Community in Action

Health care access

Expand existing project, program, or initiative (expanding and continuing ongoing, successful work)

Lack of appropriate healthcare affects families, systems-impacted youth, and their caregivers who are managed care plan members. They face multiple intersecting challenges: poor access to mental health services, mistrust of health care systems, housing, and inadequate social support. Systems-impacted youth are at a higher risk of experiencing mental health issues, homelessness, and insufficient support. LAHSA states that there are 66,000 homeless people in L.A. Co., many of whom are youth. The pandemic exacerbated issues, with a 30% increase in mental health-related emergency visits among youth. Consider "Maria", a single mother of 3 who lost her job during the pandemic. Maria faces eviction and severe stress, affecting her mental health and her children's well-being. As a result of her own experience growing up in foster systems, Maria carries trauma that requires support to manage. She does not understand/trust her Medical Managed Care Plan or health care team.

Communities need integrated support to foster resilience. Through our program, we will hire 20 community members who will be trained in evidence-based Community Health Worker (CHW), Community Supports, Mental Health and Managed Care Plan Navigation curriculum to help people like Maria. Vulnerable Angelenos will connect with a trusted CHW--someone who lives, plays and worships in their neighborhood, and who understands their experience and challenges. CHWs will provide community supports and enhance care management to help 500 vulnerable adults, youth and children navigate health care appointments, manage insurance re-enrollment processes, appointments, referrals, housing assistance, mental health services, and secure fresh food support. El Sol will focus on vulnerable families, systems-impacted youth, and their caregivers in L.A. We will concentrate our efforts in high-need areas using referalls from HealthNet and data software to guide our efforts. We will focus on neighborhoods where disparities in health care access, mental health services, housing, and social supports are most pronounced. Each CHW will work with approximately 25 families, youth and their caregivers and will give customized, compassionate support and comprehensive care coordination within the settings where they feel safe. We will provide virtual tools, ensuring that support is always available to assist those in need, like Maria. This consistent presence helps build trust and provides reliable support.

Currently, Los Angeles social and health care services are fragmented, duplicative and are not always culturally appropriate. Our project will help to address service gaps in systems by offering community-based solutions in:
- Mental Health: By providing/referring people to inclusive and culturally sensitive mental health services, we address the psychological well-being of vulnerable Angelenos, reducing the stigma and barriers to seeking help. - Health Care Access: CHWs assist families in navigating systems, ensuring they receive the medical attention they need, improving overall health outcomes. - Homelessness: We will partner to secure affordable housing for families/youth at risk of homelessness, providing stability and preventing adverse effects of housing insecurity. - Foster Youth: Our program supports systems-impacted youth, offering them support to transition into adulthood successfully, reducing the risk of homelessness or mental health issues.

Health Care Access: Connect 500 individuals/families to health care services annually. Metric: # of participants attending medical appointments and receiving care. Mental Health Services: Provide mental health support to 300 individuals. Metric: # of behavioral health appointments/sessions and improvements. Housing Stability: Secure stable housing for at least 20 families/youth. Metric: # of participants achieving housing. Social Supports: 400 participants access a range of services. Metric: frequency/variety of services utilized. Monitoring/Evaluation: We use cloud-based data services to measure quantitative metrics: service utilization rates, outcomes, and housing. Inputs: electronic health records, service databases, and service tracking tools. We conduct regular surveys and interviews from participants to understand their experiences, identify improvement, and measure impact. CHWs provide monthly reports: activities, challenges faced, and successes achieved.

LA Health Net will refer foster youth and their care givers, adults and families who are managed care plan members and who need either community-based Community Health Worker education and support, Community Supports, Enhanced Care Management, and/or screenings and treatment. LA Health Net will share electronic health records, referrals and service and care coordination information. LA Health Net will also provide supports, such as asthma remedition funds for in-home education or repairs to address the root causes of asthma; referrals for fresh foods, and other support options for their members that CHWs will integrate into our care model. LA Health Net values El Sol because we provide compassion, shared lived experiences, and active listening along with culturally-sensitive services.