. It’s been wonderful to see everybody come together with more effort and say, ‘OK, how can we make this work?’ It’s been amazing to watch. We’re hopeful that our communities will come out of this pandemic stronger than we were before.”
Power in the Positive: CHI St. Anthony Hospital
Sometimes parents need a hand, particularly those in troubled homes. The Positive Parenting Program®, or Triple P, can help. This evidence-based program was founded in Australia and helps parents build the skills and confidence they need to manage their children’s behavior and form healthy relationships with them.
In July 2020, CHI St. Anthony Hospital’s parent organization, CommonSpirit Health™, awarded a second three--year grant to train community providers on teaching parents and caregivers about Triple P. The grant totaled $375,000 plus half the funding for a full-time Parenting Education Coordinator position from Greater Oregon Behavioral Health, which allows the hospital to reach more families in Umatilla and neighboring counties.” Triple P is for anyone who wants to learn positive ways to parent. We want to get rid of the stigma of asking for help,” says Emily Smith, Director of Marketing, Communications and Foundation at St. Anthony. “We tell parents, ‘You know your family best, and here are some options to try. We’re here to support you.’”
Seventeen parenting strategies take parents virtually through five levels—a large-group informational seminar, small-group discussions with other parents, one-on-ones with a Triple P provider to address specific concerns, a consult for those more likely to abuse their children and another for higher-risk families.
During the first three years of the program, “many parents shared that after just one seminar with a few tips, they saw a marked change in their child’s behavior and felt more hopeful about them, their parenting style and life in general,” says Smith. “Stories like that reassure us that we’re making a difference, helping parents restore harmony into their homes, especially since it’s such a tumultuous time for them right now.”
Grateful for the Grant: PeaceHealth Sacred Heart Medical Center
PeaceHealth always has had an unwavering commitment to community benefit programs, with housing, food and health care as major focus areas. Susan Blane, Director of Community Health for PeaceHealth Oregon, says, “Our many partnerships with community-service organizations and Lane County Public Health and our purposeful funding of community benefit programs have allowed us to effectively target that funding where it can help the most.”
Through four of its hospitals, PeaceHealth Oregon gave $537,500 to 16 organizations in Lane County. Catholic Community Services of Lane County (CCS) is one of them. When CCS received $50,000, “it was a godsend,” says Sue Paiement, its Executive Director.
CCS and PeaceHealth Sacred Heart Medical Center have enjoyed a longstanding partnership, meeting regularly to discuss community members’ needs and opportunities for further collaboration. “We feel that our existing relationship led to their generosity, and we are so appreciative of it. This grant money arrived at just the right time!”
CCS has some of the funding to add an operations director focused on program and agency adaptations as well as staff to distribute the $1 million-plus in CARES Act funds for rental and energy assistance. Some of the grant also funds emergency resources, food distribution and other basic needs, which CCS gives directly or by referral.
Founded in 1952, Lane County CCS supports low-income individuals and families, including the unhoused. When their two centers closed between March and June due to the COVID lockdown, CCS didn’t miss a day providing food. Staff donned masks and kept right on moving meals even as the medical center’s scheduled procedures were interrupted.
The facility switched from the on-site “grocery-shopping” experience to a pre-made food box pickup with a drive-through option. At least 35 percent of CCS’s recent clients are accessing food pantries for the first time. “They often express embarrassment at needing that assistance, but they’re thankful,” says Paiement. “They don’t have to make the difficult choice of going without food or getting behind in rent and utilities.”
CCS employees are also grateful. “I know I speak for our staff when I say how blessed we are to be on the front lines helping people,” she says.
Family Forward: PeaceHealth Cottage Grove Community Medical Center
Ana Maria Dudley clearly remembers the day in 1992, her first at a drop-in family-resource center in Cottage Grove now called Peggy’s Primary Connection.
“To see parents playing games and coloring with their children was life-changing for me. I found community,” says Dudley, who fled El Salvador as a refugee in 1980.
