health fairs. Homeland Health Specialists addresses underserved minority health care needs through free flu shot clinics
August 2007
by Nora Livesay
Influenza (the flu) is a serious illness affecting millions. Each flu season is unique, but it is estimated that approximately 10 to 20 percent of U.S. residents get the flu. An average of 114,000 people are hospitalized for flu-related complications, and about 20,000 die of complications each year.
The flu usually spreads from person to person when an infected person coughs, sneezes, or talks and the virus is sent into the air. Unlike many other viral respiratory infections, such as the common cold, the flu causes severe illness and life-threatening complications in many people.
And while a simple yearly flu vaccination can protect against the flu, many people – especially members of minority or low income communities -- do not get a flu shot because of lack of access to health care and mistrust of the traditional health care system.
Homeland Health Specialists, Inc., a Minnesota health care services company offering vaccinations and wellness screenings, is working to change access and the venue for health care delivery for minority communities in Minnesota. Since founding the company in 2002, owner and licensed public health nurse Marge Kern has been providing free flu shots at charity clinics in minority and low income communities.
“It’s always been our belief to go out and do charity clinics,” said Kern. In Minnesota, where the flu season runs from November until April, Homeland Health Specialists provides flu shot services to clients throughout a 5-state area, but by the end of December is generally finished with corporate flu clinics. Leftover vaccine cannot be saved because the formulation changes each year; whatever is not used during the flu season must be discarded.
“We have vaccine left, and it’s going to go to waste. We just think charity flu clinics are the right thing to do,” Kern explained.
Beginning with the 2003 flu season, Homeland Health Specialists donated nearly 1000 doses of leftover vaccine, along with supplies and nursing and staff time, to offer free flu shot clinics in the Twin Cities and Duluth metro areas. The clinics were held at community centers, food shelves, homeless shelters and local churches.
A nationwide shortage of flu vaccine for the 2004 flu season left Homeland Health Specialists in the unique position of having the largest and nearly only vaccine supply in Minnesota. Many health care providers in the state were without vaccine. Those who bought primarily from Chiron Corp., the company whose manufacturing plant was shut down by the British government, halting shipment of 46 million doses destined for the United States, received no supply.
Although worksite flu shot clinics make up 75 percent of Homeland Health Specialists’ annual revenue, they cancelled all worksite flu clinics and reallocating all their flu vaccine to high risk individuals only. Using their own staff and working with community partners and the State Department of Health, Homeland Health redistributed all their vaccine to high risk individuals within two weeks.
“Homeland Health should be commended for its around- the-clock efforts to redirect its flu vaccine to Minnesota’s most vulnerable citizens. They’ve worked to cancel hundreds of worksite flu shot clinics that Blue Cross makes available for its customers and have coordinated with the Minnesota Department of Health to instead schedule flu clinics for at-risk Minnesotans through county and city health departments,” said Georgia Pavoloni, FluStop coordinator for Blue Cross.
During the 2005 flu season, Homeland health Specialists worked primarily with the Hispanic community in the Mankato area to again provide free flu shot clinics using 788 doses of unused vaccine.
As Homeland Health Specialists grew its flu shot business, Kern knew that she wanted to expand the free flu shot clinics as well. “You can’t just practice diversity in hiring practices and in the office setting,” she said. “You have to practice it in the community. It has to be part of your business model to do community outreach.”
During most of the year, the company is comprised of five staff people, and then swells to 80 employees – primarily additional nurses and insurance techs -- from September to December to cover the flu season. Charity clinics provided unique challenges though in terms of organizing, publicizing and staffing. In the past, we’ve had site coordinators at charity clinics, said Kern, but not the dollars to put into translating forms and interpreting at the clinics. And that, she said, is one of the keys to a successful clinic.
“At many of the facilities we go to, it’s not unusual for us to bring lots of translated forms for different languages and to bring interpreters on site,” Kern said.
