City leaders play an essential role in helping residents navigate to the safest and best possible health services to meet ongoing needs. They do this through:
- collaborating regionally, with partner organizations, state and federal officials, and local businesses;
- providing resources; and
- communicating clearly to residents, especially to vulnerable groups.
Swift, efficient, and timely action from city officials can alleviate stress and trauma experienced by various groups grappling with the COVID-19 pandemic.
The enormity and uncertainties surrounding COVID-19 increases stress and fear, overburdens the healthcare system and causes disruptions in access to quality ongoing care. This has resulted in increased trauma among various groups. Vulnerable populations, such as children and elderly people with chronic conditions, continue to have health needs that the pandemic makes more difficult to address. Reliable access to ongoing health service needs is critical to preventing further strain on overburdened emergency rooms and urgent care centers. School closures impede student access to nurses and school-based health centers. Residents reliant on mobile clinics now find those services unavailable. Reduced access to family members adds stress for patients in long-term care and skilled nursing facilities already at greater risk for getting sick. The outbreak causes trauma more broadly for the uninsured, healthcare providers, first responders, those with mental health, substance use disorders and/or experiencing homelessness, incarcerated individuals, the elderly, and undocumented people among others.
Municipal leaders can support reliable access to health care by:
- Collaborating with state and regional lawmakers to expand the healthcare workforce, including short-term flexibility for out-of-state licensed health care providers and telehealth.
- Ensuring timely, safe and accessible information on health care access to all city residents to meet on-going and emerging care needs and avoid further overcrowding of hospital emergency rooms.
- Helping to provide resources (e.g. masks, gloves, gowns, tests, etc.) for patients, health care workers, caregivers and first responders to limit spread of COVID-19.
- Advocating for expanding health care access points with state/regional partners. These could include temporary field hospitals using Federal Emergency Management Agency (FEMA) resources, as well as temporary flexibility for licensed providers to practice outside of the scope of their license to assist with short-term needs.
- Communicating through trusted partners, city government portals/texts, and other mechanisms to ensure availability of timely and accurate information. This includes getting information to the most vulnerable populations.
- Ensuring financial resources from federal, state and local entities are getting to where they are most needed to enable reliable access to health care treatment and services.
- Addressing the impacts of trauma, mental health and substance use disorders. Existing and emerging conditions can be exacerbated by the stress associated with COVID-19. Consider special outreach to healthcare workers, first responders, and those with existing healthcare conditions.
Local leaders can help ensure access and information is provided to address on-going health care treatment and service needs by:
- Working regionally with county officials and health care stakeholders (community health centers, hospitals, public health) and service providers (e.g. non-profits, homeless serving organizations, food banks, etc.) to align and coordinate on-going health care and related needs in communities. Consider short-term approaches including temporary field hospitals, respite care locations and temporary housing sites (vacant hotels, motels, etc.) with services.
- Developing regional/community action plans through multi-sector collaboration (health care, community development, non-profits, philanthropy, etc.) that consider available resources in the community (retired medical providers and medical/nursing students, existing land/space, etc.), to develop innovative approaches to meeting immediate health care and essential service and treatment needs.
- Providing guidance and detailed information through known and trusted community-based organizations (food banks, Salvation Army, Goodwill, faith-based organizations) that serve the poor and vulnerable communities on where to access care.
- Working with community partners, philanthropy and local businesses to provide guidance and resources for patients, healthcare workers, caregivers, first responders, incarcerated individuals, people experiencing homelessness, individuals with substance use disorders and/or experiencing mental health issues. This will promote health and safety and reduce stress throughout the crisis.
- Urging providers to postpone elective surgeries to make hospital beds available for emergencies and by emphasizing the need for a protocol to distinguish type of elective procedures to account for more urgent needs related to on-going chronic illnesses.
- Ensuring skilled nursing centers and long-term care facilities that work with Medicare and Medicaid populations are following new CMS guidelines for the health and safety of all residents and providers.
Local leaders can advocate for federal and state resources by:
- Collaborating with local and state officials on Medicare access to explore and advance telehealth options (virtual appointments) and alternatives to in-person appointments and by providing that information through community-based organizations that serve the poor.
- Making residents aware of new opportunities to enroll in health insurance as several states have opened new enrollment periods in response to the epidemic and ensure more people are covered.
Local leaders can address trauma and mental health for first responders and healthcare providers by:
- Providing mental health services and trauma-informed approaches and care for first responders and healthcare workers to support professionals integral to helping people manage through these difficult situations.
- Working with community stakeholders to ensure support and resources to families, caregivers, and others experiencing disruptions and trauma associated with the pandemic.
Local Government Examples
- Managing Stress and the Threat of COVID-19 and COVID-19 Responder Self Triage (Minnesota State Department of Health)
- Statewide recruitment and mobilization of nurses in New Jersey
- Trauma Intervention Program (TIP) in Maine provides emotional and practical support to first responders in times of crisis
- Chicago hotel space to be used for quarantining patients
About the Authors:
Laura McDaniel is a program manager at the NLC Institute for Youth, Education, and Families.
Sue Pechilio Polis is the Director of Health & Wellness in the National League of Cities Institute for Youth, Education, and Families.