Your Source for Health Reform

Community-Based Organizations Play A Critical Role in Reform

CBOs’ Critical Role in Reform
In every community across the south and west Sides, as well as other areas of Chicago, there is an individual Celine Woznica calls a “mother hen.”

“There are usually one or two people in a community-based organization who are such trusted and respected members of their communities that people come to them,” says Woznica, program director for the Chicago-based Asian Health Coalition of Illinois.  “They know their communities, know their clients and know what those clients need.  And they can get those clients connected to services.”

Often, “mother hens” also reside in the community, attend the temple, mosque or church and serve as the individuals folks turn to with questions, she adds.  Inquiries may range from where to go for a flu shot to how to get heating assistance to when to go for citizenship classes.  Many of these community-based organization staff members are trained in linking people to health care.

Already stressing preventive care and a coordinated approach to patient management, including long-term monitoring of chronic problems such as heart disease and diabetes, Lawndale Christian Health Center is expanding its efforts with a new facility and a continuing investment in an underserved Chicago neighborhood.

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“Their position is elevated by the pastor, monks in the temple, or other people in their community,” Woznica says. “The respected elders refer anyone who comes to them to the community-based staff members.  These staff are the very people who have to be well versed on the Affordable Care Act, and how to help people take advantage of it — from preventive care to the health exchange.”

As Woznica notes, community-based and social service organizations will be crucial to the success of health care reform, and their “mother hens” will be essential in helping their broods grasp reform’s provisions.  In addition, there exists more the community-based organizations can and will do.  Much more.

No one knows that better than Dr. Mari Egan, MD, director of medical student education in the Department of Family Medicine at University of Chicago Pritzker School of Medicine.  On organizations’ role in reform, Egan is unequivocal.  “We can’t do it without these agencies,” she says.  “We will be lost, and doctors will flee, if we don’t have those agencies, because they’re crucial.”

Health Reform’s Expected Impact

There’s no doubt health reform will benefit those served by community-based organizations, says Jim Duffett, executive director of the Champaign and Chicago-based Campaign for Better Health Care (CBHC), the state’s largest grassroots coalition fighting for accessible, affordable quality health care.

Health care reform “will mean greater accessibility across the board, not only for those on Medicaid but for those who are uninsured and for small businesses,” he says. “It will begin to address the issue of affordability. There won’t be as much discrimination against women.  And there will be more people in the system, which will make the system more affordable.  The other good thing is that quality of care will be addressed . . . People will be able to have physicals and go to a doctor and have the doctor take care of things that bother them right now, rather than allowing them to fester.”

While much has been written about health reform’s complexity posing an added burden for small businesspeople, negatively impacting small business hiring, Duffett argues health care reform will achieve the opposite effect.  “This will be a jobs creator.  Lots of people are locked into jobs because they are too scared to go out and get another job [due to insurance concerns].  Some of these people will now be able to go out and start their own companies.”

At Erie Neighborhood House, a west side social service organization and community service agency founded in 1870, director of development Rhea Yap believes reform’s benefits will positively impact the younger, working families her agency serves.  “They tend to believe they can do without preventive care,” she says, adding under reform, “They’ll be more proactive about seeing a family doctor for all members of the family, and getting regular checkups.”

In the meantime, accessibility and affordability are two reform outgrowths mentioned most prominently by Kathy Chan, director of policy and advocacy for Chicago-based Illinois Maternal & Child Health Coalition.  “But another component, especially for low-income communities of color, is that it will hopefully reduce health care disparities, helping level the playing field,” she says.

How Organizations Can Help

The ways community-based organizations and social service agencies can get involved to help make health care reform a success are limited only by their own imaginations.  But what follows is a partial list of roles they may play:

Gaining and dispensing education. Community-based organizations will best serve their constituents, patients and clients by being well informed themselves about health care reform, Chan says.  “The education could take place by participating in conference calls with organizations like ours, with and organizations like Health & Disability Advocates and the Sargent Shriver National Center on Poverty Law,” Chan reports.

This past summer, she adds, Illinois Maternal & Child Health Coalition participated with the Shriver Center and Illinois PIRG (Public Interest Research Group) on a webinar about the likely impact of reform on children and families.  “It educated at least 100 people representing community organizations, who took this information back to their organizations and clients,” Chan says.

