How a Flawed Tech Strategy Threatens California’s Ambitious Health Vision

Understanding CalAIM’s $1.85 Billion Closed-Loop Referral Problem

The average Californian would have no reason to know the details of the State’s five-year, $1.85 billion effort to transform Medi-Cal. However, the government’s investment, aimed at improving outcomes for millions of Californians, lays the groundwork for a sweeping reimagining of California healthcare—particularly by fostering collaboration across healthcare and social services. The initiative, known as CalAIM (California Advancing and Innovating Medi-Cal) and led by the Department of Health Care Services (DHCS), is a development every Californian should be aware of. 

The vision is ambitious. CalAIM has the potential to save Medi-Cal billions of dollars by improving California’s healthcare delivery system to ensure that Medi-Cal members receive both the medical and social services they need to stay healthy. But while the vision is bold, and the goal virtuous, it will require DHCS to rethink its technology strategy to make CalAIM work effectively.

The Problem

To be successful, DHCS needs a digital bridge—or digital infrastructure—that connects providers in healthcare to providers in the social sector. This bridge aims to close the communications, data, and billing gaps that currently separate these two sectors, enabling more effective coordination and delivery of diverse medical and social care services for Medi-Cal members. It is increasingly understood that as much as 80% of what influences an individual’s health is determined by social factors, so cross-sector care coordination is a compelling and practical idea. 

The unanswered question is “how”—how should DHCS invest CalAIM dollars to reform the digital infrastructure needed to carry this out?  And this is where things get complicated.

At the highest level, DHCS is trying to create a better way for medical providers working with Medi-Cal members to coordinate care with a growing cohort of social service providers. Since care coordination relationships and systems are scant across the state, DHCS has put together a $1.85 billion package of CalAIM incentives and requirements to generate new approaches and, ideally, outcomes.  Many of these changes are codified in the contracts being signed between DHCS and  the managed care plans (MCPs) selected to serve Medi-Cal members across the State. The details of these contracts are extensive and get complicated quickly, but there are three important elements of the CalAIM plan driving technological change:

  1. MCPs are required by DHCS to provide Enhanced Care Management (ECM) for high-need patients and are generally required to provide ECM services through community-based organizations.
  2. MCPs can, and are now encouraged, to contract with local social service providers to deliver certain authorized Community Supports, like Housing Navigation, Medically Tailored Meals, and Respite Care, for their Medi-Cal members.
  3. MCPs are responsible not only for coordinating and referring ECM-eligible Members to community resources but also for following up to ensure services were rendered, a process known as “Closed-Loop Referrals” or “CLR.” 

These changes seem straightforward and uncontroversial on paper but, in the real world, they are making it more complicated for social sector organizations to collaborate with healthcare—not less

Let’s consider a real-life example.

In San Francisco, the San Francisco Health Plan (SFHP) is the dominant Medi-Cal MCP,  serving about 175,000 Medi-Cal members. In March 2024, SFHP released a Request for Proposal (RFP) inviting bids for the following service:

“SFHP is seeking a web-based SaaS (Software as a Service) Closed-Loop Referral System (CLRS) that incorporates current Industry Standard tools and technology, adaptability and scalability to accommodate current trends, technological advances, and regulatory requirements.”

Although SFHP has already been contracting with dozens of local ECM and Community Support Providers for the past year, the RFP is the final step in fulfilling CalAIM’s Closed-Loop Referral requirement. To do so, SFHP needs technology to serve as a digital bridge between their existing healthcare provider network and newly engaged social care providers. For example, if a physician refers a patient to a transitional housing organization, the referral will be recorded, received, and tracked digitally to “ensure the service was rendered,” aka a “Closed-Loop Referral.” 

While DHCS’s CalAIM requirements don’t mandate that SFHP purchase a CLRS, they do require SFHP to have Management Information Systems in place to report these referrals quarterly. Therefore, like most MCPs across California, SFHP is shopping for a reliable CLR platform.

But SFHP is not alone. Also serving Medi-Cal members in San Francisco—and subject to the same Closed-Loop Referral requirements—are Kaiser Permanente and Anthem Blue Cross. In one city and at the same time, three health plans are preparing to scale collaboration networks with local social services providers—the same community of social services providers—but, sticking with the analogy, building their own private bridges to do it. Instead of constructing a single shared bridge to connect healthcare to the social sector, San Francisco will soon have three. 

The question is, who cares?

Unsurprisingly, the MCPs are not overly concerned about having their own bridge. Once a CLR system is established, they will have honored their contract with DHCS, State money will have paid for it, and they won’t have to share their bridge with anybody else.

DHCS does not yet seem to be very worried either. Yes, they may end up absorbing the cost of subsidizing more bridges than San Francisco needs, but they avoid a potential fight among the MCPs over which systems to use and what data to share and, ultimately, get exactly what they asked for in their contracts.

And, of course, the two biggest commercial providers of Closed-Loop Referral Systems, Unite Us and FindHelp, have no reason to complain. In fact, it is a financial windfall that DHCS’s CLR guidance can be interpreted to suggest that each Medi-Cal MCP in California will need a bridge of its own, whether it will be well-utilized or not.

So, who does care? 

Let’s start with the social service providers who, like their healthcare counterparts, deliver services to vulnerable populations but will never get a private bridge. Instead, they will inherit the considerable burden of caring for and tracking clients across the tangle of commercial bridges the MCPs will have erected with CalAIM funds.

Here’s what this burden can look like in real life: 

Martina works for a social services agency and recognizes that a client might be eligible for Medi-Cal’s Enhanced Care Management services. Because her agency sees a lot of Medi-Cal members and is trying to do right by their clients, they have a contract with all three MCPs serving the community locally. 

Now, if Martina is lucky, her client knows which Medi-Cal plan they are on. But if not, she will have to guess which system to log into first to find the patient’s ECM approval status. Fortunately, Martina keeps a sticky note of phone numbers on her monitor, so she can quickly call each plan until she can confirm which one the client is on and if they’ve already been approved for ECM services. If they’ve been approved, good news because Martina doesn’t have to fill out the PDF enrollment form. Still, once Martina logs in, the administrative haze continues—she may or may not need to conduct a formal Social Determinants of Health (SDOH) screening, which will be different on each platform, and search through a directory of local social services, which will also vary from platform to platform. 

Despite all of this, Martina will finally carry out her most important task—identifying the specific organizations that have been authorized by the client’s MCP to provide Community Supports like Housing Navigation. Once Martina has done this, the client can complete a consent form allowing Martina to initiate the referral process.   

Now, both Martina and the client wait. The Housing Navigation provider, who may also be juggling three incompatible CLR platforms, has to accept the referral and, later,  remember which system to use to “close” the referral once services have been rendered. Maybe both Martina’s agency and the Housing Navigation provider use a separate client management system (CMS) to track which client is associated with each MCP’s system, but from the outset, the competing CLR technologies have made care coordination unnecessarily time-consuming and complex.

If we imagine this inefficient process unfolding every day across thousands of community-based social services organizations in California, it becomes clear why there is growing discontent in the field and why the adoption and engagement of these new CLR systems has been problematic.

DHCS is in a difficult spot: the fragmentation of multiple incompatible CLR systems across the health and social care sectors isn’t helping them achieve CalAIM’s goals, but what can they do? From a policy perspective, solutions are typically framed as a choice between:

  1. Government intervention: Bring the problem in-house and try to build a single statewide governmental system.
  2. Free-market competition: Let the market decide.

Right now, the de facto situation is that DHCS is betting the future of CalAIM on option two. Problematically, this option, free-market competition, is poised to produce either a protracted and painful stalemate, where social services providers struggle with or fail to adopt incompatible commercial referral systems, or, perhaps worse, a dominant commercial vendor with an unregulated statewide monopoly. If DHCS was hoping  to foster a vibrant ecosystem of competing CLR systems, it is  becoming evident why this outcome is so unlikely.