A year after that visit, Peggy’s Primary Connection hired her. Today she’s a community health worker there and at PeaceHealth Cottage Grove Community Medical Center. “I’m the bridge between the two, which share resources with each other. That’s the beauty,” says Dudley.
Peggy’s Primary Connection is part of the South Lane School District Family Resource Center. Normally housed at the South Lane Early Learning Center, it offers parenting classes, homework help, computer access, school lunches and more.
Almost half of the families who benefit are Spanish speaking, but some are indigenous Guatemalan migrant and seasonal workers who speak only Mam. Of the $345,000 PeaceHealth gave to the district, $30,000 funded a Mam interpreter, and helped with clients’ rents, utilities, food, childcare and transportation.
In March and April, the Family Resource Center joined forces with Be Your Best, the Rural Organizing Project, Food for Lane County and the Migrant Education Program. Together they acquired food and distributed it to migrant worker families from the Cottage Grove Elementary School parking lot.
When schools re-open, part of that six-figure PeaceHealth grant will help set up a culturally appropriate preschool for Latino children and those whose first language is not English.
The coronavirus may be unpredictable, but one thing is certain. “Everyone who comes to the center knows they’ll feel cared for, loved and safe,” says Dudley.
Mobilizing for Migrants: OHSU Hillsboro Medical Center
What would Oregon do without its migrant and seasonal workers? They are a vital resource in the state’s agricultural economy, but these workers are statistically underserved when it comes to health care. Nearly 300 winery and vineyard owners have worked to close that gap with ¡Salud! Services. Since 1992, operated by OHSU Hillsboro Medical Center, ¡Salud! has connected wine-industry farmworkers with free, basic health care on-site and by referral. Services include dental exams and diabetes management and are delivered by full-time bilingual staff including three registered nurses, a health educator and an administrative coordinator.
Throughout the Willamette Valley in Washington, Clackamas, Yamhill, Marion, Polk, Benton and Lane Counties, ¡Salud! serves about 2,500 people, mostly from Central America. Many are year-round core workers.
“They provide an essential service, helping the region’s economy. ¡Salud! breaks down health barriers—the premise of this organization—and gives the services they so deserve, collaborating with other community organizations,” says Leda Garside, a native of Costa Rica who now serves as Salud’s manager and cultural liaison.
When the coronavirus barged in, ¡Salud! marshalled its OHSU mobile unit, now used for office space instead of its usual patient care. With 45 percent of Oregon’s new COVID-19 cases coming from the Spanish speaking community, ¡Salud! was ready.
Three days a week, PPE-clad staff roll in to the vineyards and wineries and set up five socially distanced stations—for registration, vital signs, agreed-to COVID-19 testing, lipid panel and blood-sugar screening, tetanus-vaccination boosters, education and, if needed, referrals to primary care. It’s a sign of the COVID era to see masks, face shields and protective gowns in the vineyards of Oregon’s beautiful wine country, but it’s necessary to deliver important care to patients and meet them where they are. “If someone tests positive, we follow up with them and any family they’re living with, and make sure they know what measures to take to fully recover, and diminish spreading the virus,” says Garside.
Since May, ¡Salud! has done more than 500 COVID-19 tests, resulting in 20 positives. The organization has seen this number continue to decrease, which speaks to the effectiveness of the health education efforts.
“We’ve also seen the resilience among workers and their communities, how they’re helping each other, trying to stay healthy and keep afloat,” says Garside. “And they’re really loyal to their employers.”
From Obstacles to Opportunities
Likewise, Oregon’s hospitals and health systems remain devoted to their community benefit programs. COVID created opportunities to re-think programs and forge new alliances.
“COVID-19 has brought our community closer together. There’s been a lot of good from what is otherwise a horrible health crisis,” says Dr. Ogden. “If we can make good things come out of a pandemic, then this is just the start of what we can do to enhance our services to all members of our communities. Giving better and better care—this is what it’s all about.”