Supporting Diversity in Pennsylvania: How WellSpan Health Cares for Patient Groups During COVID-19

CEO Roxanna Gapstur shares strategies the health system has implemented during the COVID-19 pandemic and beyond to serve the unique needs of its patients.

A focus on racial disparities and social determinants of health have become a focal point for many hospitals and health systems during the pandemic. One health system, Pennsylvania-based WellSpan Health, has been serving diverse communities including the Amish and Plain Community, Latinx, migrant, and homeless communities for decades.

WellSpan Health President and CEO Roxanna Gapstur, PhD, RN, spoke with HealthLeaders about the organization's strategic initiatives for communicating with and caring for its culturally diverse communities amid COVID-19 to help slow the spread.

This is part two of a two-part interview series. Part one focused on WellSpan Health's short- and long-term goals for its communities and how it created programs, invested finances, and "is leading the way during the pandemic" to take care of its patients.

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This transcript has been edited for clarity and brevity.

HL: What strategies are in place that enable WellSpan Health to meet the needs of the Amish and Plain Community?

Gapstur: It is a big job to think through how you serve different groups and populations … our counties are very diverse. Our community health team, and our medical group, and hospitals have done a tremendous job.

To us, the Plain Community is the Amish community and the conservative Mennonite communities in our areas. There's about 40,000 people in those communities in the counties that we serve. [We] have liaisons that work with the community and with us.

There are some specific geographic and cultural barriers that that community has; some of it is related to the amount of education that their families have. Some have limited access to internet and TV. They also tend to live in larger family units, and church and services and community are very important for them.

The first thing we thought about when the virus became more prevalent was to work with this community around understanding the spread of the virus, and then how we would get messages to them to make sure that they could contain the virus.

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We did a number of things with that community. We worked with our liaisons to make sure that we were able to give great information. We did a mailing to over 400 deacons in the Amish and Plain Community, so that they would have information at their fingertips, and they could learn more about the virus. We set up a call line, and we posted information in their communities as well.

We had a great story of one of our Amish patients who was at end of life. Generally, they stand around the bed and sing during that time. Our nurses were able to create a phone line where Amish family members were able to sing over the phone to their family member as they were dying. It was a touching thing that our team did to help support this important cultural element for this population.

I think because of things like that, we are a trusted partner for the Plain Community. They turn to us and have turned to us for over 20 years to get their healthcare.

HL: Could you talk about the strategies in place to serve the Latinx communities?

Gapstur: We've done a number of things with [the Latinx] community. We've partnered with public health agencies and nonprofits that also serve that community. We've translated all of our materials for COVID into Spanish, and we did that early on in the pandemic. We had an assessment tool, webpages, online content for video visits, and other virtual care. Our My WellSpan portal, which is the way that patients can connect with us, is also translated into Spanish.

We've done a number of drives for the Latinx community where we've distributed resource guides for them, facemasks, toothbrushes, and sanitizer. We focused more in Lebanon County, which is one of our counties that has a lot of Latino patients, and then also in York, where we have the biggest groups.

We've done digital displays in Spanish for the grocery stores and restaurants in the area, and public service announcements in the Spanish newspapers and radio stations. So, just a lot of different strategies to try and reach that community and help them slow the spread as well.

HL: Tell me about the telehealth and online tools WellSpan uses to reach out and care for patients in your rural populations.

Gapstur: We use web and telehealth, and, in fact, we increased our telehealth visits up to nearly 1,900 visits a day across our counties during the pandemic. What's difficult about that in a rural area [is], we have some people who don't have access to the internet as much as you would see in larger cities, and then we also have people who don't have an electronic device.

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One of the things that we did with our homeless population is that we gave out about 30 different iPads across different hotels, shelters, and communal living areas. [These are facilities] where we were able to place people and pay for their housing so that they would have a place to recover or to quarantine during the COVID-19 pandemic. Those iPads were very helpful because it allowed people access to the virtual urgent care that we have, and it also allowed them access to behavioral healthcare right on their iPad.

HL: Tell me about WellSpan's housing program.

Gapstur: We have a lot that we've done here at WellSpan for transitional housing and in the housing area. We have temporary housing assistance programs that we offer to our patients, both in long-term care facilities where we're able to lease beds, [and] a personal care home program called Arches to Wellness. We pay for patients to be at those shelters and transitional facilities for a period of time while they're recovering. And then we help them look for long-term housing after that.

We have some of those same strategies across all of our counties. During the pandemic, we developed a program that's now being used by the entire state of Pennsylvania. And it is a housing program that we developed together with area hotels where we provide temporary housing at the motel, and the food banks would provide food, and then Rabbittransit—which is one of our partners—provided transportation. And that is now serving as the model for the state for COVID transitional housing.