While California could still bring the problem in-house and build a statewide closed-loop referral system, similar to the path being pursued in states like New Mexico, this approach presents other challenges. These include the loss of local participation, DHCS’s limited access to technology talent, and the risk of political blowback due to perceived government overreach. Despite the potential merits of a single state-run system, the efficacy of big government technology solutions remains a contentious subject—particularly in California.

Fortunately, there is another way:

  1. Open infrastructure & standards: In partnership with local communities, build an open, standards-based referral network that can be shared by the MCPs and their network of social service providers.

The operating principle here is that if DHCS is using CalAIM funding to build infrastructure, they shouldn’t be underwriting private, proprietary solutions. They should be investing in standardized, interoperable, and high-quality systems that—like bridges—operate as public infrastructure open to all. San Francisco does not need three private Golden Gate Bridges competing for traffic, any more than we need three CLR systems competing for market share at the expense of social services providers and Medi-Cal enrollees. What the city does need is shared digital infrastructure that all the MCPs, along with every other interested stakeholder, can use to bridge the gap between healthcare and the social sector.

It is time for new ideas, and this is why we’re excited about the partnerships we have developed with our local United Ways, 211s, and Health Information Organizations. We’re excited about joining forces with local organizations that have been doing this work for decades to respond to new innovations, like San Francisco Health Plan’s RFP for a Closed-Loop Referral Service. We aren’t just critics of the status quo; rather, we hope to create new possibilities through government-community partnerships. An open, non-commercial, and stakeholder-developed infrastructure to support closed-loop referrals can unite our community, not silo it by vendor, and make care coordination work for all.

One-e-App Mission Accomplished

Crossing the finish line in the world of nonprofits is a rare and gratifying experience. In 2020, when One Degree merged with Alluma, we inherited a gem – One-e-App. This legendary platform didn’t just start the conversation around benefits access technology; it revolutionized it.

Farewell to One-e-App

Last year, we announced the start of a year-long process to sunset One-e-App (OeA), our pioneering benefits eligibility and enrollment platform that has served the community for two decades. Today marks the culmination of that journey, as we bid a bittersweet farewell to OeA. This milestone is not just about closing a chapter; it’s a celebration of the transformative impact OeA has had, not only fulfilling its mission but also catalyzing innovation for benefits access and raising the bar for digital healthcare access across the country. Standing here today, it feels almost surreal to be part of the team wrapping up this significant chapter. How many leaders in the nonprofit sector can truly stand up and say with pride, “Mission accomplished”? 

Thanks to colleagues past and present who worked to shift policies at the state and federal level, the OeA baton is being passed to where it belongs: government. This is what systems change looks like. This transition ensures that the innovation we pioneered with OeA for accessing essential safety net programs and public benefits are not only sustained but also expanded through new government-led healthcare initiatives.

Special thanks to our current and past staff who have tirelessly built, managed, and evolved OeA across two decades of dedicated service. Let’s take a moment to celebrate this incredible journey and gear up for the exciting new chapters ahead for One Degree.

Learn more about OeA’s impact and legacy in our May 2023 feature: “Tech for the People: How One-e-App Pioneered Digital Healthcare Access.”

One Degree Welcomes Back Founding CTO and Policy Expert as Member of Board of Directors

San Francisco, CA. March 25, 2024 – One Degree is pleased to announce the appointment of Eric Lukoff to its Board of Directors. Having served as One Degree’s founding Chief Technology Officer before serving as Chief Operating Officer, Lukoff returns to the organization as a board member, bringing a wealth of experience in product development as well as federal policy, particularly in poverty alleviation, public benefits, and technology.

“I am thrilled to welcome Eric back to One Degree as he brings both a dedication to our mission and a long track record of driving social change at our organization and beyond,” said One Degree CEO Rey Faustino. “His insights, strategic guidance, and deep familiarity with our work will be invaluable as we continue to innovate and expand our reach in the social care sector.”

Currently serving as Legislative Director for a member of the U.S. House of Representatives, Lukoff’s career has been characterized by a deep commitment to leveraging technology, policy, and the law to empower underrepresented and marginalized communities. Previously, Lukoff was a Congressional Innovation Fellow in the U.S. Senate, and earlier in his career, he played key roles in building large-scale consumer web platforms, including Change.org, Vote.org, and VoteAmerica. He also holds a B.A. in Computer Science and Political Science from Goucher College, and is currently pursuing a J.D. at American University Washington College of Law.

On his return to the organization, Lukoff shared, “I’m honored to be back at One Degree—my home for many years—particularly at this critical time. Policy and market dynamics that favor corporate investors threaten to drive out nonprofit, community-driven solutions that empower people to truly break the cycle of poverty. The role One Degree plays—as a technology platform, an innovative engine, and a thought leader in social care—is more important than ever. After helping millions of individuals find the resources they need to improve their lives for more than a decade, now is the time to position the organization for the years to come. I look forward to working with Rey and the board to further secure One Degree’s future.”

About One Degree

One Degree is a tech-for-good nonprofit that collaborates with public sector clients and community-based organizations to build world-class technology with heart. Our community care networks aim to bridge the gap between low-income communities and vital resources, from housing to healthcare and beyond.

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One Degree’s CalAIM Vision: Bridging Technology and Trust for Community Impact

We’ve all been enticed by the seductive myth that technology alone can effortlessly resolve the deep-seated issues at the intersection of healthcare and social care. This belief held promise for an efficient future where barriers to access and inequities were things of the past. However, the hard truth is that such promises were a mirage. If we examine social care technology initiatives across the country, it becomes clear that many have struggled to gain traction, undermined by challenges such as low adoption rates, misalignment with community needs, and a lack of transparency combining to erode community trust. Despite a decade of efforts to implement community resource referral technologies, the core issues in social care persist. 

In an era where state and federal initiatives, such as CalAIM and the CMS Accountable Health Communities Model, are pushing for the creation of digitally integrated care networks, the need for a smarter approach has never been more pressing. These efforts are reshaping our systems right now, and yet technical advancements like closed-loop referral systems, data standardization, and interoperability cannot, on their own, inspire the trust and widespread adoption of social care technology needed to improve the health and well-being of communities.

How, then, can we build social care infrastructure—centered on trust—that can drive positive outcomes at scale?

Empower Participation with Supportive Incentives

The first problem we have to acknowledge is that community-based organizations (CBOs), staffed by frontline providers with community knowledge, are perpetually underfunded, understaffed, and marginalized within existing power structures. They are already struggling to meet public demand for community resources, so any influx of referrals or increase in administrative burden created by newly implemented digital care networks calls for a corresponding increase in funding. 

In addition to the new Medi-Cal billing frameworks offered by CalAIM, we propose a range of supportive incentives designed to expand the capacity of CBOs and acknowledge their critical role in the success of our social care ecosystem. Here are a few approaches we think could be useful during the CalAIM implementation and beyond:

  • Financial Incentives: Give CBOs equitable remuneration for their engagement and service delivery within the network. This approach directly addresses the funding shortfall, enabling organizations to improve capacity to meet public demand.

  • Success-Sharing Models: Introduce success-sharing initiatives that reward collective achievements and improvements in service quality. This method drives toward collaboration and shared accountability among stakeholders and incentivizes investment in regional initiatives to address Social Determinants of Health (SDoH) and social needs.

  • Data-Driven Recognition: Publicly recognize CBOs that demonstrate exceptional performance based on relevant and publicly available impact data. This would promote the visibility of effective practices and performance metrics, enabling successful strategies to be implemented more widely.

