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Community health centers get new funds to tackle the COVID vaccination gap

An older woman in graying hair is wearing a mask as a nurse prepares to give her a coronavirus shot at a temporary clinic in Asheville.
MAHEC Nurse Katie Neligan vaccinates Esther Camero, 75, of Henderson County, at a coronavirus vaccine clinic in Asheville. Photo credit: Liora Engel-Smith.

By Liora Engel-Smith

Even as North Carolina’s health care providers have administered nearly 5 million coronavirus vaccinations, the state’s Latino and African American populations remain underrepresented among those who received at least one shot.

To help decrease that gap, the Biden Administration has awarded a collective $161 million to 40 safety net clinic operators. Community health centers  — 250 of which are in North Carolina — serve hundreds of thousands of uninsured and underinsured patients across the state. The money is part of the administration’s $10 billion plan to increase access to vaccines among the county’s “hardest hit and higher-risk communities,” including rural populations, people of color and low-income people.

The nation’s health centers, partially funded by federal grants, have long-standing community links and deep relationships with local leaders. Of Biden’s $10 billion plan, the community health center system has received a collective $6 billion in vaccination outreach. As in other parts of the country, North Carolina’s community health centers are at the forefront of the effort to vaccinate marginalized and disenfranchised residents, said Leslie Wolcott, spokeswoman for the North Carolina Community Health Centers Association.

While community centers have made some progress to close the vaccine gap, financial constraints, especially surrounding the creation of massive testing and vaccination campaigns overnight have slowed down the efforts, Wolcott said. The new funds from the federal Health Resources and Services Administration cover some of the costs health centers have already incurred this year, as well as future outreach efforts.

“The struggle for community health centers has not [been] not knowing where the historically marginalized populations are,” she said. “But it’s been giving the vaccines out in the way that best serves those populations.”

Community health centers have been creative with their outreach efforts, from partnering with African American churches to working to get the word out through community leaders, Wolcott said.

These initiatives demand time, forethought and resources at a time where many community health centers struggle to recruit and retain staff.

The health center operator CommWell Health, for example, held a vaccination clinic in rural Brunswick County last month. To encourage African Americans to get vaccinated, health center staff partnered with leaders of the local chapter of the NAACP. Members of that organization used an established phone tree to get the news out. Within one day, more than 200 residents showed up to be vaccinated.

Robert E. Spencer, who heads the state’s largest health center provider organization Kintegra Health, said his staff had to be just as creative in its 10-county region. The Gastonia-based organization administers more than 1,200 vaccine doses a week. A large percentage of these doses have gone to people of color and other underserved populations.

To address some long-standing challenges, including transportation, technology limitations and ability to take time off of work, Kintegra staff use mobile vaccine clinics in small towns. They’ve also held events in the parking lot of a Hispanic grocery store and at local fire departments.

These and other approaches have made Kintegra the agency that vaccinates the most people of color in the state with its allocations, he added.

But financial constraints limit the organization’s reach, according to Spencer, who said that much of the federal aid community health centers received thus far does not account for the added costs of recruiting and retaining health care providers to administer these vaccines, for instance. The $14 million infusion Kintegra is expected to receive from HRSA also does not cover improvement to health center facilities, even when these improvements may make administering vaccinations indoors safer.

“This support is very focused on the COVID response,” he said but the pandemic demands an overall increase in other services, including mental health support or missed cancer screenings.

“Is that in some way going to have a different … backlash going forward?” he asked. “I’m concerned about that.”

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