Human-services focused community-based organizations (CBOs) provide underserved communities support to address many social determinants of health (SDOH), including access to affordable, quality healthcare and correct, easy-to-understand public health information. Effectively addressing SDOH is challenging for even the most experienced CBOs, especially during something like the COVID-19 pandemic. Northern Virginia Family Service (NVFS), a human-services focused CBO that has been serving its community for 100 years, managed to successfully continue almost all community services during COVID, while adapting to the community’s needs by expanding the services it offered. How did NVFS achieve this success? What lessons did NVFS learn that might help public health departments prepare for future crises? And how can public health departments foster better relationships with CBOs like NVFS in their communities to further advance their goals?
Who is Northern Virginia Family Service (NVFS)?
NVFS, based outside of Washington, DC, is a 100-year old nonprofit organization that empowers more than 30,000 individuals annually to achieve self-sufficiency by providing the essential building blocks for financial, emotional and physical well-being. During COVID, CBOs like NVFS often operated as an extension of the public health department, successfully disseminating accurate health and safety information deeper into communities than public health departments were able to reach.
3 Factors Behind NVFS’s Success Addressing SODH During COVID-19
1. Relationships and Trust Built Before the Crisis Hits – When faced with a crisis, people turn to the dependable groups that they know and trust. NVFS is intentional about building trusted relationships with a variety of audiences, in part because in times of crisis, the organization is often called upon first by its community partners. To successfully deliver during those critical times, it leverages the trusted relationships built before the crisis. Some examples include:
- Funders – According to the World Bank, COVID-19 saw the largest scale up of social safety net transfers in history. Eligibility for financial assistance was generally simplified to make it more accessible. With relaxed requirements, funders relied on trusted organizations to effectively and efficiently distribute assistance. Funders trusted NVFS based on their proven ability to scale up processes and swiftly deliver to those who needed it most.
- Community – NVFS serves a large community, with a breadth of services that create more touch points for community interaction. This breadth, combined with the agency’s long-standing history of serving the community, and NVFS staff’s own lived experiences, creates a deep understanding that allows staff to prioritize clients’ needs, get to the root cause, and be viewed as a trusted advisor.
- Partners – Community partners rely on CBOs like NVFS, especially when resources are constrained. Specifically, when local public health departments were overwhelmed and taking on new roles like managing vaccination clinics, NVFS was trusted to take the health department’s messaging further and deeper in the communities it serves.
2. Culture – NVFS prides itself on being a learning organization that responds to the community’s needs. Its leadership has been intentional about building a culture that is rooted in a natural curiosity and a desire to serve. Asking questions, active listening and willingness to pivot are expected, whether staff are working together or with clients. NVFS is also intentional about building staff’s cultural competence (the knowledge and ability to understand people and treat them equitably despite cultural differences), which is critical for effectively supporting its community.
3. Capacity – Building capacity, before a crisis hits, is critical for any organization to be able to effectively respond. With limited resources, CBOs like NVFS must be intentional about this. Here are some examples of where they have invested:
- Transferable skills – NVFS is diligent about cross-training frontline staff with transferable skills that allow them to shift to different services as needed. For example, during COVID, foster care placement paused while demand for temporary housing, hunger resources and health access skyrocketed. Frontline staff that were cross-trained could easily be shifted to meet the demand.
- Scalable processes – NVFS also focuses on scalable capabilities and processes. When COVID-19 hit, NVFS was one of only a few CBOs serving the community that was able to receive and immediately distribute the influx of donations and millions in federal relief funding.
- Financial reserves – Prior to COVID, NVFS performed most community services in-person (at a NVFS building or clients’ homes), and staff used desktops at the office. NVFS’s financial capacity allowed them to swiftly purchase the necessary technology, invest in necessary training for employees and clients, and develop new ways of delivering services that worked and kept clients and staff safe.
4 Ways Public Health Departments Can Foster Relationships with CBOs
1. Value the lived experience and professional expertise of community partners. Both public health departments and CBOs bring value and expertise to the table. For example, public health departments have resources and staff with advanced degrees and expertise that CBOs cannot match. On the other hand, NVFS employees come with a variety of educational backgrounds, professional expertise and often, lived experiences. The first-hand knowledge gained from shared experiences allows staff to authentically connect with and understand the realities clients and their families face.
2. Aim beyond providing information and referral sharing to resource access through navigation. NVFS serves a large community, most of whom have been marginalized and live in poverty. This population faces many barriers to access including lower literacy rates, language and a healthy amount of distrust of government institutions. Providing this population with a phone number or referring them to a resource is not enough to overcome the barriers to achieve resource access and utilization. CBOs and public health departments can work together to help address disparities and improve access, ensuring the best health outcomes.
3. Establish a CBO liaison who can build strong relationships that endure crises. CBOs are often an afterthought in executing public health initiatives, even though they provide frontline, direct service. For example, during COVID, NVFS’s clients relied on the agency for support, direct service and guidance. To safely continue service delivery during the pandemic, NVFS had to advocate for frontline employees to be prioritized for PPE and vaccinations. Additionally, NVFS did not have access to a medical professional within the public health department who could clarify conflicting or changing information for the staff. NVFS heard updates when clients did, which created challenges for ensuring accurate comprehension and dissemination of the correct information.
4. Work with CBOs as partners on the holistic problem, not just in silos. Despite its long-standing presence in the community, breadth of services and regional reach, NVFS has working relationships with the public health department only at the programmatic level. CBOs like NVFS bring a broad perspective and can partner with public health departments to address the holistic challenges facing the populations they both serve. This shift in approach can also help form organizational-level relationships that are better able to withstand turnover.
Moving Forward
NVFS recognizes that not all public health departments operate the same, support communities that look the same, or even have a strong CBO to partner with, like NVFS. Regardless, strong relationships built before a crisis with the CBOs in your community would be mutually beneficial to both groups. We encourage all public health departments to reflect on the CBOs in their community and engage in open dialogue with those they partner with to create the most impact. Some questions that may be worth considering: How do you work with CBOs in your community? What works well? What could be done differently? How strong are your relationships? What can your team do to improve those relationships? What is something that would be useful for CBOs to better understand that maybe they don’t? What value can the CBOs in your community add that maybe you’ve overlooked and how can you add greater value in return?
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This project is supported by funds made available from CDC’s National Center for State, Tribal, Local, and Territorial Public Health Infrastructure and Workforce through cooperative agreement OT18-1802, Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nation’s Health award #6 NU38OT000303-04-02. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.