Ultimately, meaningful incentives and transparent use of data will foster the trust and reach social care technology requires to deliver on what it promises to communities.

Balance Coordination with Decentralization

In communities across the country, it’s common to find multiple social care systems at play. While this decentralization empowers grassroots innovation and local responsiveness, it often contributes to our current fragmented landscape and, without sufficient coordination, can perpetuate inefficiencies and systemic inequities. 

We would like to see a balanced approach, one that combines the benefits and innovation that arise from decentralization with the information exchange, standardization, and coordination centralized digital infrastructure can offer. 

For California, we recommend the following within the framework of CalAIM:

  • Integrate Community-Guided Governance: Implement a shared-governance model for the oversight and continual development of regional care networks, one that enables diverse, community-based stakeholders—from CBOs to local providers, local governments, and residents—to have a seat at the table with policymakers and contribute to the analysis, discussion, and promotion of best practices in care coordination and data exchange across the State.

    By facilitating regular feedback loops, this model would ensure that the dynamism and learning inherent in decentralized systems are built into the ongoing refinement of digital care infrastructure and help such systems adapt and evolve practices to meet changing community needs.

Our hope is that CalAIM and similar initiatives can avoid the pitfalls of the top-down, one-size-fits-all approaches that lead to systemic problems in social systems, as seen in education reform efforts like No Child Left Behind and Common Core. By integrating community governance into California’s statewide vision for care coordination and data exchange, we can ensure that strategies are rooted in community needs.

Relationships as Infrastructure

While technology can go a long way toward facilitating service coordination and information sharing, relationship-building is the glue that binds the infrastructure together. As such, we recommend that reforms not only facilitate but also enhance relationships among stakeholders who are connected through digital care networks:

  • Backbone Organizations as Advocates: Beyond their role in technical facilitation, backbone organizations are uniquely positioned to act as trusted, neutral third-party advocates for CBOs. Through advocacy, backbone organizations can amplify the voices of CBOs, advocate for their needs, and ensure their equitable participation in regional and statewide systems. In this role, they can help close the policy gaps between what the CBOs need and what they receive from the state and county entities. This is a critical step toward maximizing the effectiveness of backbone organizations and preventing them from acting solely as bureaucratic entities or replicating existing inequities. Notably, many Closed-Loop Referral (CLR) systems implemented in California and across the U.S. lack these backbone organizations, contributing to struggles in system utilization. Our recommendation is that communities invest in developing this crucial layer.

  • Invest in Collaborative Practices: Investing in digital care infrastructure should go beyond allocating resources to recognizing the return on investment that collaborative relationships and partnerships deliver to social care. Fostering these relationships—through joint training programs, shared platforms, and community events designed to nurture partnership among healthcare professionals, social services agencies, and CBOs—can result in innovative initiatives, improvements in service delivery, and, ultimately, better outcomes for the communities being served.

    Additionally, adopting equity-centered frameworks like Collective Impact to co-develop community impact metrics for referral systems can help ensure that stakeholders across the ecosystem are aligned with mutual accountability and shared goals. 


A Holistic Vision for Digital Care

To transcend the challenges in the social services landscape, we need a shared vision—one that integrates a deep understanding of stakeholder needs with an unwavering commitment to trust and collaboration. Our aspiration for California, and for the entire nation, is that initiatives like CalAIM mark a transformative shift toward a future where digital infrastructure and the people-centered ethos of social care converge to create the sustainable change every community deserves.

Want to learn more about our 2023 projects and initiatives? Check out our recent Annual Report: Community Empowerment in Action.

Bridging Gaps, Building Futures: A Year of Impact and Innovation

Can you believe it’s already the end of January? At One Degree, we always spend time at the beginning of the year to both reflect and set our sights on the future.  And at our team retreat last week, we took some time to celebrate One Degree’s achievements from 2023, like transforming rural resource accessibility in New Mexico to launching groundbreaking initiatives such as Stay Housed Bay Area

We also discussed exciting plans for 2024, as we gear up for a new chapter: continuing our work to build open community care networks, doubling our efforts to build public digital infrastructure, and exploring how cutting-edge technologies like artificial intelligence can be safely used to improve the effectiveness of the social safety net.

Check out our 2023 Year in Review below, and let us know what you think about where we should go in 2024! 

  1. Unlocking $80 Million in Social Services & Benefits
    Celebrating a groundbreaking $80 million worth of services to our communities, we set a new standard in community support and impact.

  2. 9,000 Conversations for Community Support
    Engaging in 9,000+ conversations with community members, we provided unparalleled support to connect low-income communities with life-changing resources.

  3. Strengthening Closed-Loop Referral Networks in LA
    We expanded our partnership with ACES-LA to enhance closed-loop referrals across LA County, making strides towards integrated and efficient social care delivery.

  4. Transforming Lives in Rural Southwest New Mexico
    Surpassing a milestone of serving over 21,000 people with One Degree Southwest New Mexico, we redoubled our commitment to New Mexico’s rural communities.

  5. 8 Million Served by COVID-19 Testing Site Portal
    Our LA County COVID-19 testing site portal, having served a remarkable 8 million people, concluded its mission with the end of the public health emergency.

  6. Innovative Homelessness Prevention in California
    With the launch of Stay Housed Bay Area and a comprehensive resource platform in Los Angeles, we’ve taken bold steps towards reducing homelessness across California.

  7. A Digital Leap in Pediatric Screening 
    Our digital PEARLS (Pediatric ACEs and Related Life-events) screener launched for Northeast Valley Health Corporation, empowering early intervention for Adverse Childhood Experiences.

  8. Streamlining Access with Resource Availability
    A game-changer in resource management, our ‘Temporarily Unavailable’ feature was launched to make accessing resources more transparent and less burdensome.

  9. Securing Futures with Document Locker
    Our Document Locker feature marked a groundbreaking pilot year, providing community members with a secure, user-friendly way to store and share essential documents.

Want to learn more about our 2023 projects and initiatives? Check out our recent Annual Report: Community Empowerment in Action.

A Response to the White House Playbook on SDOH

Last month, the White House took a pivotal step towards advancing health equity with the release of The U.S. Playbook to Address Social Determinants of Health. It’s a promising step towards improving the well-being of low-income communities and reducing the multigenerational impacts of poverty. It’s also exciting to see the White House legitimize the important work that One Degree and countless other organizations have been doing for years. 

The White House playbook stresses the importance of taking a “whole-of-government approach,” signaling a shift towards a coordinated effort to address health-related social needs in a field traditionally marked by fragmentation. A strategy at the national level undoubtedly paves the way for progress, but what’s also clear is that this playbook was developed primarily for federal government agencies. Underlying its approach is the assumption that top-down changes will trickle down to our communities. Experience has shown us that this is rarely the case, and we hope to see them expand their focus as follows. 

Adopting an Equity Framework

Central to addressing SDOH interventions is recognizing the true target: the deep-rooted inequities of race and class that drive poor health outcomes. The White House playbook needs a stronger race and class equity lens to ensure truly inclusive and effective strategies. This is particularly important in the health and human services sector, where interventions—including community health hubs, health technologies, and community-based services—have historically manifested as either paternalistic, savior-designed systems at their best or exploitative and predatory ones at their worst. Adopting a robust equity framework is, therefore, a necessary safeguard against perpetuating these historical patterns.

A clear example of the need for this focus is evident in recommendation 1.4: “Improve capacity of backbone organizations to make effective referrals.” This recommendation, while well-intentioned, encourages a top-down effort to develop and disseminate best practices, while neglecting to recommend funding for community-based service providers to design optimal referral practices at the local level. The recommendation mistakenly implies that the technical capacity of CBOs to exchange referrals is the primary issue. We dispute this and see a more significant concern: the lack of power-sharing and collaboration between backbone entities and CBOs in determining how referrals can best support patients and reflect CBO expertise. 

