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Thousands of COVID home tests sent to 20 Kansas counties as part of COPE, a $13 million grant to improve community health

The grant was offered in response to COVID-19 but its design allows for a community response to all kinds of health issues.

Three women in masks hold prepared COVID-19 tests
Christina Pacheco, COPE Project Director, Brenda Griffin, Public Health nurse with White Cloud Indian Health Services in Hiawatha, Kansas, and Ruaa Hassaballah-Muhammad, COPE Community Regional Lead for Northeast Kansas, helped to prepare COVID-19 test kits for delivery to 20 Kansas counties. CONTRIBUTED PHOTO.

Faculty, staff and students at the University of Kansas Medical Center recently joined volunteers from area middle schools and high schools for one monumental task: labeling, packing and shipping 22,500 COVID-19 rapid home test kits.

The kits were bound for 20 counties in Kansas as part of a new community health initiative, Communities Organizing to Promote Equity (COPE). Funded by a $13 million grant from the Kansas Department of Health and Environment, COPE is a partnership of stakeholders that will try to improve the health of underserved populations in select counties in the state. KU Medical Center obtained the grant and will manage the program. Partners include:

  • KU Medical Center
  • Community health clinics
  • Community organizations
  • County health departments in 20 counties

The Centers for Disease Control and Prevention (CDC) made funding available to state health departments to address health equity, particularly in response to COVID-19; however, the funds are not limited to pandemic-related health concerns. 

COPE Project Lead Sarah Finocchario Kessler, Ph.D., MPH, associate professor of family medicine and community health in the KU School of Medicine, said, “We are very excited to get these tests to partner organizations and families in COPE counties as a great way to launch our program.”

Hiring community health workers

In addition to providing the COVID-19 tests, funds from COPE will be used to hire and train three community health care workers (CHWs) in each county through the grant’s end date of June 2023. Kessler said the CHWs will aim to: 

  • Build rapport and trust with underserved community members by linking them to needed services
  • Facilitate access to COVID-19 testing and vaccinations through partnerships with trusted community-based organizations
  • Strengthen the role of community health workers in the public health response to COVID-19 and build health equity in local communities

“This an opportunity to potentially hire from the underserved communities we’re trying to reach and to provide CHWs and community leaders with the budgetary resources needed to put good, practical ideas into practice,” Kessler said.

Building on a previous grant-funded project

COPE shares some similarities with another recent community health initiative, RADx-UP. In 2020,Workers preparing COVID tests around conference table KU Medical Center received a two-year grant from the National Institutes of Health (NIH) to support projects designed to rapidly implement COVID-19 testing in populations disproportionally affected by the pandemic. RADx-UP established small community task forces in 10 counties in Kansas. These groups, called Local Health Equity Action Teams, or LHEATs, identified COVID-19-related inequities in their communities and devised strategies for improvement.

Kessler said the COPE program will adopt the concept of LHEATs and even retain some of the team members who helped in RADx-UP. But more importantly, she said, these new teams will be able to expand health-equity efforts in the state (from 10 counties to 20) and have direct funding to reach people who are often missed by more traditional strategies.

Putting funds behind improvement ideas

Kessler led the learning collaborative for RADx-UP, where representatives from each of the 10 counties met virtually to share innovations and discuss best practices. She knew the RADx-UP initiatives already set in motion and realized that many of the ideas would need funds not initially established in RADx-UP. Those funds will now come from the COPE grant.

“One lesson we learned is that community members will come up with a lot of good ideas, but if it wasn’t something there was money for, it kind of fizzled out,” Kessler said. “If you don’t have the resources and the money, and the time of people who can be the arms and legs of these initiatives to do the work, you can only go so far.”

Edward Ellerbeck, M.D., MPH, professor of population health and internal medicine in KU School of Medicine and one of the principal co-investigators of RADx-UP at KU Medical Center, said RADx-UP provided some important insights into the barriers faced by underserved populations in Kansas in getting tested and vaccinated for COVID-19. “COPE builds upon the lessons learned in RADx-UP and takes it to a new level,” he said.

