A year after COVID-19 made its way through the community, KC CARE Health Center has adjusted to a new normal, from Telehealth visits to community testing, administering vaccines and expanding primary care services.
KC CARE is one of 29 federally qualified health centers (FQHC) in Missouri, meaning that it is eligible for federal funding because its mission is to serve the uninsured and underserved populations of the United States.
In the Northeast, KC CARE Health Center at 4601 Independence Avenue has been serving our community since 2017, when it took over Dr. Elaine Jocelyn’s practice upon her retirement. KC CARE has about 20,000 patients across its four locations.
“It makes our work there really rich and meaningful because we’re able to carry a legacy that this retired physician had with the community forward and treat the next generation of her patients, so it’s a really nice opportunity to connect, carry out our mission, and carry on Dr. Jocelyn’s mission, as well,” said Wil Franklin, CEO of KC CARE.
The health center was founded in Kansas City in 1971 as the Westport Free Health Clinic in the lobby of the Alcazar Hotel, run by volunteers providing free medical services to those in need.
In the late ‘80s, the clinic moved to the east side of Kansas City and changed its name to the Kansas City Free Health Clinic. By the late ‘90s, the clinic launched behavioral health services, expanded to 39th and Main, and became the lead agency in Kansas City responsible for building a system of HIV services in the region.
“Over time we’ve garnered a lot of recognition around that work, and we’re still the largest HIV provider in the region. However, now that we’re a federally qualified health center we also offer primary care,” Franklin said.
The clinic continued to add more services and expand, and today, the Kansas City Free Health Clinic is the KC CARE Health Center, which stands for Care, Access, Research, and Education for all.
“We have an emphasis on providing quality care for anyone who walks through our doors, regardless of ability to pay,” said Dr. Kelsey Ryan, a women’s health physician at KC CARE Health Center. “If a patient walks through our door and they are uninsured, we have dedicated workers at our clinic who can sign them up for Medicaid if they are eligible.”
Their list of services include primary care, women’s health, testing and screening, sexual health, dental care, behavioral health, HIV services, pharmacy, and community services.
KC CARE Health Center offered Telehealth appointments before COVID-19, but in the early weeks of the pandemic, nearly 40 percent of their business transitioned to connecting patients to healthcare providers virtually, either via phone, tablet, or computer.
Telehealth offers a way for patients to still be able to see and talk with a doctor while complying with social distancing and not compromising their health. Telehealth uses HIPAA-compliant technology to protect patient privacy.
“Part of our mission is to be accessible to our patients, and we feel like that model that we do in Northeast – and then we have a relatively new pediatric-focused site that’s on Troost – is kind of the model of the future of healthcare and FQHCs, not these big brick and mortar healthcare facilities, but more neighborhood-based, mobile units, meeting our population where they are as much as possible,” Franklin said.
In September KC CARE will roll out its first mobile pediatric dental unit, which can visit patients where they are, even if that’s at schools. Franklin said KC CARE is already growing out of the Northeast location.
“We don’t have space in there to do any dental work or things like that, so having that mobile dental unit will allow us to offer dentistry, and until we can expand that space or do something like that, then it gives us some options to serve more patients there,” Franklin said.
While this will be the first mobile dental unit, a mobile medical unit is set to arrive this summer.
“We felt like the expansion of Telehealth and doing more mobile health allows us to be where people need to see us,” Franklin said. “I imagine our medical unit will likely focus a lot in the short term on vaccine administration.”
KC CARE has administered just under 5,500 vaccines so far, despite being limited to the Midtown location initially because they had the Pfizer vaccine, which needed to be frozen.
“Thankfully, starting last week, we were able to start getting the Moderna vaccine, which allows us to store it in a regular vaccine refrigerator,” Franklin said.
Although the cold weather delayed shipments, KC CARE is back on track to administer vaccines to patients who meet the criteria in Northeast.
“Actually, it was a priority for us to deliver vaccines there because there’s not many places around that neighborhood who are administering vaccines, and when we were doing community-based COVID testing, we had some of the highest incidences of positive cases in that area,” Franklin said.
KC CARE has worked in collaboration with other FQHCs and public health departments to do testing and contact tracing in the locations that have the highest number of cases, making sure that they were getting neighborhoods that potentially didn’t have access to large healthcare facilities.
“We really wanted to focus on the brown and Black communities, and because of stigma – and reality is, historically, Black and brown members of our society have had good reason to sometimes lack trust in these types of efforts – so it’s been a real important part of our communication,” Franklin said.
KC CARE is gathering both Black and brown providers and patients to talk about getting the vaccine in an effort to familiarize people with the process and build trust.
“I think the other piece is trying to make sure that we can give the vaccine in these ZIP codes, in locations where we’ve had these high incidents of positive cases and low access to care and resources,” Franklin said.