Such disconnects reflect power imbalances currently inherent to the social sector, ones we must address to improve SDOH interventions at the local level. Therefore, we recommend the adoption of the following equity frameworks, ones that we implement at One Degree and believe can be effective across the sector:

  1. Challenge Privatized and Proprietary Data Silos
    The playbook suggests breaking down silos within government and nonprofit organizations, which is commendable. However, this recommendation falls short by omitting the role of for-profit entities. In today’s digital era, data is a valuable asset, and private companies contracted by health and human services agencies often develop proprietary data silos that hinder cross-sector collaboration. For health and human services technology to meet community needs, it’s crucial to extend these guidelines to include for-profit tech vendors. Furthermore, we recommend that more substantial guidelines be developed for states to establish open, public infrastructure in alignment with federal data sharing goals to reduce fragmentation of local SDOH data.

  2. National Alignment on Outcomes and Impact
    A notable missed opportunity in the playbook is a unified strategy for national outcomes and impact measurement. While recognizing the uniqueness of each community, establishing national health equity indicators—similar to economic indicators, such as GDP and CPI—could unify the sector’s efforts towards a common goal. The current practice of communities independently defining outcomes disincentivizes collaboration and perpetuates fragmented SDOH interventions at the local level. A standardized, nationally agreed-upon framework would enable better strategies toward cohesive and quantifiable impacts.

  3. Investment in Public Digital Infrastructure
    Another significant omission is a call for public digital infrastructure. While the playbook touches on SDOH data standards and the role of backbone organizations, it fails to address the tendency of local backbone organizations to create isolated systems, exacerbating the existing fragmentation. To effectively counter this, we advocate for the development of a universally accessible public digital infrastructure. Such a system should cater to the needs of health systems, backbone organizations, and community-based organizations alike, creating a unified and integrated approach to health interventions across the nation.

Beyond the Playbook

We thank the White House for making SDOH intervention a national priority. To meaningfully address SDOH and advance the health of communities nationwide, we must push beyond the playbook’s starting points. A national vision that is rooted in equity, outcomes, and public investment is not just a suggestion, it’s fundamental for success. Otherwise, we run the risk of ceding the future of digital health and human services infrastructure to for-profit entities that are motivated solely by their bottom-line, not the well-being of low-income communities.

Annual Impact Report: Community Empowerment in Action

We are excited to announce that, after three years, One Degree’s Annual Impact Report is back! 

One Degree Digital Infrastructure Empowering Communities Across the Country

In our 2022-2023 report, you can read more about how we’ve co-created truly transformative digital infrastructure, including our closed-loop referral system, document locker, and advanced social needs screening tool, with our partners from California to New York, New Mexico, Colorado, and Michigan. Over the last year, we’ve helped people unlock over $80 million in social services and healthcare benefits through our various programs. The report also includes stories from a few of the amazing partners and community members who shape our work.

The Future Is Open

We’re very proud of what we’ve accomplished, and there is still more work to be done. With One Degree’s technology as the foundation, our next step is to build open community care networks—digitally connected networks of providers and community members that provide public access to comprehensive support for low-income communities. By opening up the power of One Degree, we want to enable even more communities with the infrastructure to support people on their journey towards healthy and fulfilling lives.

Thank you to all of our funders and partners for fueling the transformative impact we’ve achieved together. Your unwavering support continues to propel us toward equity and lasting change.

Read our 2022-2023 Annual Impact Report

Introducing Stay Housed Bay Area: First Regional Platform to Keep Bay Area Residents Housed

San Francisco, CA. October 26, 2023 – A new digital platform launches today to help Bay Area residents find housing-related resources and services that can enable them to stay in their homes. Stay Housed Bay Area is an online gateway to resources for community members to find help paying their rent, responding to eviction notices, or asserting their rights as tenants. 

Stay Housed Bay Area is the first region-wide platform of its kind—curated with up-to-date, relevant information in plain language in both English and Spanish. Until now, these resources were often hard for people to find, and where available, only listed county-by-county or city-by-city. Now they are all easily accessible through one centralized website. 

Stay Housed BayArea is a collaboration between All Home, a regional organization advancing housing and economic security in the Bay Area, and One Degree, a tech-for-good nonprofit that bridges the gap between low-income communities and vital social services. 

“To solve homelessness, we have to prevent it before it happens, and do that on a large scale. Stay Housed Bay Area is an important part of the regional homelessness prevention system we need,” said Tomiquia Moss, founder and CEO of All Home. “People here cross city and county lines all the time, without even thinking about it. Now no matter where you are, there’s one simple place where you can find the best help that’s available in your area. We need more solutions like this that reflect the reality of our region.”

Key features of Stay Housed Bay Area include:

  • More than 150 curated resources in all nine Bay Area counties with actionable, up-to-date information
  • Simple screening questions to assess needs and provide relevant results
  • Plain language at a sixth-grade reading level
  • Spanish language version
  • No log-in, registration, or personal information required
  • Resources for specific populations, such as people with disabilities, veterans, seniors, or people living with HIV/AIDS

“What we’ve learned over the last decade of supporting Bay Area communities is that people need a wide array of services and benefits to prevent homelessness,” said Rey Faustino, CEO of One Degree, which built the Stay Housed Bay Area platform. “This endeavor is more than just a website; it’s a community-driven model for creating regional networks of care, ones that help people get the resources necessary to maintain stability in their lives.”

“It’s really powerful to have a region-wide resource for people in the Bay Area who are at risk of being pushed out of their homes,” said Mary Carl, Executive Director of Health Leads, a racial health equity-focused non-profit that advised on the development of the site. “Housing stability is necessary for a healthy life and thriving communities, and Stay Housed Bay Area will be a valuable tool to help prevent evictions and displacement among residents who are struggling to make ends meet and afford the high cost of living here.” 

A community event to celebrate the launch of Stay Housed Bay Area will take place on November 14, 2023, at the BFHP Hope Center in Berkeley, CA. Berkeley Mayor Jesse Arreguin and other community leaders will be in attendance. 

About All Home

All Home is a Bay Area organization advancing regional solutions that disrupt the cycles of poverty and homelessness, redress racial disparities, and create more economic mobility opportunities for people with extremely low incomes.

About One Degree

One Degree is a tech-for-good nonprofit that collaborates with public sector clients and community-based organizations to build world-class technology with heart. Our community care networks aim to bridge the gap between low-income communities and vital resources, from housing to healthcare and beyond.

About Health Leads

Health Leads is an innovation hub that seeks to unearth and address the deep societal roots of racial inequity that impact our health. Today, Health Leads works both nationally and locally, across the U.S., to build partnerships and redesign systems so every person, in every community, can live with health, well-being and dignity.

One Degree of Change: Transforming Resource Accessibility in Rural New Mexico

Aptly named “The Land of Enchantment,” New Mexico is known for its beautiful landscapes, from the Chihuahuan Desert to the Sangre de Cristo Mountains to the High Plains in the east. The state’s rich cultural and demographic diversity also captivates: with a population of 2.1 million — 50.2% of whom are Latino or Hispanic — and home to 23 federally recognized tribes, New Mexico ranks among the most diverse states in the U.S.

At the same time, New Mexico’s cultural and physical landscapes intertwine with economic and healthcare disparities that affect hundreds of thousands of New Mexicans: 25% of the population lives at or below the federal poverty level and 43% are enrolled in Medicaid. The state also reports elevated rates of obesity, diabetes, and diseases of despair—including significant suicide and alcohol-related deaths. Furthermore, a third of the population resides in rural areas that consistently suffer from practitioner shortages, underscoring an urgent need for social care networks that meet the unique needs of rural communities.