Allen Greiner, M.D., MPH, professor of family medicine and community health in KU School of Medicine and one of principal co-investigators of the medical center’s RADx-UP, said he sees COPE as a way to bring together various partners in the selected urban and rural counties. “Community health services are rarely tied to public health and health care delivery partners such as clinics and hospitals,” Greiner said. “The COPE project aims to build new bridges to improve a variety of health and social outcomes for those in need. COVID and other chronic disease outcomes will improve as a result.”

Role of the community health workers

Hiring and training of CHWs is still ongoing, said Ton Miras Neira, project manager for COPE. A health background gives applicants a leg up, but not all new hires have a formal health education. KU Medical Center is providing the training for the new CHWs to do their jobs effectively, which Neira said he and his coworkers created “completely from scratch.” No other states or programs had the existing materials they wanted to use.

“The CHW is the extension of services from a clinic, but out in the community,” Neira said. “The medical staff of a clinic might not go out into the community to help people in their houses, but the CHWs actually do, and the magic of the CSW is that they bring those outcomes back to the providers. Like, say somebody struggles with diabetes, for example. The provider is giving them the medication, but something is not working. The CHW goes to that person’s house, they build a rapport, and the patient says, ‘That medication doesn’t make me feel good, so I’m not taking it.’ That’s very common.”

Neira said CHWs can build this rapport because they aren’t as intimidating as doctors can be, and if CHWs have a strong understanding of the patient’s culture and heritage, they can create that rapport more quickly than the provider.

Essence Miller, EMBA, is the community health worker supervisor for the Community Health Council of Wyandotte County. She said COPE fits into her personal mission to be a servant to others. “COPE is about mobilizing communities and being advocates for the community members,” she said. “With community support, I believe COPE can have a lasting impact on the communities that have been identified as being in great need. Community members are tired of talk; they want to see action. I feel that those working on this project have the same goal in mind – to lessen the needs of these counties and to leave community members empowered to do the work when the program ends.”

Looking ahead

Kessler said she hopes COPE clinical partners end up hiring some of the CHWs after the grant funds are depleted, especially if they have additional health credentials. “If someone is a licensed practical nurse or has nursing skills, and then that person gets all of this community health experience, the facility will want to retain that person.”

Also in the long term, Kessler sees other states adopting this program to improve community health. “Those of us who work in community health, either in the U.S. or abroad, really appreciate the immense value that community health workers bring,” she said. “The great silver lining in these COVID-related funds is that they’ll help us strengthen the infrastructure for public health.”

 

Two Federal Grants for Kansas Community Heath Initiatives in Response to COVID-19

Grant-funded initiative

Rapid Acceleration of Diagnostics – Underserved Populations (RADx-UP)

Communities Organizing to Promote Equity (COPE)

Grant agency

National Institutes of Health (NIH)

Centers for Disease Control and Prevention (CDC)

Grant amount

$3.5 million

$13 million

Kansas counties involved in grant

10

Crawford, Douglas, Finney, Johnson, Lyon, Riley, Saline, Sedgwick, Seward and Wyandotte

20

Barton, Bourbon, Cherokee, Crawford, Cowley, Finney, Ford, Geary, Gant, Harvey, Johnson, Labette, Marshall, Mitchell, Montgomery, Shawnee, Sedgwick, Seward, Thomas and Wyandotte

Active dates

21 months, 2020-June 2022

24 months, 2021-June 2023

Use of Local Health Equity Action Teams (LHEATs)

Funds to support LHEAT-led initiatives

Yes

 

Indirectly, via partner orgs

Yes

 

Directly, $20,000/year

Focus on COVID-19 testing opportunities

Focus on COVID-19 vaccination access

Focus on other social needs

Yes

Indirectly

No

Yes

Yes

Yes

New community-based employees hired

20

75+

 

 

Inset image: COPE project staff, along with family members and friends, labeled COVID-19 test kits late into the evening while on the KU Medical Center campus. CONTRIBUTED PHOTO


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