During the summer of 2020, I completed a full-time project in collaboration with Neighborhood Healthsource, a community health center (CHC) in Northeast Minneapolis. This project was funded through the Chuck Green Fellowship, a competitive fellowship through the Political Science Department at Macalester.

Because they are federally funded and serve particularly vulnerable patient populations, CHCs faced an incredibly challenging summer due to the COVID-19 pandemic. Neighborhood Healthsource, along with every other CHC in the United States, was struck by extreme budget cuts and funding shortages. Simultaneously, the clinic was responsible for providing healthcare services to low-income populations who were (and continue to be) disproportionately affected by every aspect of the pandemic. As Northeast Minneapolis faced heightened food insecurity, racial injustice and police violence, and spikes in COVID-19 case rates and deaths, CHCs such as Neighborhood Healthsource proved to be an essential part of the healthcare safety net system.

Many patients of the clinic became (or already had been) uninsured or underinsured at the onset of COVID-19. Many were Medicaid enrollees, or were enrolled in MinnesotaCare, which is Minnesota’s public program for individuals who do not qualify for Medicaid but still cannot afford to purchase private insurance. For any individual of any education level, navigating and accessing public (or private) insurance in the United States is very difficult. Rules surrounding eligibility change frequently and involve many variables.

As Northeast Minneapolis (like many communities across the country) grappled with the challenges of the pandemic, these patients lost their access to affordable, quality healthcare, which is an essential right and necessity. Neighborhood Healthsource, with the leadership of their Community Health Director, found ways to monitor and address public health issues within the neighborhood, organizing food drives, mammogram clinic events, public STD screenings, and ongoing free COVID-19 testing. Below are a few examples of the ongoing community health work done by Neighborhood Healthsource:

My summer goal was to work directly with patients facing challenges navigating the complexities and inequities of our current healthcare system. I was able to accomplish that goal despite the setbacks presented by the pandemic. I worked with Neighborhood Healthsource’s Community Health Director on an outreach project for their patients who owe the clinic high outstanding balances.

Together, we developed an outreach script and I contacted patients who needed help applying for sliding scale discounts, receiving insurance benefits, or paying off their balance so they could continue to receive health care. There were over 300 patients, many of whom struggled with chronic health conditions, who needed guidance surrounding the best way to bring down their owed balance and schedule new appointments. I also became certified as an MNSure Navigator to help patients apply for public insurance (like Medicaid).

Additionally, I helped gather data about this specific group of patients so that the community health team could better address their financial and health needs in the future. By the end of the project, I was able to compile a list of observations about this patient population’s needs and make financial policy suggestions to the Quality Management Team. By speaking directly to the patient population, I was able to ask them what their needs were and what parts of the system were not working for them. This patient-centered work informed my policy recommendations and allowed me to convey to the Community Health Director and the Quality Manager some of the unique challenges that had developed for these patients during the pandemic.

These suggestions included new ways to manage patient outreach, track patients’ financial barriers to care, and communicate policies to the patient population to ensure that they are not left without access to healthcare services. It is my hope that these policy changes will improve patients’ access to healthcare both during and after the COVID-19 pandemic.

For me, the most important takeaway from this project is the importance of engaging directly with the communities that you are hoping to serve. At Macalester, we talk a lot about equity, community engagement, and justice in many forms. Sometimes in my academic engagement with equity issues, I forgot to keep individual people and all their complexities in mind. Through my experience at Neighborhood Healthsource, I learned that policies are best formed with the input and leadership of the people they affect. This was true within the boundaries of the clinic, and it remains true at any level of public policy.