The middle-aged Latina was the only person not in motion as the typical Thursday morning buzz unfolded at 701 Alabama St. For a few minutes, she observed the Resource Hub volunteers and Color Labs technicians offering free Covid-19 testing; then, in a sudden bolt of courage, she approached someone for help.
Her husband had tested positive for coronavirus the week before, she said in Spanish, so she guessed this might be the place for advice and resources. Jon Jacobo, the health committee chair for the Latino Task Force, which launched the Hub, listened to her. He then guided her to testing and information about how to access food and economic relief.
This is what the Latino Task Force’s Community Wellness Team was designed to do: deploy care and wrap-around services to San Franciscans infected with Covid-19, in a quick and culturally appropriate manner. And, it’s managed to do this without funding from the city – a predicament that could change in the next few months, with a promise of at least $450,000 for one Mission organization to deploy covid community outreach and care.
This model – one that other community based organizations have adopted – was the brainchild of the Latino Task Force and University of California San Francisco doctors, who deployed and fine-tuned it during three joint mass testing campaigns.
With their permission, the team contacts individuals as soon as they receive positive covid results, educates them about the disease, and asks if food, cleaning supplies, or other resources are necessary to assist their recovery and isolation. Community Wellness Teams then deliver those resources rapidly, and check up on individuals throughout and after their quarantine period.
“It’s not just about treating covid,” said Valerie Tulier-Laiwa, a creator of the Community Wellness Team model and a Latino Task Force member. It’s about treating the whole person; their psychological and economic impacts, and longer term needs like connecting families to primary care physicians.
Early on, two messages are delivered to the covid patient: infection is no one’s fault, and a whole group of people and institutions are here to help. This goes a long way to keep people quarantined, said Susana Rojas, a Latino Task Force member closely involved with the Community Wellness Teams, noting it offers mental and resource support seven days a week.
“Having that understanding of respect with the people who come out positive makes a huge difference in the way that the people respond to the services being offered,” Rojas said.
The model has been so successful that it has been endorsed by the Department of Public Health. At recent hearings on why DPH has moved slowly in dispensing resources in the Latinx community, Isela Ford, a Department of Health Worker who has worked in the Mission District said that when a person decides to isolate at home, a lot of needs kick in.
“It’s not just food delivery. It’s also checking up. It’s ensuring that the rest of the household is safe, that they have the appropriate cleaning supplies, that they need medical care, that it can be accessible to them on site. … And again, we have this at covid command, but as the Latino task force has shown through their studies at UCSF, they are much more able to do this,” she said.
Tracey Parker, the Health Department’s director of community health equity and promotion, at a Oct. 28 informational meeting about DPH’s new grants for covid community care, said: “The most appropriate people to do both case investigation and contact tracing are people who know the community [and] are from the community.”
From the first UCSF/Latino Task Force study in April to subsequent ones conducted at BART stations this summer, the Latino Task Force and UCSF doctors learned what processes work.
To reach a person takes multiple calls, though often texts work best. Ideally, callers would have a work phone with a caller ID that identifies them as Latino Task Force workers so people pick up.
And, just because people turn down help the first time doesn’t mean they don’t need it. Or as Rojas put it — they learned to recognize when a sick resident says no to resources but really means yes. “Are you sure? We want to help you,” is often the extra nudge people need to accept help, she said.
Susy Rojas, a volunteer involved in developing the Community Wellness Team model and the daughter of Susana Rojas, said they also found that it is helpful to drop by people’s houses unannounced, to check if they are quarantining — most are — and if they need any other supplies.
Moreover, if someone is ill, they want comfort food — or at least culturally appropriate food that they recognize. “And meat,” Susy said. Other tidbits she and the other Community Wellness Team volunteers have picked up: bring lemon and tea to soothe sore throats, cleaning supplies, and diapers if a family has infants.
“People always say they don’t need anything, but they’re happy to see us,” Susy said.
The impact keeps people quarantined — a result that benefits the whole city, doctors said.
“I find it very effective,” said Dr. Luis Rubio, a UCSF clinical fellow who assisted with past UCSF testing projects in the Mission and whose team regularly collaborated with the Community Wellness Teams. “Just saying to isolate is challenging without resources. Bringing the community to them is a good method to have them stay at home.”
Wellness Teams also advocated for families who qualify for Right to Recover funds, a safety net check of $1,285, equal to two weeks of minimum wage. During UCSF studies, Wellness Team members found residents misunderstood the question about the Right to Recover funds, so they had to intervene and explain.
Once team members verified a person’s eligibility, they could follow up on whether the check arrived. In Tulier-Laiwa’s vision, she sees training a whole group of teams across the city but especially in the impacted neighborhoods like the Bayview, Excelsior and Oceanview, Merced Heights and Ingleside (OMI); some already exist in Bayview and Sunnydale.
Ideally, Wellness Teams will have four team members per 50 active covid cases in the neighborhood. At present, that would mean approximately 16 members for the 199 cases in the Mission this month, and 12 members for the 149 cases in the Bayview.
Each team will be tailored to their specific community, Tulier-Laiwa explained, but all will have access to phone-scripts, assessment tools and training based on the Latino Task Force’s model.
Despite praise the model has gotten from city officials, a lack of funds has kept it from an official launch. In the past, the Community Wellness Team could only run during joint testing campaigns with UCSF, which raised money for the teams.
“Not only have we seen it working, but we’ve been intricate in making sure it worked,” Rojas said. “Everyone that comes out positive deserves to have the level of care when a UCSF study happens.”
The Latino Task Force estimates one fully operating team costs at least $1 million, and has advocated for the money for months.
“The task force has yet to receive a dollar from the Department of Public Health in terms of our resources and what we need. And we need those resources now,” Jacobo said at a hearing last month on how the city has failed to allocate resources to the Latinx community.
The Health Department agreed at the hearing that the model should be funded, but why it has taken so long — a request for proposals did not go out until late last month and funds won’t get to community groups until December at the earliest – remains unanswered.
At the October hearing on how the Health Department has used its resources, Ford presented a slide that showed 36 percent of the city’s $204 million plus covid budget going to the Latinx community. It was a number that stumped Supervisor Hillary Ronen.
“Quick question,” she said. “Can you be more specific?”
Ford deferred to the Health Department’s Dr. Naveena Bobba, who passed the ball to Greg Wager, the Health Department’s chief operating officer, who said that they had done an estimate on spending in various populations.
Ronen hardly seemed satisfied: “It’s just, you know, there’s these claims out there, but they don’t seem to be matching the reality of what’s happening on the ground.”
That appears to remain the case. The Latino Task Force’s Wellness Teams have yet to be funded. Latinx residents make up 43 percent of city cases in the last two weeks, and are 15 percent of San Francisco’s population. Meanwhile, testing at the Mission’s Hub remains at 250 tests once a week — or less than 5 percent of the city’s total daily collected tests.
Mission Local reporters Lydia Chavez and Hayden Manseau contributed to this report.
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