He recommends Kansas Citians waiting on the vaccine sign up on multiple lists in their area and watch KC CARE’s and the health departments’ social media pages for updates.
“Until we have a really predictable supply chain, our vaccine administration efforts are week-to-week,” Franklin said. “It’s a challenge to manage the supply chain right now and we’re really kind of operating – really just wetting our fingers and putting them in the wind sometimes to understand how many resources to allocate, things like that. But we’ve been working closely with the state, the city, we’re collaborating with the other health care institutions in the area.”
KC CARE has been working closely in partnership with the St. Luke’s Hospital system. On occasions when KC CARE did not get a shipment, for whatever reason, from the state, St. Luke’s has been able to reallocate some of their supply to make sure, from an equitable stance, that the healthcare community is focusing on the higher risk patients in the region.
Samuel U. Rodgers Health Center, Swope Health Center, also FQHCs, and KC CARE are seeing 70,000 of the most vulnerable patients in the region.
“I think looking at federally qualified health centers as an important tool in the implementation of vaccines is critical because of the patients that we serve, and we already have those established relationships, as well,” Franklin said. “A lot of our patients aren’t going to go to a hospital system to get a vaccine, and a lot of it is just lack of awareness or sometimes trust, and not being able to predict that interaction, what’s going to happen.”
If Kansas Citians have to prioritize food, rent or medicine for the month, and are worried about getting charged for a visit, FQHCs have resources to help.
KC CARE works with a group of community health workers, and insurance navigators, who are dedicated to advocating for patients. Many of them speak either Spanish or another language often heard in Kansas City, they live in the neighborhoods, or they’re connected to whatever patient group that KC CARE is trying to reach.
Translators are an essential piece of the puzzle, especially in the Northeast, where many of the staff are bilingual, including a nurse practitioner who stayed on after Dr. Jocelyn’s retirement and has a long history of relationships in the community.
“We also use translators and we do it by telephone so that we’re not calling someone and waiting for them to get there, we have immediate access to a video, video link or an interpreter to be able to offer service in any language that the patient speeds,” Franklin said. “Now, obviously we have some bilingual providers who speak Spanish, so that makes it easy for Spanish speaking patients. But having all the other languages available for translation is important, too.”
Franklin believes Telehealth and some of the other tools that have been implemented during the pandemic are options that should have been available all along. No-show rates for appointments have gone down with the use of Telehealth, which provides a new layer of flexibility.
“I think Telehealth and things like that are providing a really important form of access, especially for people who, whether it’s a work schedule, childcare, transportation, a lot of these barriers that really prevent people from getting here,” Franklin said. “We’re still seeing about 15 to 20% of our patient visits in Telehealth.”
Many other services have shifted and adapted, as well, like virtual support groups and HIV care. For patients with chronic care diagnoses like diabetes and hypertension, KC CARE is working on innovative ways to get glucometers into people’s hands at home so they can log necessary information and communicate with electronic health records.
“We want to make sure that we’re keeping up with people’s medications, and one of the benefits of being an FQHC is we have an in-house pharmacy that has discounted costs for patients, especially who don’t have insurance or Medicaid,” Franklin said. “For instance, insulin, on average, costs $300 a month; however, our patients pay about $10 a month for insulin.”
Initially, it was a challenge for KC CARE to transition to vaccine distribution because it was pulling staff from clinical operations, but now at the Midtown location, most of the individuals who are actually giving the shots, the vaccinators, are volunteers. A lot of them are medical students, residents, UMKC School of Dentistry, UMKC School of Pharmacy, KCU medical students, or retired health care professionals.
“We’ve seen a drastic reduction in the demand for testing, and so I think our best indicators of viral load in the community are probably hospitalization rates,” Franklin said. “I think that’s going to be a better indicator for Missouri and Kansas, just because we’ve seen so much demand for testing.”
At the height, KC CARE was testing sometimes 100 to 200 people a day in the community, but there’s been a couple times recently where they’ve had a full schedule of people to come in and test and about 20 people showed up.
“I’m hoping that the state and the city can really put out the message that we’re still a ways away from mass vaccination,” Franklin said. “We don’t have the supply yet to vaccinate everyone. Just because the vaccine’s here doesn’t mean that we can start curtailing prevention, whether that’s getting tested, whether that’s wearing a mask, whether that’s not socially distancing, things like that.”
Individuals shouldn’t let their guard down because they feel hopeful now that a vaccine is here, Franklin said.
“People, even if you’re vaccinated, you could still potentially spread the virus, even though you may not get sick from it,” Franklin said. “I think those are important public health messages that I’m hoping that the state and city can get behind so that we don’t lose momentum. I think it’s great that we’re seeing a reduction and cases, but I also think we need to be careful.”
KC CARE’s Northeast location is open Monday through Friday 8:30 a.m. to 5 p.m., and Telehealth and in-person appointments can be scheduled at kccare.org or by calling (816) 753-5144.