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Part of the long-term funding challenge is quantifying what workers like Scott do in a day, especially if it doesn’t relate directly to COVID or another communicable disease. How do you tabulate the difference made in a client’s life when you’re securing beds for their children, laptops for them to go to school, or tapping into Federal Emergency Management Agency funds to pay funeral costs after a loved one dies of COVID? How do you put a dollar amount on wraparound services that may keep a family afloat, especially when a public health emergency isn’t occurring?
As Scott likes to point out, most of the time she’s helping people use resources already available to them.
The National Association of Community Health Workers’ Denise Smith is worried that even though programs like Illinois’ are doing the work to help with health inequities, they may go the way that many Affordable Care Act grants did. In 2013, she was working as a community health worker in Connecticut, helping cut the uninsured rate in her area by 50%. But the money ran dry, and the program disappeared.
She said North Carolina is an example of a state that has designed its pandemic-inspired community health worker program to be more permanent. But, nationally, Congress has yet to approve more money for COVID testing and vaccines — much less for longer-term public health investments.
Meanwhile, Scott can’t help but worry about people such as 40-year-old Christina Lewis.
As she leaves Lewis’ mobile home after dropping off a load of groceries, Scott reminds Lewis to keep wearing her mask even as other people are shedding theirs. Scott used her own family as an example, saying they all wear their masks in public even though people “look at me like I’ve got five heads.”
Lewis said Scott’s help — bringing over groceries, talking through budgeting — has been invaluable. Lewis has stayed home throughout the pandemic to protect her 5-year-old daughter, Briella, who was born prematurely and has chronic lung disease. The struggle to make ends meet is far from over amid rising inflation. Briella knows to turn off the lights as soon as she’s out of a room. And now they are eyeing rising gasoline prices.
“I already know I’m going to have to get a bike,” Lewis said.
Over the past months, Scott has listened and consoled Lewis as she cried over the stress of staying afloat and losing family members to COVID. Scott isn’t sure what will happen to all her clients if her support disappears.
“What happens to people when it goes away?” Scott asked.
Kaiser Health News is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.
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