Like other health care providers across the nation, St. John’s Well Child & Family Center was blindsided by the COVID-19 pandemic when it first hit.

“We were responding, literally, minute by minute to something none of us had ever experienced before,” said Jim Mangia, CEO of St. John’s, which operates health clinics and community health centers that provide care for patients at 18 locations in South Los Angeles, Compton and Lynwood. “It was a horrendous situation. Everyone was out there fighting for themselves, without any support from the federal government. It was like having to build an airplane while you’re in flight.”

After the initial period of confusion and uncertainty, St. John’s mobilized quickly. In early March, St. John’s began erecting isolation tents at its health centers and implementing coronavirus screening and triage procedures. Administrators scrambled to procure personal protective equipment (PPE) and test kits as the number of patients seeking care began to climb. Rather than furloughing employees in service areas that were shut down due to the pandemic, St. John’s trained and redeployed them to support new telehealth services and perform screening for COVID-19 out in the community, including in homeless encampments. “We had to reorganize and retool our whole practice,” Mangia added. “It was a major undertaking.”

Fast Facts (Los Angeles Community Clinics
• 65+ clinics
• 350+ full-time sites
• 1.7 million patients served annually
• 50% of patients are below the poverty level and either on Medi-Cal or uninsured

Now, Los Angeles County health officials, hospitals and community health centers are coming together to discuss lessons learned and share
best practices from the opening phase of the pandemic. The goal is to better coordinate and improve their response for possible additional
waves – as well as to prepare for any potential future pandemics.

“We, in partnership with the community health centers, are a safety net system serving the most vulnerable populations in Los Angeles County,” said Anna Gorman, Director of Community Partnerships and Programs with the LA County Department of Health Services (DHS). Gorman oversees the county’s My Health LA program, which contracts with the community health centers to provide no-cost care for low-income patients who do not quality for public insurance. “We’ve always worked well together, but I think we’ve come together even more closely to respond to this crisis,” she added.

“Our 25-plus-year partnership with LA County has continued to grow, especially now,” said Louise McCarthy, MPP, President and CEO of
the Community Clinic Association of Los Angeles County and Chair of the California Primary Care Association. “We share common missions and patient populations. We’re a common network of care for the uninsured and underinsured.”

As part of this long-established relationship, the county contracts with the Community Clinic Association to provide a portion of the PPE it receives through the federal Hospital Preparedness Program to the community clinics. “Thanks to that partnership, our clinics are much better off than clinics in other counties around the state,” McCarthy said. “While we’ve had to get additional supplies from outside the county stockpile, the PPE we’ve gotten from the county has helped some of our clinics stay open.”

During the pandemic, the county is providing logistical support for COVID-19 testing, including vetting of commercial laboratories, and distributing communication materials to raise awareness of the coronavirus among disadvantaged populations, according to Clemens Hong, MD, MPH, MPH, Director of Whole Person Care at LA County DHS.

“The county has done a lot of work to ensure the testing quality is high,” Dr. Hong said. “As we move to a more mature stage of the pandemic, the county is working to move testing into clinical care, including building community test sites in community health centers. During the initial stage, we started testing sites where we could, including in malls, parking lots and fairgrounds. We’re trying to move testing to where patients go for care – to the clinic or hospital they trust.”

Community health centers, like St. John’s, have helped the county test some of the most difficult-to-reach populations during the pandemic.

“They’ve committed their staff to walk homeless encampments and conduct testing through mobile units,” Dr. Hong said. “Staff at other clinics also have done swabbing in people’s homes, rather than having them come to the drive-in sites. These are solutions to meet the need that is out there.”

Providing education and public messaging about COVID-19 also is a key role the county has played during the pandemic. “We’ve partnered with the clinics, different community organizations and other county agencies to get the word out to populations that are disproportionately affected,” said Gorman. For example, the county’s Office of Immigrant Affairs has developed and distributed materials such as flyers and posters in several different languages, including Spanish, Chinese, Korean and Khmer.

The materials give basic information about the coronavirus and stress the importance of sheltering in place, washing hands, wearing masks, and physical distancing. “It’s not just about doing testing,” said Dr. Hong. “Without wrapping education and counseling around it, a test is just a test.” As they plan for additional surges and the upcoming flu season, a closer collaboration among the county, community health centers and hospitals will be essential.

“Los Angeles County can serve as a model for other counties, big and small, that are trying to figure out how to work together to respond during this crisis, not just now, but as we move into new phases of the pandemic,” said Gorman.

For additional information about Communities Lifting Communities, contact Karen Ochoa, CLC Project Manager, at (213) 538-0765 or kochoa@hasc.org