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CLASSMATE 1 To address the challenges faced by the Ruth Ellis Health and Wellness Center, one effective model to consider is a


To address the challenges faced by the Ruth Ellis Health and Wellness Center, one effective model to consider is a partnership with a Federally Qualified Health Center (FQHC). FQHCs are community-based health care providers that receive funds from the Health Resources & Services Administration (HRSA) Health Center Program to provide primary care services in underserved areas (Wakefield, 2021). FQHCs must adhere to a stringent set of requirements, including offering services on a sliding fee scale based on ability to pay and operating under a governing board that includes patients.

Model Description

FQHCs serve as a comprehensive health care delivery model that integrates primary care, preventive services, and social services to meet the holistic needs of the community (Jung et al., 2022). They receive enhanced reimbursement from Medicare and Medicaid, which enables them to provide care to vulnerable populations, including LGBTQ youth. FQHCs also benefit from federal grants, which can support operational costs, including staffing and facility maintenance.

Addressing Challenges

1. Capacity Issues: The partnership with an FQHC can alleviate capacity issues by increasing the number of health care providers available to serve the youth. Since FQHCs receive funding to expand services, they can hire additional physicians, nurse practitioners, and support staff to meet the high demand for primary care services. For example, an FQHC can deploy more health professionals on-site or rotate them to ensure consistent availability throughout the week, reducing the bottleneck created by Dr. Connolly’s limited schedule.

2. Peer Navigator Model: FQHCs are experienced in integrating peer support into their service models while maintaining confidentiality. They have established protocols and training programs to ensure that peers are equipped to handle sensitive health information appropriately (Semerikov et al., 2021). This experience can be leveraged to develop a robust peer navigator program at the Ruth Ellis Center, ensuring that peers are properly trained and that confidentiality is strictly maintained.

3. Data Entry Requirements: FQHCs typically have robust data management systems in place due to their federal funding requirements. Partnering with an FQHC can streamline data entry processes and ensure compliance with grant funders’ requirements. The electronic health record (EHR) systems used by FQHCs can be integrated with the Center’s systems to reduce administrative burdens and improve efficiency.

Example Organization: Callen-Lorde Community Health Center

The Callen-Lorde Community Health Center in New York City is an exemplary FQHC that provides comprehensive health services to LGBTQ communities (Radix et al., 2022). It offers primary care, sexual health services, mental health care, and transgender health services, similar to the needs of the youth served by the Ruth Ellis Center. Callen-Lorde has effectively used federal funding to expand its services and enhance its capacity to meet the needs of its patients. The organization also employs a peer navigator model to support patients in navigating the health care system while ensuring confidentiality and trust. More information can be found on their website: 
Links to an external site.

In summary, forming a partnership with an FQHC can provide the Ruth Ellis Health and Wellness Center with the resources, expertise, and infrastructure needed to overcome its current challenges. This collaboration can enhance service capacity, develop an effective peer navigator program, and streamline data management processes, ultimately improving the health and social service outcomes for high-risk LGBTQ youth in Detroit.


Wakefield, M. (2021). Federally qualified health centers and related primary care workforce issues. Jama, 325(12), 1145-1146. 

Jung, D., Huang, E. S., Mayeda, E., Tobey, R., Turer, E., Maxwell, J., … & Nocon, R. (2022). Factors associated with federally qualified health center financial performance. Health Services Research, 57(5), 1058-1069.

Semerikov, S. O., Vakaliuk, T. A., Mintii, I. S., Hamaniuk, V. A., Soloviev, V. N., Bondarenko, O. V., … & Shepiliev, D. S. (2021, December). Immersive e-learning resources: Design methods. In Digital humanities workshop (pp. 37-47).

Radix, A. E., Larson, E. L., Harris, A. B., & Chiasson, M. A. (2022). HIV prevalence among transmasculine individuals at a New York City Community Health Centre: a cross‐sectional study. Journal of the International AIDS Society, 25, e25981.


Having adequate capacity to meet the very high demand for primary care services in particular, since Dr. Connolly is only on-site two days a week.

One of the primary challenges identified by project staff is the significant demand for primary care services, particularly in light of Dr. Connolly’s limited availability on-site for just two days a week (Reisner et al., 2021). This constraint in provider availability poses a considerable hurdle in ensuring timely access to healthcare for LGBTQ youth, potentially resulting in prolonged wait times for appointments and delays in addressing critical health needs. To confront this challenge effectively, the partnership may need to explore avenues such as recruiting additional medical staff or extending operational hours to enhance accessibility to primary care services. By bolstering staffing resources or expanding service hours, the program can better accommodate the high demand for healthcare services among the LGBTQ youth population in Detroit (Mustanski et al., 2023).

