By Kenya Godette

“Nurse led. Patient Centered.” That’s the way the Community Care team approaches their work.

Their patient-centered model, that solves health challenges faced by rural and underserved populations, is what won the 2024 Silver Rating for quality standards programs from the .

The NAFC ensures medically underserved individuals have access to affordable health care through its formalized set of Quality Standards — that member organizations must uphold. Standards include quality patient care, risk management systems, clinical and pharmacy solutions and administrative tasks.  

“Selfishly, we joined the NAFC just to learn more about free and charitable clinics, how to run them, get resources and ask questions,” said Tammy Speerhas, director of Community Care.

“Being a new member, they said it’s unheard of to get a silver ranking. But we're showing good quality outcomes and that is what put us at the silver rating for the first year. I'll be shooting for gold next time.”

It’s an innovative and intentional approach that makes Community Care stand out as a leader in community health — like their direct impact on pre-K students and 7th graders in the Franklin County Schools system. Students must be vaccinated at the start of school to avoid isolation from their peers, but barriers like lack of transportation and insurance hinder many of them from meeting the deadline.

Community Care worked directly with Franklin County schools, social workers, community partners and school coaches to provide on-site vaccination services to ensure all students were compliant— a first in the 30-year career of Lorraine Green, director of Early Childhood Western Tidewater.

“That was a direct reflection of you guys coming into town,” Green said to Speerhas.

Another factor that qualified Community Care for the silver ranking was their focus on assessing populations for social determinants of care and asking important questions like “what could prevent someone from being healthy?”

“Some people can’t even think about medicine because they can’t afford food for their children,” Speerhas said.

Partnerships with local food banks equip Community Care nurses with the tools to refer patients to weekly grocery collection programs where individuals can collect fresh fruits, vegetables, milk, eggs and other food staples at no cost. But nurses don’ just stop at addressing physical needs, they focus on patients wholistically.

“If you come in and say, ‘I have chest pain’, I'm going to ask you about everything,” Speerhas said. “Because maybe your chest pain is heartburn because your family member just died or got a new cancer diagnosis, maybe it's anxiety. We look at the whole person and all the factors that that could be impacting their health.”

Another community service that influenced the award is the student-run mobile health clinic, which hit the road in April 2023. Staffed by nursing students and professional nurse practitioners, the mobile unit has provided free health services in the rural communities of Franklin and Southampton County. Not only does the clinic offer services like sports physicals and acute and chronic care, it provides nursing students with needed clinical rotation experience.

But mobile health services are just the tip of the iceberg for ’s nurses. Their very first community program in Virginia Beach set the trajectory for the work they do today.

Through a partnership with , ’s nurses established a brick-and-mortar clinic that focuses on patient-centered care for the homeless population. By joining nurse practitioners, nursing students and social workers under one roof, they solve serious barriers to health care like lack of trust, food and transportation.

Health services at PiN also include preventative care and managing illnesses to avoid emergency room visits. Through this wholistic and integrated approach, the community impact was undeniable. On the days the clinic was closed, twice as many patients were seen in the ER — 71% could have received care at PiN.

With PiN as the model, Community Care has now expanded this approach to include a second location.

“We wanted to replicate what we do at PiN at the Human Resource Center,” said Tina Gustin, associate professor in the School of Nursing.

The Human Resource Center (HRC), funded by a $300,000 grant from Sentara Health, will also offer community-based care to the homeless population in Virginia Beach, while ensuring wholistic training for nursing students.

“Our goal is not just to serve the community with quality care, but to open our students’ eyes to populations of people they aren’t familiar with, and who they don’t understand,” Gustin said.

The HRC has only been open since March 2024, but the team already has big goals. They hope to develop a dental clinic, formalize mental health programs, develop wound management training and educate patients on when to use the clinic versus emergency services.

As Community Care expands its reach into the most vulnerable areas of Virginia, it’s going to take a lot to slow them down.

“It’s big work, but we are a fearless little group of people,” Gustin said.

In April, the team traveled to Baltimore to speak with universities from around the country about the work that gained them the NAFC award, and their future plans. Speerhas recalled many of the universities sharing that they had been trying to create similar programs but “couldn’t get them off the ground” because of logistical hurdles.

Speerhas praised the School of Nursing for its support — without which they could not have built such a robust collection of services.

“They’ve afforded us an opportunity to be creative and not have everything in a tight, beautiful, little bow before we launched,” she said. “We told them, ‘We’ll build it as we as we fly’ and we're going to keep building. We have parachutes if we need to jump, but we're going to be brave and we're going to launch. Because if you keep trying to put something together until it's perfect, you're never going to launch.”

With an innovative and dedicated approach, Community Care is setting a new standard for quality health care in underserved communities while creating a training pipeline for its future health care professionals.

“In a very short period of time of having the Community Care umbrella, we are filling that umbrella” Speerhas said. “We are we are filling that umbrella with amazing services to help the community.