The new coronavirus moved fast, unleashing a health care crisis that evolved into an economic and social emergency, hitting the most vulnerable communities hardest. Realizing what they were up against, nonprofit and outreach organizations across Chattanooga forged a web of partnerships to tackle a catalog of needs - from free, accessible testing for COVID-19 to meals for kids suddenly out of school and cash for newly out-of-work families to make rent.
Providers who had already been focused every day on closing gaps in health care saw the challenges of COVID-19 magnify existing problems, requiring entirely new solutions.
"As far as the economics of the underserved, it's huge," says Dr. Kelly Arnold, the founder and clinical director of Clinica Medicos. "As people quickly were displaced from employment, as the hotels were closed, the restaurants were closed, a lot of the industries where people were dependent were shut down, the very first thing to go for the uninsured population is health care."
As the data came into focus, it was clear cases among Latino residents outpaced other groups, and infections among Black residents grew at a faster rate than among white residents. The virus spread deep into the area's most at-risk ZIP codes - neighborhoods already grappling with worse health outcomes and limited resources. Free, fast and accessible COVID-19 testing became an urgent need that local health care and community outreach organizations quickly collaborated to deliver.
From May through early August, organizations including Cempa Community Care, Clinica Medicos, La Paz, Lifespring Pediatrics and Alleo Health System, which owns Hospice of Chattanooga, organized 21 mobile community testing sites.
"We've tested close to 3,000 people - 37% Black and 28% Hispanic, so 65% have been from minority communities," says Shannon Stephenson, CEO of Cempa Community Care. "We recognized that we needed to mobilize very quickly.'
Clinica Medicos and the Hamilton County Health Department established a free-standing COVID testing facility - affectionately known as the COVID cabana - to reach Latino residents who might not be able to get to mobile testing sites, and who might not feel comfortable showing up at other sites established with National Guard support, Dr. Arnold says.
"The government has called you illegal, but now you are essential, and now you need to trust our recommendations, now you need to show up where there's the National Guard in a uniform?" she says. "There was a lot of thought that went into, how can we message this, how can we educate, how can we be culturally competent, how can we be unthreatening?"
Meanwhile, Bill Ulmer with the Hamilton County Health Department worked to establish COVID-19 testing in partnership with a dozen Black churches all over the city. The Community Foundation of Greater Chattanooga funded the effort, and the sites ran every weekend from June through August, says Ulmer, who has been with the department for 37 years.
"Being African-American, I have an appreciation for what my neighbors and my colleagues and friends who are African-American are going through," he says. "It's a labor of love."
The number of people tested each weekend varied from around 450 to more than 1,000, and the collaboration with pastors, volunteers and community organizations such as the Southeast Tennessee Health Consortium has been crucial, Ulmer says.
Hamilton County COVID-19 Task Force
* Dr. Kelly Arnold: Founder and Clinical Director of Clinica Medicos* Dr. Carlos Baleeiro: CHI Memorial Lung Care Associates* Becky Barnes: Hamilton County Health Department Administrator* Rae Bond: Chief Executive Officer, Chattanooga-Hamilton County Medical Society * Dr. Matt Gibson: President & CEO, Siskin Hospital for Physical Rehabilitation* Dr. Timothy Grant: Chief Medical Officer, Parkridge Health System* Dr. Martina Suttles Harris: Assistant Dean of Nursing & Allied Health at Chattanooga State Community College* Dr. Gregory Heath: Guerry Professor of Public Health, University of Tennessee at Chattanooga* Dr. Keith Helton: CEO, One to One Health* Dr. William Jackson: President & CEO, Erlanger Health System* Dr. Robert Magill: Chief of Staff, Parkridge Health System* Angel Moore Esq.: Vice President of Population Health & CEO, Erlanger Community Health Center* Tom Ozburn: President & CEO, Parkridge Health System* Janelle Reilly: CEO, CHI Memorial Hospital* Dr. Colleen Schmitt: President, Galen Medical Group* Dr. Sanford Sharp: Diagnostic Pathology Services* Dr. James Sizemore: Medical Director of Infection Prevention at Erlanger Health System and Chief Medical Officer at Cempa Community Care* Shannon Stephenson: CEO, Cempa Community Care* Andrea White: CEO, Kindred Hospital Chattanooga* Dr. Christopher Young: Vice Chief of Staff, Erlanger Health System
"My quest was that I'm not going to just go to the largest churches," Ulmer says. "I want to get deep in the African-American community so as many people can feel and take advantage of these services as possible."
For the people who work every day to care for Chattanooga's homeless population, the crisis presented specific challenges. Hand-washing, social distancing and testing are all extraordinarily difficult when you don't have a place to live, says Casey Tinker, a program manager with the the city's Homeless Services Division. The city quickly teamed up with the county's Homeless HealthCare Center to visit encampments and distribute hand sanitizer, soap and water, and to share information about how to protect against the virus, he says.
When services including the Community Kitchen had to shut down, the city and county joined forces with the Salvation Army to deliver meals, and that organization has also provided quarantine facilities for people who test positive, Tinker says.
"Early on it was more education and prevention," he says. "As we got further into it, we started seeing positives in the homeless community."
Beyond health care
As urgent as medical needs have been during the pandemic, an avalanche of related crises has tested nearly every system - from emptying schools and spiking unemployment to closing down some industries.
The next looming challenge for the Homeless Services Division will be the eviction crisis as people who can't pay rent because of the economic slowdown lose their homes, Tinker says. Homeless Services is working with Chattanooga Neighborhood Enterprises to try to identify short-term housing for people at risk of homelessness, he says.
"It's coming," Tinker says. "We have several clients right now that have just been evicted."
Funds to help individuals and families pay the bills have become essential resources. In the early days of the crisis, the United Way of Greater Chattanooga launched the Restore Hope fund, more than 100 organizations attended the group's first Zoom meeting, and the COVID Community Task force quickly formed.
"All were welcome as a place to try to share problems and try to solve them, and it's still meeting," says Lesley Scearce, the CEO of United Way of Greater Chattanooga. "It's been so action-oriented, and incredible stories are coming out of that time together. One week we needed to figure out how to feed 44,000 kids the next week, and by God, they did it."
La Paz created the Latinx Relief Fund as unemployment skyrocketed and the county shut down, providing one-time $500 payments to families, especially those who would otherwise be ineligible for other social services. The group received funding from the Community Foundation of Greater Chattanooga, as well as from the United Way's Restore Hope Fund.
"From all of the challenges that we as a community and a nation and a world have faced through the pandemic, I'm proud of the Chattanooga nonprofit ecosystem and all of the people who have come together and work together to make sure the community is being taken care of," says Stacy Johnson, the executive director of La Paz.
A focus on the needs of children in particular is the mission the the Children's Cabinet, a cross-section of agencies that serve children and families. In recent months, the organization, which launched about a year ago, quickly shifted its focus to needs precipitated by the pandemic, says Molly Blankenship, executive director of Chattanooga 2.0.
"We've focused primarily on supporting the educational needs of students due to school closure, reaching students and families who fell off the map when school closed," Blankenship says. The support of organizations including the YMCA, Boys and Girls Club and Northside Neighborhood House expanded their reach, she says.
"It's been amazing to see what happens when urgency really drives our work," she says. "Things we thought weren't possible in February were possible in the span of a few days or weeks."
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