A Rural Gateway to Resources for Children and Families

“Big city issues with small town resources” is how Dr. Brian Etheridge, a pediatrician who has worked in Grant County for sixteen years and most recently for six years at Hidalgo Medical Services (HMS), described the healthcare challenges in rural Southwestern New Mexico. During his tenure, he saw the health issues his patients and their families faced grow hand-in-hand with healthcare practitioner shortages. Notably, when Dr. Etheridge arrived in Silver City, he was just one of four pediatricians serving all of Grant County; a decade and a half later, he was the last. Issues related to social determinants of health, such as substance abuse, poverty, and lack of access to care and transportation, have skyrocketed during the past several years.

It was these obstacles that compelled One Degree to partner with HMS to expand access to vital resources in the community. In 2020, One Degree Southwest New Mexico was born.

The impetus for the project arose from a series of conversations initiated by Dr. Etheridge and Alicia Edwards, the Coordinator for Healthy Kids Healthy Communities Grant County and Grant County Commissioner. Wanting to bridge the gaps between healthcare practitioners and those addressing the social determinants affecting health in the community, they convened a series of multidisciplinary meetings that included a range of healthcare providers, therapists, childcare providers, and community partners. 

From these conversations, a central theme emerged: the lack of access to resources for both families and providers. Reflecting on these discussions in a presentation to the state’s Legislative Health & Human Services Committee, Ms. Edwards stated, “It is a constant and unending struggle for families and providers to find resources — there are never enough resources, we cannot access the existing resources, and it is very difficult to navigate the existing system.”

Equipped with a shared understanding of the problem, the group sought to create a comprehensive resource guide, transitioning from an outdated paper-based system to a digital platform accessible to both families and practitioners. With a leadership grant from the Robert Wood Johnson Foundation, Dr. Etheridge and HMS introduced One Degree’s public, community-resource platform to Southwest New Mexico. 

In this region, many residents lack broadband access, but cell phone usage is prevalent. This made One Degree’s mobile-friendly platform an attractive choice for connecting individuals to housing, food, and other basic needs services. The technology’s ease of use and ability to send resources directly to clients’ phones also made it a valuable tool in bridging access gaps in the community. Additionally, One Degree incorporated local as well as state and national-level resources and provided a dynamic, regularly updated database that could be improved and refined based on community feedback. 

One Degree’s Impact in New Mexico

Since 2021, One Degree has served 21,290 users in various locations, from rural counties like Grant, Catron, and Hidalgo to the metro areas of Albuquerque and Santa Fe. By providing access to over 500 local resources, the platform supports both front-line workers and community members in finding critical services and benefits for all age groups.

This extensive reach — especially the ability to bridge service and public health gaps in rural zones — is directly linked to One Degree’s mission and capacity as a nonprofit provider. While community care technology has immense potential to bridge resource gaps, privatized solutions often proliferate in densely populated areas where higher usage and funding yield larger revenue streams and profits. 

Furthermore, federal and state-mandated initiatives often fail to incorporate the input of community members and community-informed providers in rural areas.

“We believe that trust and sustainability are critical to social net infrastructure,” said One Degree CEO Rey Faustino. “If social care technology goes unused due to misalignment with cultural and community needs, impact, trust and funding can be lost. Partnering with those who deeply understand the community allows us to remain adaptable, and by promoting open access to our resource technology, we create an essential feedback loop between us, community members, and providers that enhances the platform, expands its reach and solidifies One Degree as a definitive public good.”

Dr. Etheridge also emphasizes the advantages of the One Degree approach. “One Degree is the only system I’ve seen where you can easily get information in front of patients and their families. This is crucial, especially in rural areas where people know each other and hesitate to engage neighbors or relatives for their health and social needs. What’s remarkable about One Degree is that it allows us to present information informally. I frequently found myself providing WIC and childcare resources right from the platform. My patients didn’t have to engage with community health workers or care coordinators first to access this resource; it was readily available. And, in cases where families needed to be walked through using the platform, I’d often just talk about it, print something from the site, and they’d take the info and run with it. It’s impressive how quickly this can happen during a clinical visit.”

Top 15 Searches on One Degree Southwest New Mexico (as of September 2023)

The search data of One Degree platform continually provides feedback about the evolving needs of New Mexico’s communities. With 6,575 searches revealing diverse and interconnected needs that no single organization can meet, One Degree data — gathered directly from the public’s independent access to the platform — not only gives visibility to the complexity of community needs, but also underscores the platform’s pivotal role in effectively responding to and addressing them.

A Beacon for the Future: Open Care Networks

Despite the positive strides made by dedicated healthcare providers like Dr. Etheridge, the regionally delivered services of HMS, and the relentless efforts of community providers supporting families daily, significant hurdles to accessing safety net resources persist both in New Mexico and nationwide. One Degree Southwest New Mexico is just one step among many necessary to expand and fortify opportunities for rural communities.

Nevertheless, One Degree sees its regional platform as a beacon—a compelling demonstration of how collaborative, cross-sector partnerships can effectively bridge service gaps by responding to communities at the local level. The platform also highlights how important it is for safety net technologies, which are often publicly funded, to engage directly with both those providing vital services and those using them. When community-resource platforms are open and accessible in this way, it empowers entire networks of care to grow, learn, and succeed collectively. With this approach, One Degree strives to ensure that safety net technology genuinely serves the public and delivers what communities need.

Former CEO of VolunteerMatch Named One Degree’s Head of Development and Partnerships

OAKLAND, CA. September 12, 2023 — One Degree is pleased to announce the appointment of Greg Baldwin, former CEO of VolunteerMatch, as Head of Development and Partnerships. An accomplished leader and technologist, Baldwin brings twenty years of experience securing strategic partnerships, cultivating major gifts, and growing earned revenue to support impact and innovation in the nonprofit sector.

“I am honored to be joining One Degree,” Baldwin shared. “The team’s innovative technology and commitment to expanding the digital infrastructure for public services and benefits is transformational. One Degree is setting new standards for social care technology, and I am eager to help them expand their influence, impact and reach.”

One Degree builds digital social care infrastructure for low-income communities and the organizations that serve them. Leaders in equity-centered technology, they offer products and services ranging from referral management systems to white-label community resource portals and partner with government agencies and nonprofits to help people build paths out of poverty. Their community resource platform, 1degree.org, provides free public access to a database of over 31,000 life-changing social services and benefits serving the San Francisco Bay Area, Los Angeles County, New York City, Southwest New Mexico, and other regions nationwide.

“We are honored to have Greg on board,” said One Degree CEO Rey Faustino. “His expertise will be crucial to building relationships with funders and partners who share our values and vision. We’re seeing the rapid privatization of social services technology at the expense of community voice and equity, and Greg’s guidance and fundraising efforts will help us respond effectively to build safety net infrastructure that truly meets people’s needs.”

As CEO of VolunteerMatch, the web’s largest volunteer engagement network, Baldwin oversaw a platform serving 125,000+ nonprofits, 150 companies, and hundreds of thousands of volunteers weekly. His leadership helped communities engage over $14 billion worth of volunteer services during his tenure. He joined the organization as Chief Imagination Officer, after an early career in the advertising industry. 

In his new role, Baldwin will focus on engaging cross-sector stakeholders to collaborate with One Degree to expand social services infrastructure as a vital public good.

Media inquiries: press@1degree.org

View the official press release…

Fighting Invisibility in Social Care with One Degree’s Document Locker

An unhoused veteran, managing chronic medical conditions, loses identification in a tent sweep and faces an uphill battle to access prescription medications.

A mother and child, fleeing domestic violence, leave personal documents behind and struggle with bureaucratic delays to secure stable housing and enroll in a new school.

After an emergency hospitalization, a person discovers their ID was stolen during the ordeal and finds it difficult to access follow-up healthcare services or insurance benefits.

