1.
Team-Based Approaches to Meeting
Patient Population Needs
February 3, 2021

2.
Introducing Joint Accreditation
Community Health Center, Inc. (CHC) and its Weitzman Institute have received
Joint Accreditation for Interprofessional Continuing Education. This designation
confers simultaneous continuing education accreditation across nine national
accrediting bodies.
This Weitzman ECHO program is now able to award continuing education credit
to a wide array of health professionals, including physicians, nurses practitioners,
physician assistants, pharmacists, nurses, psychologists, dentists, social workers,
and dietitians.
If you have not been filling out previous CE evaluation
forms because you were not able to use credits through
AAFP, we highly encourage you to begin filling them out
moving forward so you can receive credits!

3.
This week’s COVID-19 ECHO session
is a collaboration with

4.
Disclosure
• With respect to the following presentation, there has been
no relevant (direct or indirect) financial relationship
between the party listed above (or spouse/partner) and
any for-profit company in the past 12 months which would
be considered a conflict of interest.
• The views expressed in this presentation are those of the
presenter and may not reflect official policy of Community
Health Center, Inc. and its Weitzman Institute.
• We are obligated to disclose any products which are off-
label, unlabeled, experimental, and/or under investigation
(not FDA approved) and any limitations on the information
hat I present, such as data that are preliminary or that
represent ongoing research, interim analyses, and/or
unsupported opinion.

5.
Team-Based Approaches to Meeting
Patient Population Needs
Stephen Scholand, MD;
Infectious Disease Specialist, Midstate Medical Center
February 3, 2021
www. mildred-elley.edu

6.
26,377,125 cases on 2/2/21 with 445,030 deaths
COVID-19 in the United States
https://coronavirus.jhu.edu/us-map

7.
https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html
Cases
dropping

8.
How Many ‘Jet Liners’? A320 seats 182 passengers

9.
Pressure on Hospital Systems
https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html

10.
At least 32 states U.K. strain
• 315 total (B.1.1.7 strain):
FL (147), CA (113), NY
(42), MI (22), CT (8)…
Other strains have arrived:
• B.1.351 (S. African strain)
• P.1 (Brazilian strain)
www.cdc.gov/coronavirus/2019-ncov/transmission/variant-cases.html
Strains Threatening the United States

11.
COVID-19 Vaccinations Across the Nation
https://covid.cdc.gov/covid-data-tracker/#vaccinations
• As of 2/2, ~32 million people had received
at least one dose of Covid-19 vaccine
• About 6 million received 2 doses
• Averaging ~1.3 million doses/day
• Alaska, W Virginia and Connecticut lead

12.
Resources
• Nuvance Health 2000+ Articles Reviewed:
https://spark.adobe.com/page/nM7AVuPoJ2SN0/
• CDC:
https://www.cdc.gov/coronavirus/2019-ncov/index.html
https://emergency.cdc.gov/coca/calls/2020/
• WHO:
https://www.who.int/emergencies/diseases/novel-coronavirus-2019
• Johns Hopkins:
https://coronavirus.jhu.edu/map.html
• Others
http://covidactnow.org/
https://www.thelancet.com/coronavirus

13.
Approaching the Social Determinants
of COVID Care Neighborhood Health
Courtney Riggle-van Schagen, MSW, LCSW
Director of Behavioral Health, Neighborhood Health
February 3, 2021

14.
“I had a fever of 105 degrees
and pain all over my body
and I was like that for a
week…”—Maria Zelaya
Korff, Jay. (2020, May 13). 'Things are getting worse': 28% of Virginia COVID cases
are in Latinx/Hispanic communities. ABC7. 'Things are getting worse': 28% of
Virginia COVID cases are in Latinx/Hispanic communities | WJLA

15.
NH at a Glance
• 40,000+ patients
• 13 sites across Alexandria, Fairfax and
Arlington in suburban Northern Va.
• Primary care, behavioral health, dental
services, HIV, prenatal
• 71% Hispanic/Latinx
• 19% Black/African American
• 56% uninsured
• 29% Medicaid/Famis

16.
COVID Response
May 2020
• State-wide 10% positive
• NoVa-25% positive
• NH patients-54% positive
Response
• Testing
• Primary care treatment
• Contact tracing
• BH support for primary care
teams
• Social Determinants of
Health actions to support
prevention and treatment

17.
SDOH Response-The Successes
• Individual needs assessment of each COVID+ pt to
identify those unable to isolate due to lack of masks,
food, secure housing
• Partnerships with community stakeholders
established
• Contact-free delivery of food, masks, sanitizer, pulse
oximeters, thermometers, diapers to support
quarantine
• Referral relationships between local government
partners to secure safe spaces providing quarantine
options for those unable to isolate

18.
Isolation as an SDOH of COVID
• How do you target isolation?
• Who does it impact (anecdotally/based on clinical
observation)?
– Elderly
– Minority populations
– Youth (teens)
– What do you see in your areas of work?
• Build connections and help patients tell their
stories
• Community partnerships and stakeholders

19.
Food for Thought
• How can we build on community relationships
to address concerns about vaccine efficacy?
• Are we asking the right questions to be sure
that we are addressing the most important
social determinants for our particular
populations?

