Inaugural Listening Session helps pave the way for knowledge sharing and policy development in our Post-COVID Future
By Stephanie Johnson, All In Online Community Manager at DASH
All In collaboration members are on the front lines of this crisis. Responding to the day-to-day needs of their communities with everything they have. At the same time, they are seeing firsthand all of the ways our systems are broken. Some are also identifying surprising new ways to make systems work for people, even as their communities are already stressed by economic hardship and inequities.
At DASH and within All In, we are in a unique position to help think about the future. While we are not on the front lines ourselves, we can collect, collate, and promote what is working and what isn’t. We want to learn from your stories, share them with others, and begin to co-create a national conversation about policy and systems changes for a post-COVID nation.
On Tuesday, May 5, 2020, All In hosted the inaugural Listening Session with more than 75 participants in attendance. Participants were encouraged to ask questions as well as offer examples of what their communities were practicing. Topics ranged from apps involved in contact tracing to the social determinants of health exposed by the outbreak.
What you said
How are you leveraging multi-sector collaborations or data systems for the COVID response?
- Maryland HIE, CRISP, is very active in sharing data with providers, labs, the state, and local health departments.
- Texas Homeless Network is working to connect all 11 of Texas’ HMIS systems into one statewide data-sharing network to efficiently provide those experiencing homelessness with the care they need with plans to integrate healthcare systems in the future.
- Developing COVID Tracking Tool & Risk Assessment for highly vulnerable people in HMIS (Community Homeless System), matching HMIS Data to state Medicaid data, and sending patient homeless and health plan information to health plans.
- The Health Improvement Collaborative of SE CT is using an online survey tool to gather COVID19 related needs, including food, rent, child care, and contact info to link community members to support.
What policy opportunities are more possible or immediate?
- Health care policy- delivery of Telehealth and loosening the previously help restrictions.
- Highlight value of Community Health Workers (CHWs), particularly for “tracing” in vulnerable urban and rural populations. It will also be useful to address structural determinants for the longer term.
All In often says that the “wisdom is in the room,” meaning communities are the experts on their own community, professionals are the experts in their respective area of work. The All In network of members often learn as much from one another than from any formal presentation. As the COVID-19 crisis continues, we are all in need of a little wisdom these days. Attendees provided valuable insight into several COVID-related themes:
Health and Housing
All In communities continue to pivot their projects to focus on COVID-19, particularly in the health and housing space, and are eager to share their lessons learned. For instance, the Crisis Response Network in Arizona is using their HMIS data to track the status of risk assessments for homeless individuals, which has led to stories of people being provided temporary housing.
Although a nationally accepted mechanism for contact tracing does not yet exist, many people are trying to figure out the most appropriate way to address contact tracing, while also being sensitive to and respecting issues around consent. The San Diego HIE has worked to support activities to address COVID by allowing dispatch centers access to the HIE, this gave them more information as they dispatched to certain locations. They have set up contact tracing with their local health department. They set up a potential patient registry that provides alerts when individuals are admitted or discharged from the hospital. However, sending lab results where they need to go has been a barrier, specifically at the point of care.
Investment in Community and Health Services
- Participants were interested in understanding different responses as well as coordinating responses and building alignment. While data helps us understand the disparate impact of COVID in places, examples from communities like New York City demonstrate the impact of investment in community and health services to mitigate an increase in mortality rates.
- NY area received a waiver to restructure Medicaid regionally. They involved CBOs and health providers and connected them all with a technology platform that has screening for determinants, management, and HIPAA sign-off. Whoever has contact with the client gets a sign off from HIPAA that says “yes you can help me”.
- Maine is about to launch a municipal dashboard in healthy aging with an aligning systems for health grant. They are trying to figure out how to get CBOs and the municipalities to share data. Many municipalities have services that affect how people live in the community, but are struggling to get services to people in their homes. One attendee commented, “It’s really trying to take another look on how different organizations work together. What sort of data would have made a difference if we had these data systems in place. This is how we’re trying to approach it. The thing about COVID is its got everyone’s attention, everyone seems to want to do something about it, and it highlights the importance of social services.”
Expand Existing Collaboration and Partnerships
Now more than ever, All In communities are interested in furthering their existing collaborations and starting new partnerships. These collaborations can be useful for long-term needs, as a listener from Jacksonville, FL expressed, collaborations early on in their data sharing journeys would benefit from bridging silos in order to consider the impact of COVID-19 on long-term health care needs and social determinants such as early childhood education, violence and trauma, and nutrition.
Bridging sectors is also an ongoing area of interest at Nemours Children’s Health Systems, getting at the nuances of how multi-sector networks accelerate the ability of a community to respond to COVID-19 related needs, and any needs. If networks can demonstrate the ability to accelerate responses that include a focus on health equity, it will (ideally) position the network for COVID response funding.
The COVID response has highlighted the necessity to share data across sectors. For example, communities trying to help their health departments gather data must demonstrate discretion and transparency to maintain trust and privacy. To assist with sharing data legally and ethically, the Network for Public Health Law provides support for all kinds of public health law. The Network has been doing a webinar every week on a different topic, and have expertise in multiple aspects, including crisis standards of care, public health authority, and executive decision making. The Network also provides FAQs and legal assistance.
Many attendees highlighted coordinating responses and addressing gaps in an equitable manner. One attendee shared that they are soliciting input from a team of community leaders to address clinic systems so as to not inadvertently contribute to race/ethnicity-based health disparities. Another attendee said now is the time for internal policy and systems change as it relates to race equity. There is recognition that the COVID pandemic has provided the momentum to address structural racism through policy. Right now this might look like better access to testing and treatment, and will be equitable access to vaccines in the near future. For some, health equity may also look like leveraging the movement towards virtual platforms to reach populations that are traditionally hard to reach in person.
In closing, we will have the opportunity to reflect and leverage what we have learned collectively in the upcoming months. DASH, as part of All In, is interested in how we understand and build on those lessons, and then how we can work together to move into an action space for policy and systems change. As we all come together, we are finding ways to leverage existing relationships on our communities to influence longer-term policy issues that will result in lasting, equitable change. We are grateful for our relationships with so many of you who are caring for your community’s immediate needs and intentionally reflecting on the advocacy opportunities this crisis is revealing. We encourage you to keep the conversation going in the COVID-19 community on the All In Online Community platform.
On May 29th, from 12 pm CST, we will host the second virtual listening session. Learn more below and sign up here.