Drawn from the harsh realities encountered on the frontlines of our social care system, these scenarios depict the challenge of accessing basic resources without personal identification. The absence of such critical documents doesn’t just mean an inability to access housing, healthcare, food programs, public benefits, and employment; it often translates into an invisibility trap, a never-ending cycle of hardships, bureaucratic red tape, and missed opportunities, all of which perpetuate poverty and homelessness.

One Degree has been monitoring the impact of personal ID requirements on community members for several years. Informed by feedback and discussions with our community and healthcare partners, including the Los Angeles Department of Public Health, we built the Document Locker, a HIPAA-compliant secure storage feature, into our platform. This feature enables our registered community members to save and store sensitive documents, using photos taken with their phones or by having a caseworker scan and then upload them securely. One Degree community members using the feature not only store personal identification, but also utility bills, income verification, food stamps, medical information, and other essential records.

Importantly, we designed this feature to ensure that individuals retain full control of their documents—members can view who has access to individual documents and can revoke access at any time. Our aim with the Document Locker is to reduce the effects of documentation loss, theft, or damage and enable community members to share their personal information with more ease and control.

However, a year into the pilot of the Document Locker, we see the scale of the need and a bigger issue more clearly: millions of people nationwide lack IDs. 

A June 2023 report from the California Statewide Study of People Experiencing Homelessness (CASPEH) highlighted that 52% of participants identified the lack of documents as a barrier to housing. A 2018 article published in the Journal of Immigrant and Minority Health delved into the identification issue more deeply, reporting that the absence of valid government-issued IDs restricts access to healthcare and essential services and disproportionately impacts the following populations

  • Adults who identify as Black or Latino
  • Undocumented immigrants
  • Seniors, over the age of 65
  • People navigating housing insecurity, homelessness, or catastrophic events 
  • People who identify as transgender 
  • Formerly incarcerated individuals
  • People with annual incomes under $35,000 

This raises a crucial question: How can One Degree and our partners address a predicament that can have disastrous consequences for members of marginalized communities? 

We are evaluating various possibilities. Can we enhance community outreach to raise awareness about helpful technologies? Can community-based organizations encourage secure document storage without compromising privacy and trust? Can statewide and/or federal digital IDs be developed to address the issue in ways that are inclusive, equitable, and safe?

California’s Department of Technology is already developing digital IDs. In 2022, they began exploring “best practices and confirmed the approach to develop secure digital ID capability for California residents.” However, the CDT conversation so far has engaged primarily with the private sector and governmental agencies, leaving a gap in community input that could result in unforeseen and disproportionate impacts on marginalized communities. 

The unfortunate reality is that a cottage industry of solutions has exploited low-income and BIPOC communities because of lack of documentation: check-cashing services, payday lenders, and fraudulent immigration assistance services, just to name a few. More ‘normalized’ identification solutions, such as ID.me, are being developed with profit in mind and can create new barriers to access by requiring challenging technology, internet access, or digital literacy that many disadvantaged people lack.

This is why when building the Document Locker or any new technology, One Degree prioritizes the privacy, safety, and agency of the communities we serve. As digital ID technologies develop further, it’s imperative that community and nonprofit voices are at the table, providing input on matters of privacy, accessibility, accountability, data security, and oversight, before digital ID becomes a fixed feature in our lives.

In collaboration with you—our community members, partners, and supporters—we want to help shape the future conversation about this issue. But to learn more and go deeper, we need to hear from you on this issue: How do ID requirements continue to impact your clients and your work? How would you like community leaders and tech innovators to help address this problem? As state and federal agencies develop and implement digital IDs, which may be necessary to access services and benefits, what are your hopes and concerns? 

Let’s collectively ensure that those struggling to access social care have a significant voice in shaping the technologies that impact them the most.

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Your opinion matters to us! Send us a message to share your thoughts on this urgent issue and the Document Locker innovation.

Lived Experience: The Unsung Hero of Social Care

The COVID-19 pandemic dramatically changed the public discourse around social care equity and access. Laying bare disparities between low income communities of color and their whiter, wealthier counterparts, it also underscored how social and cultural understanding—or lack thereof—can determine the level of trust between communities and healthcare providers. In Los Angeles and San Francisco, for example, the need for “credible messengers” to share COVID-19 information prompted government and healthcare agencies to lean on community-informed ambassadors to reach those most at-risk. 

The pandemic affirmed what community leaders have known for decades—the messenger is as crucial as the message itself. 

Today’s social and economic landscape makes this message ever more urgent. Increasing numbers of people struggling with unemployment, housing insecurity, and mental health conditions need not just a stronger social care system, but a more credible system, with community-informed workers at the frontlines.

We are excited to see new policy and budget initiatives, like CalAIM and increased Medi-Cal spending, emerge during this recovery phase. The support and direction they provide for equitable and person-centered care are much needed for our California communities. At the same time, we are concerned that qualities central to reaching at-risk individuals and families—lived experience and community ties—are not yet central to how social care policy evolves.

As a whole, CalAIM recognizes social work and community support as central to comprehensive care. Echoing this message, the Washington Post has described social workers as the “unsung heroes of the pandemic” and fundamental to the care landscape: 

“Within our hospitals, they evaluate the needs of families, enroll patients in public assistance programs and address food-insecurity and transportation challenges. Social workers are the glue to connect patients and families with essential services, the grease that lubricates key bureaucratic processes we and our loved ones depend on in our hours of need.”

However, a recent Cal Matters report on the CalAIM Behavioral Health Payment Reform Initiative raises concerns that some of CalAIM’s reforms, including higher payments for providers with advanced degrees, value professional credentials over lived experience and community knowledge. Despite evidence that lived experience increases the efficacy and engagement of behavioral health services, this CalAIM initiative overlooks its value and, therefore, comes with barriers to equity attached.

We share this concern and worry about any vision for social care that does not uplift the experience and knowledge of people who have used safety net resources. In One Degree’s field—social care technology—services are increasingly being delivered by highly funded, for-profit corporations. Unfortunately, when profit margins and ROI drive how such technology develops, the needs and expertise of communities are often devalued.

This is where One Degree stands out. As a nonprofit, we remain beholden to the public good. More importantly, our Community Outreach & Engagement team is staffed by people who have used public services and are local to the regions they serve. Having directly helped 1,400 community members navigate One Degree resources, they continually demonstrate that frontline staff with lived experience are necessary to building dignified communities of care. For many of our community members, our approach offers the relief of feeling seen and supported by those who understand the journey. 

To implement our values more fully, we are designing a new volunteer initiative to recruit, train and certify Community Outreach & Resource Navigators—with lived experience—to connect their communities to resources. Integrating leadership development with resource navigation training, the initiative aims to elevate the voices, resilience and power of low income communities. For us, this is a necessary next step towards bridging the gap between the social care system and the diverse communities it serves.

The messenger is as crucial as the message itself. 

As social care policies and tech infrastructure develop, we need more and more organizations advocating for what we know: that community experts can reach those that others can’t. If we rally behind this truth, the unsung hero of social care—lived experience—will begin to receive the valuation our communities deserve.

Medical-Financial Partnerships: An Innovative Approach to Improving Community Health

By Steve “Spike” Spiker, Chief of Programs & Technology.

We’ve all heard the adage that it takes a village to raise a child. Perhaps less well known is that it sometimes takes a financial resilience coach to improve the health of children and their families. For the past two years, One Degree has been supporting an innovative community health intervention led by the Medical-Financial Partnership (MFP) team at UCLA Harbor-UCLA Primary Care Pediatrics, Prenatal, and Family Medicine Clinics and the Olive View-UCLA Primary Care Pediatrics Clinic. Focused on addressing the complex social and financial situations that low-income families struggle through daily, this novel initiative is staffing clinics with financial resilience coaches. One Degree is proud to be part of these creative approaches to caring for people and improving the health and well being of communities.

