The Critical Role Community Health Centers Play Across the U.S.

Mollie Melbourne, Director of Emergency Management at the National Association of Community Health Centers

Direct Relief and the National Association of Community Health Centers (NACHC) have worked closely together since the days following Hurricane Katrina in 2005. NACHC has been instrumental in helping Direct Relief connect with health centers throughout the country—both on an ongoing basis, and during emergencies.

I asked Mollie Melbourne, the Director of Emergency Management at NACHC, about Direct Relief’s health center partners’ needs and emergency response plans to find out how we can better assist them daily and in times of crisis. Below are her responses, which shed light on the important role community health centers have in meeting their local health needs.

Damon Taugher: Following an emergency, what types of assistance do clinics and health centers need the most?

Mollie Melbourne: It really depends a bit on the emergency. After a natural disaster like a hurricane or tornado, health centers frequently provide first aid and triage care to patients and other members of the community who have been affected by the event.  So, they typically ask for things like tetanus vaccine, bandages, antibiotic ointment, over-the-counter (OTC) pain relievers, and the like. Once the immediate response has passed, health centers then tend to look for medications to treat chronic illnesses, such as diabetes, hypertension, and asthma, which may be harder to find in an impacted community.

In addition, health centers will often ask for personal hygiene products, like soap, shampoo, and toothbrushes for staff, patients, and community members who can’t return to their homes because of evacuation, damage, or other reasons. They also may need patient education materials in multiple languages, support in seeking assistance for damage and loss their organization (or staff and patients) incurred as a result of the event, as well as information around policies, regulations, and standards that may apply in the situation.

DT: Community members often turn to safety net clinics and health centers for care following an emergency. What role do health centers play following an emergency and what can they do to better prepare?  

MM: Health centers are such critical partners in a community response to an emergency.  The roles played by a health center vary quite a bit based on the situation as well as the capacity of the community as a whole and the health center. Overall, a really important role that health centers play in emergencies is to maintain care for their patients—who still get sick, require follow-up, and need medications even during emergencies. This helps to maintain continuity for the patient but also protects the resiliency of the healthcare infrastructure so that those who need services beyond the primary care level can better access it.

Another typical role for health centers is that of providing triage and first aid in response to an event. In large events or cases where the health center facility was damaged, health centers have provided these services from mobile clinics, at alternate care sites, or even on foot while pulling a wagon loaded with basic supplies and bottles of water.

Health centers are truly in and of their communities—they see their patients, colleagues, friends, and families hurting (physically, psychologically, or both) and want to help any way that they can. A familiar face, kind word, or hug can go a long way to help people as they rebuild their lives and their community following an emergency. Health centers know this well and do it with such competence and caring.

DT: How can they better prepare? 

MM: Great question. There are a number of things that can help a health center become more resilient following an emergency. First, having an emergency management plan that fits their health center and will help them maintain their operations when things get difficult (power outage, infrastructure damage, and so on). The process used for creating this plan is as important as the plan—training staff, collaborating with community partners, and integrating the response of the health center into the response of the community.

Secondly, having well prepared staff on a personal level.  Your organization could have the greatest plans in place but if your staff aren’t prepared to come to work following an emergency, you aren’t going to be able to do much. Making that an organizational priority is key—and there are so many great resources available for free to help people get prepared—so health centers can help their staff by sharing information from Ready.gov and CARD (cardcanhelp.org) to name just a few.

DT: How does NACHC support the emergency preparedness efforts of health centers? (NOTE: NACHC’s emergency management work is available to all health centers, not just members.)

MM: Our main focus is building emergency management capacity at health centers and PCAs, the state based associations of health centers. We do this through webinars on particular topics, conference sessions, online learning courses, and training events targeting health centers and PCAs. We also develop and compile tools and resources to help health centers move their planning further along to promote effective response and recovery following an event. This includes sample policies, plan templates, staff training materials, and so on. Lastly, we educate health center partners at every opportunity so that they are aware of the incredible assets and skills that health centers bring to the planning table and response efforts within a community.

DT: Can you share some lessons learned from past emergencies you have been involved with?

MM: Sure. I have mentioned a few of them already—like encouraging personal preparedness among staff, having a plan that will work when you need it to, and working with your local partners, but there are a few other things that I have learned over the past six years of my work in this role.

  • Our patients will come to us whether we are ready or not—they know and trust us and we need to be ready for them.
  • Communication is going to be a problem so make sure that staff know what they are to do, how they are to do it, and when they are to do it without needing to be told before anything happens.
  • Seems pretty simple, but PRACTICE your plan. You can find a lot of areas for improvement by conducting drills and exercises. The time to find out that your plan doesn’t work as you thought it would is NOT during an emergency.
  • Never underestimate the psychological impact of an emergency on your staff, patients, and community. It is critical to build in mental health support and staff in all of your planning efforts.
  • Make time to attend local planning meetings—you can learn a lot about what your community is planning and how your organization fits into those plans. It is also a great chance to enlighten your partners about what you can do during an emergency response as well as in everyday life.
  • Health centers are incredibly resourceful during emergencies while never losing sight of their patients’ needs. I am always humbled by the way health centers just do what needs to be done for their patients and their communities following an emergency. And they do it with such grace and compassion. Truly inspiring.
  • Lastly, I have learned that Direct Relief is an amazing friend to health centers. You have been there to help when we, and our patients, have needed you most. And for that, we are and will remain, deeply grateful.

 

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