Fontenelle Health Center addressing health disparities

The health disparities documented among minority and underserved communities are nothing new to the physicians and staff of the Fontenelle Health Center, a Nebraska Medicine clinic located in North Omaha for more than 20 years.

The health center, currently located at 5005 Ames Ave. on the campus of the Omaha Home for Boys, historically serves a diverse clientele.

“The two ZIP codes that we serve, primarily 68104 and 68111, have some of the highest rates of coronavirus in the area,” said Daniel Jeffrey, MD, medical director for the clinic. “Looking overall at the communities of color that we serve, in terms of the patients who are identified as receiving care, about 52.5% of them are Black, 39% are Caucasian and about 3% are Asian, primarily Karen refugees.”

When COVID-19 appeared earlier this year, staff at the clinic worked to inform the community and provide testing as soon as possible.

“People get their information from a lot of different sources, and sometimes the information they’re getting isn’t accurate,” Dr. Jeffrey said. “We have seen both sides of that. We have patients that have told us they don’t need or want to wear masks, that they aren’t going to get sick. We have patients who have been highly affected by this, people who work in factory settings in the community who may have had symptoms early when we could not test.”

There remains distrust in the North Omaha community in spite of the clinic’s longevity, said Andrea Jones, MD, who serves as the medical director of a satellite location, at Girls Inc. in the Katherine Fletcher Center, at 2811 N. 45th St., which further expands the Nebraska Medicine clinic’s reach.

“As a designated Nebraska Medicine phase one COVID-19 clinic, we see many new patients who have a lot of misinformation about COVID-19,” Dr. Jones said. “A lot of our time during the visit is spent gaining trust and offering support and counseling.”

“Our nurses really have become experts in trying to triage patients, and phone calls from patients about where to go for care or to be tested,” said Jennifer Parker, MD, who practices at the clinic. “Our providers have been helping as well. I’ve been amazed at how quickly everyone’s been able to adapt and try to get patients seen and taken care of.”

The clinic has provided not only testing but follow-up care, informing clients about when they can go back to work, providing guidance on quarantine and self-isolation, and helping with the Family and Medical Leave Act paperwork families must file.

“We’re doing our best to support our patients so they don’t lose their jobs but also so they can maintain their health,” Dr. Parker said.

Because Fontenelle Health Center is a patient-center medical home (PCMH), the clinic also includes social work, behavioral health, a pharmacy and a nutritionist, in addition to internal medicine-pediatrics, family medicine and pediatric physicians available.

The PCMH model has been a key to expanding patients and building trust in the community during the COVID-19 pandemic, Dr. Parker said.

“Our behavioral health colleagues and our social worker have been instrumental in trying to help people process their anxiety and fear regarding COVID-19 in the community. In addition, our nursing staff has expanded dramatically,” Dr. Parker said. “We’ve been able to add a good number of nurse care coordinators, who can do a lot of outreach to our patients. They’re really helping us with transition care management phone calls and helping us keep track of our patients who have more chronic health conditions by doing chronic care management.”

Being visible in the community helps as well, Dr. Jones said.

“I participated in several of the rallies, like at the Malcolm X Memorial,” she said. “Patients saw me there, handing out masks and encouraging everybody to work on all the inequities that exist in our nation — and health inequity is a huge one.”

Many patients face transportation issues, so the clinics’ North Omaha locations are important as well, Dr. Jeffrey said.

During the pandemic, the clinic has shifted its well-pediatrics practice to the Girls Inc. location to maintain routine vaccination schedules and children’s general health care. In addition, the clinic continues to offer services like lead screening for children which is especially important for communities living east of 72nd Street and north of Dodge Street. Routine care like this helps reduce the impact the pandemic is having on already vulnerable communities.

All three providers said they have seen concern over COVID-19 rise in the community as education and information is provided. Clinic physicians have helped provide Spanish and Karen language resources, recorded informational videos and met with community leaders.

“Now, the majority of my patients say they know about this disease and are trying to protect themselves,” Dr. Parker said. “The message is getting out there, and we’re trying to provide it to every patient on every visit, in additional to general health counseling.”

Still, they hope to do more.

“There’s always opportunity for further engagement,” Dr. Jones said, including funding billboards in the area with accurate information, disseminating a handout to Black churches and exploring collaborations with key organizations.

“We need to be supporting the community infrastructure as much as we can, because the economic effects of this are acutely felt in our population,” Dr. Parker said. “We’d love to team with UNMC, potentially the College of Public Health, to see what else we can do in a more systematic manner.”

Dr. Jones also stressed the importance of recognizing that inequities exist and the health profession needs to provide resources to fight them.

“Since the recent social unrest, a lot of light is shining on this issue,” she said. “No one can deny it, or say that it’s only happening in one part of the country, or it’s about not having insurance coverage. It’s simply the color of your skin that determines some of these huge disparities.”