Poverty, according to the Council on Community Pediatrics, is a significant driver of adverse health outcomes for children and hinders access to essential healthcare. Underscoring the importance of early childhood interventions, the Council suggests that such interventions can yield “a high rate of return in both human and financial terms.” Studies by the RAND Corporation provide a concrete understanding of these returns, documenting that early childhood interventions can yield a return on investment ranging from $1.80 to $17 for every dollar spent. 

Yet, despite this evidence, the reality for many families remains far from ideal. Consider a single mother working two jobs and relying on public transportation to support her family. She is likely to face significant barriers to securing adequate healthcare for her children, unlike a well-off mother with a high-earning spouse and access to private transportation. Even though it is clear  that early access to care reduces healthcare costs and lessens the burden of disease later in life, the working poor continue to face a health and social services landscape laden with obstacles and complexity.

The Medical-Financial Partnership at UCLA is confronting these challenges head-on. By incorporating financial resilience coaches into the clinical environment, the program can address issues beyond health that lead to improved outcomes for the whole family, from improved financial wellbeing to increased rates of immunizations and preventative care visits. A recent NPR article highlights the impact of this innovative approach on Los Angeles families. Dr. Adam Schickendaz, a project lead and advocate for One Degree in clinical settings, articulated this sentiment to NPR: “Poverty drives health outcomes, especially poverty in early childhood… Food insecurity, housing insecurity, transportation issues, utility bills, all have a financial component at their core.” Similarly, Dr. Monique Holguin, another project lead at MFP, shared her insights, “Starting early, in the first few years of life, cements a pathway towards financial security.” She further stated, “Early intervention can break the intergenerational cycles of poverty that we know have long-term, detrimental health impacts on children, and on other family members as well.”

Source: Clinic-Based Financial Coaching and Missed Pediatric Preventive Care: A Randomized Trial (video abstract)

The MFP financial counseling approach supports families in building resilience through financial planning, as well as the identification of strengths, priorities, goals, and action steps aimed to improve economic stability. The MFP at UCLA also aids in connecting families to resources that can help them navigate systems and structures that might otherwise be opaque, enabling them to more easily invest in their children’s future health and wellbeing.

In addition to the support given to families enrolled in the comprehensive financial resilience coaching program, the MFP aids affiliated clinics in developing and maintaining financial and social needs resources. These resources are available to all families served by the clinic, amplifying the benefit across the community. The MFP team also works directly with healthcare team members, sharing knowledge and educating medical trainees on utilizing various tools, resources, and coaching approaches in their patient care practices. This integrated clinic approach, focused on family-centered, community-partnered clinical care improvement, has accelerated healthcare access and led to improved care for an increasing number of families. 

One Degree has played a meaningful role in the MFP initiative. Our initial contribution was the development of an eligibility and screening tool to help financial resilience coaches assess the situation of each family visiting the clinics and determine which public benefits they would likely qualify for. The light-weight and user-friendly tool is also accessible for families to use directly, via mobile device or desktop, and is currently being promoted on UCLA college campuses and clinics. Early evaluation of the tool’s use have shown that 84% of users would recommend it to other families, and nearly all users identified at least one new benefit program they could enroll in.

In addition to the screening tool, One Degree’s community resource platform and closed-loop referral system support the MFP at UCLA. As the leading healthcare providers within ACES-LA, a network dedicated to reducing Adverse Childhood Experiences (ACES), the UCLA MFP clinics worked with One Degree to develop the referral system as a way for clinics and local nonprofits to make informed, warm referrals to services and resources outside their own organizations. MFP financial resilience coaches receive training on One Degree’s referral system, enabling them to support families beyond the MFP’s financial scope. In the face of poverty, families often require a range of services and benefits that no single organization can provide in its entirety. Therefore, the ability to make informed referrals is critical. It ensures that each client is personally acknowledged and supported by the referred organizations, fostering the trust that is essential to the success of whole care initiatives. 

If your organization is interested in trying a novel approach to serving your community, we would love to hear from you. One Degree is more than just a community resource platform! We enjoy partnering with teams who are experimenting and designing new interventions and ways to serve people more holistically. Even if One Degree is not currently serving your community, we still want to understand your challenges and help turn them into opportunities.

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For more information about this research, you can explore the following links: 

Clinic-Based Financial Coaching and Missed Pediatric Preventive Care: A Randomized Trial 

Interest in Clinic-Based Financial Services among Low-Income Prenatal Patients and its Association with Health-Related Social Risk Factors

AmeriCorps Fellow Spearheads One Degree’s Volunteer Outreach Initiative in Los Angeles

The year was 2005, and two nonprofit foundations, the California HealthCare Foundation and The California Endowment, were poised to change the way individuals accessed health and social services in California. They established the Center to Promote HealthCare Access, an institution dedicated to the development and implementation of technology aimed at providing efficient access to vital services.

One Degree is proud to share the following interview with Samantha Masannat, inaugural AmeriCorps Fellow, who has joined One Degree as part of our partnership with the AmeriCorps Volunteer Infrastructure Project (VIP). Samantha began her journey with us in March 2023 and has focused on the development and expansion of our volunteer program to enhance community engagement across Los Angeles County. With the support of our AmeriCorps Supervising Organization, Foothill Unity Center, Inc., we aim to strengthen One Degree’s capacity to support community members and increase ongoing volunteer recruitment across our organization. As Samantha approaches the end of her 900-hour service term, she continues to engage community members and recruit volunteers to lay the foundation for a high-impact volunteer program.

We recently sat down with Samantha, who generously shared her thoughts about her One Degree journey:

Can you tell us about your background and what led you to join AmeriCorps and One Degree?

After graduating from college with a degree in Public Health in 2021, I began my career in community outreach, assisting low-income individuals primarily by providing them access to free cell phones. But I quickly realized I was seeking something more sustainable and impactful. I knew about AmeriCorps and decided to apply, believing it could be a rewarding experience. I’ve always been drawn to the nonprofit sector as I love working and interacting with people. In a world that often feels disconnected, I wanted to contribute to building stronger communities.

What are your hopes for the Los Angeles community?

My main hope is that we can provide necessary resources to low income individuals in our diverse LA County. I was introduced to Foothill Unity Center by my mother, where I became inspired by volunteer work and the ongoing need for community outreach. During my initial months, I worked alongside other AmeriCorps fellows, assisting low-income residents in Pasadena and Monrovia through food drives and administration duties. I’d like to see well-resourced outreach and assistance programs operating in every community in LA, so that people can find help quickly and services organizations and volunteers are regularly collaborating to close gaps in the safety net.

Can you share a little about your current responsibilities at One Degree?

At the moment, my primary focus is establishing a robust volunteer program in Los Angeles. We are developing volunteer descriptions, a dedicated website for volunteer support, and conducting volunteer outreach. We’ve published volunteer roles on platforms like VolunteerMatch and our One Degree website covering areas such as outreach and social media. My goal is to enhance our team’s capacity, allowing us to reach out to more community organizations and increase our presence in local spaces. We have new volunteer support joining us this month, specifically to attend Los Angeles events and help share resources with our community members. We are excited to expand from there and see what we are able to accomplish together.

What makes volunteering with One Degree an exciting opportunity?

Volunteering with One Degree is very exciting. Here, you’re not just a volunteer—you’re part of a team that cares deeply about helping people and finding new ways to bring resources to those who need it. I’ve been able to sharpen a number of skills, meet incredible people, and contribute to a community-based mission. Their goal of strengthening the social safety net and working day in and out to bring equitable support to all members of our community, it’s very satisfying. I feel proud of this work, knowing that when people learn about resources and find out there is help available, especially when having a hard time, there can be a ripple of positive change in someone’s life.

