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.
Also published on Medium.