20.
Thank You!
“Whatever affects one indirectly, affects all indirectly. I can
never be what I ought to be until you are what you ought to
be. This is the interrelated structure of reality.”
~Martin Luther King, Jr.

21.
Vija Sehgal MD, MPH, PhD, Chief Quality Officer
Weitzman ECHO Series on COVID-19
Wednesday, February 3, 2021
Responding to Community Needs
During the COVID-19 Pandemic

22.
• Established 1972 as a community-driven response to the lack of health care
providers available on the Waianae Coast.
• The largest and oldest of Hawaii’s 15 community health centers, with a main site; 5
satellite clinics; 3 SBHC sites; and a 24 hour Emergency Department
• In 2019, served 38,699 patients through 219,339 encounters, the majority Native
Hawaiian (47%), with 67% of patients at or below 100% of the federal poverty level
and 56% covered by Medicaid
• Largest employer on the Waianae coast with over 650 employees – 54% of whom are
residents of the community.
Waianae Coast Comprehensive Health Center

23.
•Highest number of households in the state
receiving SNAP or other forms of public assistance
•Highest percent of individuals on Oahu living
below the Federal Poverty Level, with an average
annual per capita income of $17,800
•Highest number of obese adults, adults with
diabetes, and adult smokers.
2016 State of Hawaii Primary Care Needs Assessment Data Book
(Hawaii State Department of Health, May 2016)
Waianae Coast Primary Service Area

24.
COVID-19 Timeline Hawaii
• March 6, 2020 – First presumptive positive case of COVID-19 confirmed
in a cruise ship passenger returning to Hawaii​
• March 11 - WCCHC decision made to scale back operations and
postpone non-essential visits​
• March 16 – WCCHC reduced operations begin;
• COVID-19 hotline and drive-thru testing open​
• March 16 – School spring break begins​
• March 23 – Governor David Ige issues emergency ‘stay at home’
proclamation​
• March 27 – Mandatory 14 day quarantine for out of state travelers
• April 1 – Mandatory 14 day quarantine for inter-island travelers

25.
• Fewest COVID-19
cases in U.S. (per
100,000)
• Second lowest case
fatality rate in the
country.
• 2.6% Case positivity
(4th Lowest in the
country)
• Highest daily case
count: 353 (August 12,
2020)
• Highest positivity rate

26.
April 2020: Hawaii Unemployment Soars
•Over a quarter of a million
unemployment claims filed
(Feb 1 to May 9)
•Greater than 1500%
increase from same period
last year
•Nearly 1 in 4 workers in
Hawaii were unemployed

27.
HAWAII UNEMPLOYMENT SOARS

28.
HAWAII UNEMPLOYMENT 2019-2020

29.
PRAPARE Survey Modified in Response to COVID-19

30.
Pre-Pandemic Statistics (2019)
Waianae Coast
47,774 residents
– #1 Obesity (40.9%)
– #1 Diabetes (15.1%)
– #1 Cancer
– #1 Diabetes
– 38% Food insecure
– 33.3% Households receive
EBT/SNAP
– 100% Keiki (Children) receive
free school breakfast & lunch

31.
WCCHC’s Approach (2019)
• Farmers markets
• EBT Double Bucks program
• Keiki produce prescription pilot
• Summer mobile meals
• Keiki pantry
• ʻOhana Nights

32.
WCCHC’s COVID Response to Food
Insecurity (2020)
258,718 meals distributed
2.4 million lbs. of food distributed
26,019 households served
Projects:
• Keiki and Kupuna Grab & Go Pantries
• Community Food Distributions
• Front Line Worker Food Distributions
• Keiki Produce Prescription Program
• Waianae ʻOhana Produce Prescription
Program

33.
Daily Keiki Food Distributions

34.
Large Scale Community Food Distributions

35.
Collaborating with Community Partners

36.
WCCHC’s
Community Impact
2019 2020
Food Distributed (lbs.) 250,000 2,400,000
Meals Distributed 13,384 258,718
Families Served 10,326 26,019
WCCHC’s Community Impact
(2019 vs. 2020)

37.
WCCHC’s Economic Impact
WCCHC’s
Local Food Purchases
2019 2020
Local Food Purchases $13,000 $1,71,297
Food Producers Supported 6 45+
Jobs Saved/Created
10 temporary
part-time
25 full-time+

38.
“Never underestimate the power of a small
group of committed people to change the world.
In fact, it is the only thing that ever has.”
~ Margaret Mead.

39.
Mahalo
Vija Sehgal MD, MPH, PhD
vsehgal@wcchc.com

40.
Thank You!
To learn more about The Path Forward series
WeitzmanLearning.org/the-path-forward
To view previous COVID-19 sessions:
WeitzmanLearning.org/coronavirus