Pioneering COVID-19 Pandemic Partnerships: Federally Qualified Health Centers and Geriatric Workforce Enhancement Programs Work Together to Care for Diverse Underserved Older Adults

Abstract

Background: The COVID-19 pandemic disproportionately affected populations served by Federally Qualified Health Centers (FQHCs), with high morbidity and mortality rates in ethnic minority older adults. In response to this pandemic, academic geriatric medicine teams through federally funded Geriatric Workforce Enhancement Program (GWEP) with FQHC partnership implemented new initiatives to improve the care for vulnerable older adults. Objectives: To describe how four FQHC/GWEP teams collaborated in caring for diverse communities of older adults during the pandemic. Methods: Four GWEPs have addressed pandemic response efforts with their respective FQHC partners. These collaborations to meet the increasing numbers of older adults seeking services, and the rising disparities exacerbated during the pandemic are delineated. Results: FQHC/GWEP partnerships enabled access to care, whether in-person or virtually to serve unmet needs of underserved older adults during the pandemic. Partnerships promoted COVID-19 education, testing, and vaccinations. Most FQHCs faced severe staffing shortages, and the digital divide challenged patients with barriers. GWEPs provided direct care, created educational materials, and developed telehealth programs. These partnerships addressed social determinants of health gaps caused by the pandemic. Conclusion: The findings demonstrate that strong partnerships between GWEPs and FQHCs mitigate health inequities for vulnerable ethnic minority and rural older adults during pandemic crises.

Impact of Advance Care Planning on the Hospitalization-Associated Utilization and Cost of Patients with Alzheimer’s Disease-Related Disorders Receiving Primary Care via Telehealth in a Provider Shortage Area: A Quantitative Pre-Study

“…Lastly, a call to action is needed to develop and sustain an infrastructure grounded in collaborative research and community engagement to respond to low rates of ACP documentation for the people living with ADRD [ 13 ]. Greater awareness of the potential and likely harm from the lack of ACP documentation will likely play a pivotal role in training a future geriatrics workforce to provide both telehealth and in-person primary care services [ 33 ].…”

“…In a provider shortage area, workforce training is a realistic priority strategy to enhance quality of care outcomes [ 34 ]. The Age-Friendly Health System 4M framework (What Matters, Mobility, Medication, Mentation) is an easily adoptable toolkit for evaluating the quality of care and a workforce education competency tool for use across diverse local healthcare systems and care settings [ 33 , 34 , 35 ]. In the recent quantitative analysis of reviewing EHRs to measure the rate of documenting 4M elements in one Nevada health system adopting the 4M framework in its primary telehealth services, What Matters (62.2%) was the most common 4M element to be documented, and within the components of What Matters, ACP discussion was the most commonly (29.0%) documented [ 36 ].…”

“…In the recent quantitative analysis of reviewing EHRs to measure the rate of documenting 4M elements in one Nevada health system adopting the 4M framework in its primary telehealth services, What Matters (62.2%) was the most common 4M element to be documented, and within the components of What Matters, ACP discussion was the most commonly (29.0%) documented [ 36 ]. Although the cost-effectiveness for becoming an age-friendly health system via training an ADRD-aware workforce remains to be determined, adopting the 4M framework for people living with ADRD will not likely add significant cost burdens to a health system [ 33 , 35 ]. As such, the 4M framework can be a promising innovative strategy to enhance the outcomes of ADRD care in Nevada [ 37 ].…”

Racial and Ethnic Disparity in 4Ms among Older Adults Among Telehealth Users as Primary Care

“…Telehealth holds great promise for enhancing primary care access among older and vulnerable adults especially if they need transportation support ( Gibbs et al, 2022 ). Studies have shown that telehealth utilization is associated with better outcomes in chronic disease management and reduced healthcare disparities across racial and ethnic boundaries ( Bose et al, 2022 ; Dryden et al, 2022 ; McQuown et al, 2022 ).…”