COVID-19 Response for Milwaukee’s Uninsured Adults

At a Glance

This project, led by Bread of Healing Clinic (BOHC), aimed to address and mitigate the impact of COVID-19 on low-income people of color who are uninsured. Early COVID-19 reports revealed significant disparities in its impact, like in Milwaukee where 73 percent of those dying from the virus were African Americans who comprised only 26 percent of the population. For low-income uninsured adults with chronic health conditions, access to ongoing health care, behavioral health care, medications and support in accessing community resources were major factors in managing health and COVID-19 risk.

This project made significant strides in addressing the health care needs of uninsured adults during the COVID-19 pandemic. A telehealth model engaged 14 physicians and facilitated 517 telehealth visits, including specialized care in areas such as nutrition, dermatology and psychiatry. BOHC leveraged tools like Google Suite and “My Health Direct” to enhance data collection, revealing needs in primary and specialty care, diagnostic testing, insurance assistance and housing support. Finally, the project successfully connected 50 patients to free clinics and disseminated COVID-19 safety measures to approximately 1,800 individuals through a number of outreach efforts.

The Challenge

Early news reports on COVID-19 indicated that low-income African American communities across the country were greatly impacted by the virus. In Milwaukee, 73 percent of those dying from COVID-19 were African American, while African American individuals comprised only 26 percent of the city’s population. Additionally, studies repeatedly demonstrated that uninsured individuals were less likely than those with insurance to receive preventive care and services for major health conditions and chronic diseases. For low-income uninsured adults with chronic health conditions, access to ongoing health care, behavioral health care, medications and support in accessing community resources were major factors in managing health and COVID-19 risk.

Project Goals

The overarching goal of this project was to address and mitigate the impact of COVID-19 on low-income people of color who are uninsured, a population that has experienced the greatest disparities in morbidity and mortality of COVID-19 and access to health services. This goal was addressed through five specific objectives:

1. Increase the capacity of the BOHC to address the physical health, emotional health, social isolation and service needs of uninsured adults in Milwaukee throughout the current COVID-19 pandemic.
2. Use this opportunity to test how to transform the delivery of medicine and health care, especially for uninsured adults, by training staff, interns, students and volunteers to use telehealth platforms to increase access.
3. Increase outreach, COVID-19 risk reduction education, health services and support for current BOHC patients as well as new uninsured adults referred to BOHC by health systems, FQHCs, free clinics, community partners and family/friends of current patients.
4. With the Milwaukee Health Care Partnership, rapidly create a system to accept referrals from Milwaukee County Emergency Departments for uninsured persons with COVID-19 related problems.
5. Work closely with partners to share the new model with others throughout Wisconsin through our relationship with the Milwaukee Health Care Partnership, Free and Community Clinic Collaborative and Wisconsin Association of Free & Charitable Clinics.

 

Results

This project made significant progress toward its goal. A telehealth model was developed to adapt to the evolving health needs of uninsured adults during the COVID-19 pandemic. These services, facilitated through the Updox platform, engaged 14 physicians and resulted in 517 telehealth visits. Because their patient population is primarily people of color, with 16 percent being Hispanic, BOHC provided telehealth visits in Spanish on Fridays. The model not only provided primary care but extended to specialty care, including nutrition, dermatology, physical and occupational therapy, psychiatry and allergists, with the help of an active volunteer base of physicians.

Despite the absence of electronic medical records, BOHC utilized tools like Google Suite and “My Health Direct” to enhance data collection on the unmet physical health, behavioral health, social and fiscal needs of low-income uninsured adults. The data emphasized needs such as access to primary and specialty care, diagnostic testing, assistance with Medicaid and other insurance applications and housing support. To address these needs, the BOHC Community Health Resource Center conducted intakes for 223 new patients, identifying their health care needs and providing follow-up social work contacts.

The project also aimed to connect uninsured adults to a medical home, either with BOHC or other free clinics. The grant facilitated coordination with emergency departments and the Emergency Department Care Coordination Project to ensure ongoing health care support for uninsured adults post-emergency care. Around 50 patients were successfully referred to free clinics, and connections were established with Impact 2-1-1 and the Milwaukee Health Department for additional referrals.

Lastly, this project played an important role in disseminating COVID-19 safety measures to approximately 1,800 individuals, including patients, staff, volunteers and members of the Free and Community Clinic Collaborative. The outreach efforts involved information flyers, mask distribution and wellness checks via phone to provide personalized support during the pandemic.