Medical funding for health workers is running out

GRANITE CITY, Ill. – As a community health worker, 46 -year -old Christina Scott is a professional red ribbon cutter, handcuffs, crying shoulders, and personal safety net, rolled into one.

He worked in an office in the shade of the steel mill that his grandfather rented in this small town on Greater St. Louis. Louis place. Finishing with a lot of steel works is part of the area’s strength – nearly one -fifth of Granite City’s residents live in poverty, higher than the national average.

Then another destabilizer – covid -19 – hit. And so Scott came in: He knows how to get into rental assistance for people out of work as they share the home with covid. She can bring cleaning supplies or food from a local food store. She will be on the phone with customers, helping them spend their money to keep the lights on. And the calls are coming because people know he understands.

“I’m hungry. I don’t have a car,” Scott said. “I got those things.”

Scott is one of 650 community health workers hired by the Illinois Department of State through community -based organizations starting last March. This Pandemic Health Navigator Program was made possible by a nearly $ 55 million grant from the Centers for Disease Control and Prevention through federal health insurance provided by Congress. The company completed about 45,000 applications for assistance, which were given to them through the search for covid cases.

Gaining the trust of the community, Scott said, more requests have been poured in from those who have heard about the catch-all program, many of which are considered healthy activities. crowd.

But the money started to run out by the end of June. Workers like Scott aren’t sure about their future and the people they will help on a daily basis. Dr. Georges Benjamin, executive director of the American Public Health Association, said it was a disaster of the kind of health funding boom-bust in the United States.

“When the money runs out, we will see some people fall off the cliff,” he said. The problem, as Benjamin sees, is the country’s lack of access to public health systems. “If you do this with your army, with your army, you can’t have a good security system.”

Community health workers have been placed at the forefront of President Joe Biden’s health program. Ideally, they are one and the same as the people they serve – as a trusted neighbor when they need help. Notably in countries such as Costa Rica, Liberia, and Brazil, community health workers have struggled to care for the United States without ways to pay them.

Hundreds of millions of dollars are expected to go towards building a community health worker after the American Rescue Plan Act passed into law last March, said Denise Smith, executive director. founder of the National Association of Community Health Workers. But, he said, most of the money would go immediately to health departments or government projects, not community organizations. And most of that went to AmeriCorps employees who may not be from the communities where they work – and work on poor wages, Smith said.

“For bills and a license, rent, or children, it can’t be guaranteed,” he said. “We can’t do it for free.”

In contrast, the Illinois program attempts to hire workers from local communities. Two -thirds of its employees were identified as Latino / Hispanic or black. About 40% have never worked before, and hiring them invests in the communities they serve. Jobs cost $ 20 to $ 30 an hour, and nearly half goes into health insurance or a stipend attached to it.

That’s in the pipeline, said Tracey Smith, who oversees the Pandemic Health Navigator Program for the Illinois Department of Public Health and is not affiliated with Denise Smith. He believes it is necessary to pay such workers, not valuable, to help people run the health care system and government assistance programs.

Angelia Gower, vice president of the NAACP in Madison, Illinois, was one of those paid health workers. “They see you outside every week and every month and when you’re there, they start to trust you,” he said. “You’re making a connection.”

But with the decline in covid cases, the number of Illinois mental health workers dropped by about a third, and by about 450, in part because they had other opportunities.

Smith hopes the program will fund more than 300 community health workers on staff and then use the goodwill they have built in communities to focus on disease prevention. The American health care system – and its inefficient system – is not going to go covid, he said. In addition, millions of people are ready to lose their Medicaid coverage when health benefits expire, Benjamin said, making a hole in their safety net.

Part of the long -term money dive is figuring out what employees like Scott do during the day, even if it’s not directly related to covid or other chronic diseases. How do you calculate the difference that is made in a customer’s life when you make mattresses for their children, laptops for them to go to school, or click on Federal Emergency Management Agency funds to pay funeral costs after the death of a covid loved one? How do you invest in health care services that can support a family, even if there is no health problem?

As Scott would like to point out, most of the time he is helping people use the resources they have.

The National Association of Community Health Workers ‘Denise Smith is concerned that because programs like Illinois’ are doing work to help unhealthy health, they may be on the way to Affordable Care Act grants are made. In 2013, she worked as a community health worker in Connecticut, helping to reduce the number of undocumented people in her area by 50%. But the money dried up, and the project was lost.

He said North Carolina is an example of a state that has developed its own, community health work program. But at the national level, Congress has not approved more funding for covid testing and vaccines – much less for long -term health insurance.

Now, Scott can’t worry about people like Christina Lewis, 40.

Leaving Lewis ’home phone after leaving a baggage of customers, Scott reminds Lewis to continue wearing his mask like the others running around. theirs. Scott used his own family as an example, saying they all wore their faces in public while people “looked at me like five heads.”

Lewis said Scott’s help – bringing in customers, communicating through spending – was invaluable. Lewis stayed home during illness to protect his 5 -year -old daughter, Briella, who was born earlier and developed epilepsy. The struggle to get what it needs will end in the midst of rising inflation. Briella sees the lights turn off when she leaves a room. And they are watching the price of oil go up.

“I knew I was going to get a cake,” Lewis said.

In recent months, Scott has listened to and comforted Lewis as he wept over the loss of life and the loss of covid families. Scott isn’t sure what will happen to his customers if he loses support.

“What happens to people when they go?” Scott asked.

KHN (Kaiser Health News) is a government news agency that publishes in -depth news coverage on health issues. KHN is one of three major projects at KFF (Kaiser Family Foundation). KFF is a non -profit organization that provides information on health issues in the nation.

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