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As Samantha continues to serve her term at One Degree, she will concentrate her efforts on fulfilling the Volunteer Development standard, a commitment completed within the first year of service. This involves the creation of a recruitment plan, defining clear roles, formulating retention and recognition strategies, and establishing a productive feedback process for our volunteers. Her work aims to establish a sustainable volunteer program in Los Angeles County that emphasizes utilization, involvement, and effective management. 

We look forward to witnessing the positive impact of Samantha’s volunteer work and encourage anyone interested in contributing to the One Degree mission and community to consider applying for our open volunteer roles. We are immensely grateful for Samantha’s achievements as well as the dedication and efforts of every volunteer who joins us in expanding access to social services in Los Angeles and beyond.

Tech for the People: How One-e-App Pioneered Digital Healthcare Access

The year was 2005, and two nonprofit foundations, the California HealthCare Foundation and The California Endowment, were poised to change the way individuals accessed health and social services in California. They established the Center to Promote HealthCare Access, an institution dedicated to the development and implementation of technology aimed at providing efficient access to vital services.

Their breakthrough product was the One-e-App (OeA), an innovative web-based system enabling families to connect with an array of publicly funded health and human service programs. It was the first of its kind, trailblazing a path for a future where health coverage, food and nutrition benefits, utility and cash assistance were just a few clicks away. The story of One-e-App is the story of the organization that became Solution Interest Solutions and, today, lives on as One Degree.

Before 2005, most people still went to insurance agents to fill out dozens of pages of applications for their health coverage needs. However, with the birth of the OeA system, a significant shift began that improved resource access for low-income communities. Healthcare administrators within clinics and community-based organizations started to enroll their clients online, changing the landscape of how health insurance screening and eligibility were administered. During this era, legacy systems across industries were being replaced with innovative online platforms, including the shift from paper applications to the online Common App for college admissions and the surge of web-based document storage and sharing solutions such as Dropbox. It was the OeA team that stood at the forefront of this transformation in social services.

The organization’s longest employee and lead engineer, Naresh Ravuri, shared his experience of launching OeA nearly twenty years ago. “Reflecting on my journey with this technology, I feel truly blessed. I joined the team in 2007, although the project started in 2005. From that moment, it was a whirlwind of rapid, intense work striving to scale up OeA to meet the needs of our partners and their communities. Knowing that we were developing something that could potentially help millions of people gave us the drive to keep pushing forward.”

A crucial aspect of the OeA development team’s approach was forging deep, authentic relationships with clients—including San Mateo County, the County of Alameda, Los Angeles Department of Health Services, and Maryland’s Department of Health. This allowed them to more fully comprehend the unique needs of service providers and the communities they served. The team gained particular insight into a significant gap in safety net healthcare programs: the enrollment of individuals who, due to immigration status or other reasons, didn’t qualify for comprehensive Medi-Cal coverage. Partnering closely with their clients, the team quickly developed OeA to help enroll the highest need and poorest community members into much-needed healthcare services. While initially embraced primarily by community-based organizations, OeA usage evolved to encompass county and state health departments. This expansion led to the screening of over 9 million people across four states—California, Arizona, Indiana, and Maryland—and processing upwards of 12 million benefit program applications. 

Beyond facilitating enrollment in safety net programs, OeA served to reduce duplicative administrative procedures. In the past, healthcare administrators who worked directly with communities faced the burdensome task of filling out screening and eligibility paperwork for multiple systems. OeA, however, simplified the process. Functioning as a one-stop system to determine whether individuals qualified for Medi-Cal/Medicaid or other safety net programs, OeA saved providers considerable time and resources.

Ravuri reflected on how OeA enhanced accessibility, stating, “Our application was a breath of fresh air—straightforward and intuitive. With the aid of a helper, individuals could easily fill out the application, which put all the required information at their fingertips. Unlike paper forms that often didn’t capture enough information, our application provided all the necessary details, enabling us to do accurate eligibility calculations and promptly provide the results to our clients. We also introduced kiosks to access the platform in certain areas. The kiosk proved invaluable, especially for those who didn’t have online access at home. They could simply go to a county office and apply using our web-based application, a far cry from the lengthy and daunting paper forms of the past.”

In the early days of OeA, no other nonprofits or commercial vendors were involved in similar work. The team truly pioneered the use of technology to improve access to services and benefits. Aiming to deliver on its mission to promote healthcare access, the team recognized that Web 2.0 technology created an unprecedented opportunity to provide people with faster and easier access to healthcare resources and opportunities. Over the next decade, OeA became a tailored solution, adapting to respond to changing benefits policies and serving different agencies at the local, county, and state levels. Simultaneously, OeA became a blueprint and case study that other companies used to scale up similar technology solutions for benefits access. Today, every state in the country uses a system that, at its core, was modeled off the very first online application for benefits—OeA.

In the last 10 years, few industries have been left untouched by the Web 2.0 revolution, and the benefits and social services field has been no different. Many governmental agencies now have advanced even further to deploy robust, federally and/or state funded enrollment systems, like Covered California, that have reduced the need for OeA, a powerful technology for its time. However, One Degree knows that much more can be done.

Steve Spiker, Chief of Programs and Technology, shared, “Even though electronic applications have now become commonplace, there are still significant barriers to low-income people being able to easily access healthcare benefits and social programs. Despite the digital revolution, the enrollment process can often seem like a black box, where people can be rejected for unknown reasons and spend months or years in appeals or reapplications. The system pressures many people to give up. We are excited that some things have improved over time—for instance, renewals are now just a text message away—but the struggle to access and maintain benefits is still all too real for many. Developing technology and reforming administrative systems that offer universal access, transparency, and referrals to multiple service providers is where we currently see the greatest need.”

Recent changes in California state policy and the Governor’s budget have expanded and strengthened benefits eligibility for low-income families and undocumented individuals. As a result, many original programs that used OeA are being phased out, with families being transferred to MediCal. One Degree applauds this transition, seeing it as a positive step towards ensuring high quality healthcare and reducing administrative burdens. Consequently, One Degree is gradually sunsetting OeA and channeling resources towards what it perceives is the next evolution in social services—integrated eligibility and enrollment for benefits and services through an open resource and referral platform.

One Degree CEO Rey Faustino expressed, “We are immensely grateful to the original team of visionaries who conceived, developed, and launched OeA, as well as the unwavering support of our state, county, and CBO partners throughout the years. OeA has not only facilitated the enrollment of individuals into vital benefits, but it has also had a profound and far-reaching impact on countless lives, creating a ripple effect of positive change. Today, we are redirecting our focus towards addressing the evolving needs of the communities we serve. We are committed to finding innovative, equity-centered solutions and working with community partners to achieve our goals.”

“With One Degree, our priority lies in the next frontier of social service and benefits access,” he continued, “Ensuring that the technology infrastructure actually improves people’s lives. Equally significant is the robust foundation our past work has built, which has allowed us to foster invaluable relationships with key partners and clients, spanning from Los Angeles and San Francisco to the wider reaches of California. Even as we begin to phase-out OeA, the legacy of this pioneering technology system continues to inspire and guide our work.” 

The sunsetting process for OeA begins this month and is projected to run until spring 2024. In reflecting on his experience with OeA, Ravuri shared, “It’s sad to close an application that has served millions of people and fulfilled their needs for so long, but it’s comforting to know that people today can access the benefits they need through many alternatives like Covered California. I’m proud of our work at One Degree and with OeA,” he continued, “where we prioritize people and their needs and build solutions from there. Our impact has been wide. And as we move forward, we continue to leverage our history, our experiences, and our legacy to deliver the technology that people truly need.”