“We have tried really hard to hire from minority groups,” said Thea Boyd, operations manager at Homeland Health Specialists. “We welcome people from different backgrounds. And if they know another language, it’s a big benefit for us,” she said.
In 2006, Homeland Health Specialists was approached by Patricia Peterson of the Minnesota Faith Health Consortium to partner together to expand the reach of free flu shot clinics. The collaboration resulted in 5000 free flu vaccination being offered in the Twin Cities metro area.
The Minnesota Faith Health Consortium grew out of a discussions between Fairview Health Services, the University of Minnesota and Luther Seminary on the future of health care and the connections between faith and health. Peterson, a Fairview Health Services employee, coordinates the efforts of the Minnesota Faith Health Consortium in community projects and scholarship.
In response to a 2005 meeting with the Centers for Disease Control, Peterson had developed a proposal to involve the faith community in pandemic flu preparedness. “I thought, let’s do free influenza immunizations and get the community used to the idea that this is going on,” said Peterson. If we ever had a pandemic, we would need to use community resources, she said.
Peterson had secured a $25,000 grant from the Otto Bremer Foundation and a $20,000 grant from Fairview Health Services, had community partners lined up to host flu shot clinics, but she needed a health services company to provide nursing staff and vaccine. I was initially directed to another organization, but it was too expensive. Then one of the partners said I needed to talk to Marge at Homeland Health, Peterson said.
It was a perfect match. Kern had been wanting to do charity flu shot clinics on a larger scale, but didn’t have anyone to organize the community side of the efforts. And so the Minnesota Immunization Networking Initiative was formed, brining together representatives from the Native American, African American, Latino, Somali and Southeast Asian communities to try and increase the flu immunization rates among minority and underserved populations using the resources and trust of faith-based and grass-roots community organizations. The Minnesota Faith Health Consortium acted as project director, Homeland Health provided nursing staff and vaccine, and each community site promoted the free clinics and provided volunteers for intake and interpretation if necessary.
“The immunizations were not provided at traditional sites. We went to churches, community centers, a Somali mall, a free clothing center. Wherever the community gathered, we went there,” said Peterson.
Homeland Health Specialists donated 125 hours of nursing time and 1,596 vaccine doses, and then provided additional nursing hours and 1000 additional vaccine doses at cost. MedImmune donated 1,250 doses of flu mist because school-aged children were part of the targeted populations. Target Corporation donated 1,100 doses, and several other organizations donated a combined 370 doses. In total, 5,000 doses of influenza vaccine were administered with 50 percent of the recipients receiving a flu shot for the first time.
“She is the reason – Marge and her expertise and her can-do attitude and initial encouragement was really what made it go,” said Peterson. “We had all the planning done, but we didn’t have enough dollars. We were on a wing and a prayer for sure. And I found out that wing was Marge,” said Peterson.
What we learned is that groups with more years of experience with free flu clinics had higher turnouts, Peterson said. The Latino community, with whom Homeland Health Specialists had worked with previously, had the highest turnouts. This year, Peterson says they would like to reach out more to the Southeast Asian community.
“I really believe that the nursing staff at Homeland reflect Marge’s can-do attitude. They came out on Sunday afternoons and gave up family time on evenings and weekends,” said Peterson.
“We enourage our staff to work the charity clinics,” said Kern. “And many of our staff donated their own time as well.” Kern attributes part of that to flexible scheduling practices at Homeland Health. “One hiring practice has always been to allow staff to select their own schedule. We have some guidelines, but we hire enough staff to do that,” Kern said.
Peterson and Kern are excited about the projects prospects for the 2007 flu season. Peterson has secured a $25,000 commitment from Fairview Health Services, and has other funding and vaccine requests out to various groups. “This year,” she said, “we’ll start knowing that we have the dollars and knowing we have a partner.”
“We will continue this partnership,” said Kern. She’d like to start the free flu shot clinics earlier this year, perhaps in October. Kern has plans to expand the influenza line of business by 27 percent for 2007, and working with underserved and minority communities will be part of the expansion.
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