How COVID strengthened relationships between Michigan health departments and community organizations

This article is part of State of Health, a series about how Michigan communities are rising to address health challenges. It is made possible with funding from the Michigan Health Endowment Fund.

When the COVID-19 pandemic took hold of Michigan, Barry-Eaton District Health Department (BEDHD) staff had to find new ways to reach out and protect their region's residents. Like all health departments, BEDHD was tasked with educating, informing, testing, contact-tracing, and, ultimately, vaccinating its various populations. The logical way to make that happen successfully was to leverage existing relationships, and build new relationships, with local community-based organizations (CBOs).

"We really could not have had a successful COVID response without the help of our community partners," says Emily Smale, BEDHD communications specialist. "The exciting thing about this time was the willingness of our partners to jump in wherever we needed them, in whatever capacity we needed help."

Across Michigan, the pandemic has caused health departments and CBOs to establish and strengthen relationships that are continuing to pay dividends for their communities. Rebekah Condon, BEDHD emergency preparedness coordinator, says that before the pandemic, health departments and CBOs "got a little bit siloed in our own work." While they might refer clients to one another, staffers had fewer personal relationships with each other. But COVID changed that for the better. 
Rebekah Condon.
"You build up those personal relationships," she says. "Within a community, it's really important to have these personal relationships within public health and public sectors. You have less opportunity for someone to fall through the cracks."

A small example with big results

One of the CBOs that BEDHD partnered with is My Community Dental Centers' (MCDC) Charlotte location. MCDC operates 34 community-based dental clinics throughout Michigan that focus on providing dental care to people enrolled in Medicaid, uninsured older adults, veterans, and those living with disabilities.

"MCDC is a great resource for information-sharing," Smale says. "They get a lot of populations that are hard to reach and may not have a primary care provider. They are located right next door to the health department. So they would refer people to us if they hadn't gotten vaccinated yet, didn't know where to go, or just didn't know that we offered it. They were great about helping us connect to people in that way."

With a mission of enhancing community health, offering MCDC's services in vaccination outreach was a logical decision for MCDC staff. MCDC's Charlotte location serves about 2,700 patients per year, and operates on behalf of BEDHD.  

"We've had a strong and long relationship with the Barry-Eaton District Health Department," says Kimberly Singh, MCDC chief of community and governmental affairs. 
Kimberly Singh.
BEDHD trained MCDC staff on how to educate patients, especially those who were hesitant, about the vaccine. BEDHD also gave MCDC online access to schedule vaccine appointments for their patients. And MCDC provided patients information on where and when they could schedule their own appointments.  

"When we learned of the need to expand the number of residents receiving their COVID vaccination, we felt this aligned very well with our goal of enhancing community health," Singh says. "The strategies were to work with the health department in improving outreach, assisting community members and MCDC patients with scheduling COVID vaccination appointments, and assisting community members to overcome barriers to receiving the vaccine."

MCDC also mounted a robust marketing and social media campaign to promote vaccination.

"All of our active patients received texts, messages, and emails regarding the importance of the vaccine and availability of vaccine," says Ashley Bodien, MCDC marketing manager. "... It's one thing to say the COVID vaccination is available, but it's another thing to be able to schedule them."

Other CBOs that joined BEDHD's COVID response included the Barry County Commission on Aging, Tri-County Office on Aging, and the counties' emergency response teams, which helped reach homebound residents. Vaccine clinics were held at the Barry County Fairgrounds, in area schools and libraries, and at the Lansing Mall. Schools also helped with contact tracing and local libraries provided masks. Barry County United Way helped BEDHD connect with harder-to-reach populations, such as those experiencing homelessness and households without internet or smart devices.

"We couldn't have done it without our community partners," Condon says. "Together, we saved a lot of lives."

Maintaining connections

New collaborations between health departments and CBOs have sprung up throughout Michigan, far beyond Barry and Eaton counties. Michigan Association for Local Public Health (MALPH) Executive Director Norm Hess believes that the relationships built during the pandemic have been central to the successful pandemic strategies that the state's various county health departments have implemented.
Norm Hess.
"Many of these relationships with local organizations existed prior to COVID. But there was definitely a need during the COVID response to work more closely with schools, colleges, child care centers, businesses, and places of worship — all kinds of organizations," Hess says. "For schools, especially, many of our health departments met weekly with administrators to make sure that they understood the current situation, whether cases were rising or falling. Schools shared information about cases and helped to follow up with individual students. There were lots and lots of opportunities to work closely and coordinate not just vaccines, but also share information."

Hess notes that health departments and hospital systems had to work very closely together because they were the two primary entities receiving vaccines when they were first made available.

"They certainly didn't want to be wasting vaccines, and they didn't want to be duplicating efforts in trying to reach the same people," Hess says. "I think that there's been a much wider recognition of what public health does and how they can support all types of agencies and organizations in the community. ... And public health understands the role of other agencies and how they all have their strengths to help combat several types of public health threats."

As other stellar examples of how health departments built outstanding relationships with CBOs, Hess cites Ottawa County Department of Public Health's collaboration with Community Spoke, which successfully reduced vaccine hesitancy. And, in Oakland County, JARC was able to boost the county's COVID vaccination rates by vaccinating nearly 4,000 people with physical and developmental disabilities.

Hess worries that when COVID response dollars run out, it will be hard to sustain the gains that have been made in public health, a sector that has been traditionally underfunded.

"It's all temporary money, so it's going to go away," he says. "If another public health crisis comes about, we're going to find ourselves in the same situation we were in before, where we're going to need a vast influx of resources that have to be very quickly mobilized."

However, he believes that the relationships that have been built over the past two years will continue to strengthen public health in Michigan.

"Other organizations' awareness of the roles that public health can play, and appreciation of what people [in the county health departments] have to bring to a situation, is very helpful," Hess says. "Different agencies are required to create various plans, whether it be an assessment of the health of the population or emergency preparedness. Those plans will be better informed because of the relationships that have been built and the knowledge that people have about what assets exist in the community."

Smale agrees.

"Part of what makes community organizations great is that they already have those existing relationships with the folks who we also serve. If we're able to continue to work collaboratively with them on promoting their programs, ... they can also support us," she says. "Together, we can provide services to people in a broader way, making sure we're not missing any gaps."

Estelle Slootmaker is a working writer focusing on journalism, book editing, communications, poetry, and children's books. You can contact her at [email protected] or www.constellations.biz.

Norm Hess photo courtesy of Norm Hess. All other photos by Roxanne Frith.
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