Overseeing quality of life issues.  Egan’s perspective is that health reform will result in doctors seeing many more patients.  In such an environment, the role of community-based organizations will be, she says, “making sure our patients have safe places to live, facilities to prepare meals, a place to get medicines, places for child care, and services to deal with domestic violence.  What’s crucial in Pilsen is very different from what’s needed in Englewood.”

Providing navigation.  Duffett feels community organizations will be ones most trusted during reform to offer “the three I’s” — information, implementation and improvement.  They will be central players in providing feedback about their communities to providers, and likely in playing the navigator role, he says.

These organizations have their ear to the ground in communities they serve, and will be able to inform the health provider community of ideas and solutions from their constituencies.  In addition, because organizations deal with a large percentage of people on Medicaid and people who are uninsured, who find it difficult to gain access to providers, they will be the natural entities to help them navigate the learning curve and “get up to speed on reform,” Duffett says.

Holding workshops. Yap reports her organization has community-based education initiatives, subsidized child care, and parent workshops on issues like safely disciplining children.  “This would be another topic for a workshop,” she says.  “We can help inform them about taking full advantage of their options under health care reform.  For us, it’s more in-person formal and informal conferences . . . Even if it’s an English as a second language program, this kind of thing would be discussed as a topic.  It might also be a topic for our Workforce Bridge program serving underemployed and unemployed.”

Communicating to stakeholders

There are a wide assortment of ways in which community-based organizations might work to communicate the nature of health care reform to their constituency and clients.

These range from formalized strategies to far more casual initiatives, but to reach the widest range of constituents with the clearest, most accurate messaging, most observers agree all means of communication should be tried.

Through ethnic media.  Woznica is convinced community-based groups would be best advised to disseminate information through the ethnic media — including ethnic TV, radio and print—that their constituents follow.  For those too newly arrived in this country to have established ethnic media, the information must be disseminated through their trusted faith-based organizations, she says.

Through community forums.  Dr. Egan is convinced information on health care reform should be conveyed by community-based organizations themselves through community forums.  “Figure out the most important community group in that neighborhood, and bring all those people together,” she says.  “On the south side, it’s Sunday church services, where people come reliably.”

Work reform into already established message forums.  Chan believes community organizations should convey facts through forums and messaging already established.  “It could be by means of fact sheets or refrigerator magnets that include the website, the Twitter account and the name used on the Facebook account,” she says.  “Information could be provided at health fairs, on resource tables at their sites, at their reception desks, in welcome packets sent to new neighbors, in electronic and print newsletters and in any other way they can think of.  .”

Work alongside Campaign for Better Health Care. Duffett reports many organizations work with CBHC on educational forums and district accountability meetings with state representatives and senators that let elected officials know they want a competitive health care marketplace.  “Local grassroots pressure is what we need to overcome the insurance industry’s resistance in Springfield.”

Contribute to a large and growing story bank.  Community-based organizations can also work with CBHC to increase the latter’s substantial story bank, each story chronicling how someone has been or will be helped by reform. “People in community-based organizations can help gather these stories, and they know how to publicize them in their community, and hold their own press conferences to get the media engaged,” Duffett says.

Formalize “mother hens” roles.  Notified of Woznica’s observations about the trusted individuals in community based organizations, Dr. Egan agreed and added her own unique perspective.  “Most of those roles are informal,” she says.

“If I were Gov. Quinn, I would make those informal roles formal, so every stakeholder knows where to go in that community.  Many times, doctors don’t know, they get overwhelmed and burned out in their jobs.  If they knew who that person in each community was, they could refer patients to that individual.”

The lesson?  The great strength of community-based organizations — that they are highly localized and really know their constituents — is precisely why they are key to the Affordable Care Act’s success.  As Duffett says, “The more people who take ownership at the local level, the stronger we’ll all be in winning comprehensive reform.”

Story by Jeffrey Steele,

Jeffrey Steele is an independent writer in Chicago who has researched and written more than 2,500 articles appearing in such publications as the Baltimore Sun, Barron’s, Boston Globe, Chicago Sun-Times, Chicago Tribune, Los Angeles Times, New York Newsday and others.

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Illinois Health Matters presented accessible, personal stories about how health care reform is impacting underserved communities on the South and West sides of Chicago. These stories were part of the Local Reporting Initiative, supported in part by The Chicago Community Trust.