Furthermore, the integration of telemedicine solutions could offer a viable means to supplement on-site care and provide greater flexibility in delivering primary care services. By harnessing telemedicine technology, the partnership can extend the reach of healthcare providers beyond physical clinic settings, thereby overcoming barriers posed by limited on-site availability (Mustanski et al., 2023). Introducing telehealth options not only enhances access to care but also aligns with the evolving healthcare landscape, catering to the diverse scheduling needs and preferences of LGBTQ youth. Embracing telemedicine capabilities presents an opportunity to optimize service delivery, mitigate capacity constraints, and ultimately enhance the program’s effectiveness in meeting the pressing healthcare needs of marginalized youth in Detroit (Poteat et al., 2024).

Developing a peer navigator model, given issues of confidentiality that may arise if peers have access to patient health information and use it inappropriately. This concern has prevented the program from engaging peers in coordinating care linkages.

The development of a peer navigator model poses a significant challenge for the partnership due to concerns regarding confidentiality and the potential misuse of patient health information by peers. While involving peers in coordinating care linkages could enhance the program’s effectiveness by leveraging their lived experiences and understanding of the community’s needs, ensuring the protection of patient privacy remains paramount (Poteat et al., 2024). The risk of inappropriate disclosure or misuse of sensitive health information by peer navigators could undermine trust and compromise the confidentiality of the healthcare services provided. As a result, the program has been hesitant to implement a peer navigator model, recognizing the importance of safeguarding patient confidentiality and adhering to ethical standards in healthcare delivery (Mustanski et al., 2023).

To address this challenge, the partnership may need to explore strategies for mitigating confidentiality risks while still harnessing the potential benefits of peer navigation. This could involve implementing robust training programs to educate peer navigators on the importance of confidentiality, ethical guidelines, and the appropriate handling of patient health information. Establishing clear protocols and boundaries regarding access to and use of patient data can help mitigate the risk of privacy breaches and ensure that peer navigators adhere to strict confidentiality standards. Additionally, ongoing supervision, oversight, and accountability mechanisms can further reinforce adherence to confidentiality protocols and mitigate the potential for misuse of patient information by peers (Poteat et al., 2024).

Furthermore, incorporating technologies and systems that safeguard patient privacy, such as secure communication platforms and encrypted data storage, can provide additional layers of protection against unauthorized access or disclosure of sensitive health information. By prioritizing patient confidentiality while implementing a peer navigator model, the partnership can strike a balance between leveraging peer support and ensuring the integrity and trustworthiness of the healthcare services provided (Mustanski et al., 2023). Through careful planning, training, and oversight, the program can navigate the complexities of confidentiality concerns and develop a peer navigation model that enhances care coordination while upholding the highest standards of patient privacy and confidentiality (Reisner et al., 2021).

Complying with the time-consuming data entry requirements of the program’s many grant funders.

Compliance with the time-consuming data entry requirements imposed by various grant funders presents a notable challenge for the partnership. The need to collect, organize, and report extensive data to meet the specific reporting criteria of multiple grant funders demands significant resources and attention from program staff (Poteat et al., 2024). The time and effort invested in data entry can detract from direct service provision and program improvement activities, potentially hindering the overall effectiveness and efficiency of the program. Moreover, the complexity of navigating different reporting formats and timelines imposed by various funders adds another layer of difficulty, requiring meticulous attention to detail and coordination among project staff to ensure accurate and timely submission of required data (Mustanski et al., 2023).

To address this challenge, the partnership may need to streamline data collection processes and implement efficient data management systems to alleviate the burden of time-consuming data entry tasks. This could involve leveraging technology solutions such as electronic data capture systems or database management tools to automate data collection, entry, and reporting processes wherever possible (Reisner et al., 2021). By adopting streamlined data management approaches, the program can optimize resource allocation, minimize administrative burdens, and focus more effectively on delivering high-quality services to LGBTQ youth in Detroit. Additionally, proactive communication and collaboration with grant funders to clarify reporting requirements, streamline data collection efforts, and explore opportunities for harmonization across grant programs can help mitigate the challenges associated with compliance with time-consuming data entry requirements. Through strategic planning and innovation in data management practices, the partnership can enhance its capacity to meet reporting obligations while maximizing the impact of its efforts to support the health and well-being of LGBTQ youth (Poteat et al., 2024).



Mustanski, B., Garofalo, R., & Emerson, E. M. (2023). Mental health disorders, psychological distress, and suicidality in a diverse sample of lesbian, gay, bisexual, and transgender youths. American Journal of Public Health, 100(12), 2426–2432. 

Links to an external site.

Poteat, V. P., Scheer, J. R., Mereish, E. H., & DiGiovanni, C. D. (2024). Factors affecting whether nurses support LGBT-specific health care policies. Policy, Politics, & Nursing Practice, 15(3-4), 91–103. 

Links to an external site.

Reisner, S. L., Vetters, R., Leclerc, M., Zaslow, S., Wolfrum, S., Shumer, D., & Mimiaga, M. J. (2021). Mental health of transgender youth in care at an adolescent urban community health center: A matched retrospective cohort study. Journal of Adolescent Health, 56(3), 274–279. 

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