HJNO Mar/Apr 2023

HEALTHCARE JOURNAL OF NEW ORLEANS  I  MAR / APR 2023 47 Joseph St. Mary Director of Community Partnerships Louisiana Healthcare Connections over quantity when incorporating field- based, face-to-face coordination, but in the context of Medicaid managed care, the value of meaningful relationships cannot be overemphasized. For high-risk Medic- aid recipients, establishing personal and meaningful ways to help them is pivotal to improving their health. And for those living with chronic conditions, special or complex needs, it is critical. The ability to reach them, connect with them, as well as to build trust with them means measur- able rewards for plans, providers, state agencies, and, most importantly, the ben- eficiaries themselves. CHWs often help those who are the most challenging but who have the most to gain from individual communication and encouragement. In my time as a CHW, I gleaned pro- found insights from simply being present. By being “in the field,” I had the opportu- nity to help Louisiana Healthcare Con- nections members where they live. More often than not, it was an extraordinary, often humbling, vantage. Allowing a total stranger into their home to discuss their personal health was predicated on trust built through living in and serving their community. By virtue of my proximity and even what area code members saw on their phones when I called them, I was perceived as an inherent advocate — in whose care and attention they could put their faith. Sources of support Providing education and empowerment around individual health notwithstanding, another key CHW function is facilitating access to social services, legal services, housing support, or other public pro- grams. CHWs do everything from helping someone fill out an application and mak- ing phones calls on their behalf to coor- dinating the remediation of mold in their home and assisting with child care needs. But while access to care can be com- plex, it can also sometimes be a matter of simply taking the time to discover a small detail. In visiting with a member having a transportation issue, a Louisiana Health- care Connections CHW learned why she had missed an important appointment. After outreach to our transportation ven- dor, the CHW discovered the cause of the service disruption: they did not have her exact building information included in her address. The CHWensured it was correctly recorded and subsequent rides were pro- vided without incident. Grateful for the as- sistance, the member accepted additional help in scheduling a follow-up physical therapy appointment for her as well as an important screening with an ophthalmol- ogist she had trouble reaching. In addition, the CHW contacted Volunteers of America on her behalf to set up an assessment for services through the Community Choice Waiver program. In all, they spent half a day helping change the entire trajectory of a member’s health and welfare. Conversely, another CHW assisted a member who needed help finding housing and connected him with multiple resourc- es to address his outstanding utility bills. They worked with him for over a year be- fore he was able to secure a home based on his income. The CHW never gave up on him, and today he is living independently, able to focus on his health needs rather than his housing ones. Real connections Buried inside our well-meaning efforts to achieve health equity is the risk of be- coming too abstract and academic. But we’re human . And humans must have connections — a sense of understanding and acceptance is a fundamental necessi- ty. Third on Maslow’s hierarchy of needs, “social belonging”reflects the basic human desire for emotionally significant relation- ships. Through work, through friendships, through family, through life, we’re all look- ing for personal connections because … we need them. And it’s especially true for healthcare, where a meaningful connec- tion with someone living in economic, social and geographic isolation can have powerful outcomes. CHWs aren’t a silver bullet. But they are a powerful way to go beyond simply providing health insurance to connecting Medicaid recipients facing overwhelming challenges to the care and services they deserve. n REFERENCES Lee, L.K.; Ruano, E.; Fernández, P.; et al. “Work- force Readiness Training: A Comprehensive Training Model That Equips Community Health Workers to Work at the Top of Their Practice and Profession.” Frontiers in Public Health, vol. 9 (June 8, 2021). https://doi.org/10.3389/ fpubh.2021.673208 U.S. Dept. of Health and Human Services. “Foun- dation for Health Measures: Disparities.” Healthy People2020.ArchivedApril14,2022.https://www. healthypeople.gov/2020/about/foundation- health-measures/Disparities Kaiser Family Foundation. “Medicaid’s Role in Louisiana.” July 21, 2017 https://www.kff. org/medicaid/fact-sheet/medicaids-role-in- louisiana/#:~:text=Medicare%20beneficiaries%20 rely%20on%20Medicaid,to%20be%20depen- dent%20on%20Medicaid MHP Salud. “Community Health Works and Re- turn on Investment.” Accessed February 2022. https://mhpsalud.org/programs/community- health-workers-roi/#readmoreroi A native of Lake Charles, Joseph St. Mary is a dedi- cated advocate for his community. With more than two decades of experience in community outreach, St. Mary collaborates across multiple departments andwith state and community agencies to ensure the delivery of whole person care for Louisiana Health- care Connections’ members. He holds a BS in gen- eral business administration and a BS in family and consumer sciences from McNeese State Universi- ty. In addition to numerous other leadership roles and board appointments, he served as a member of the National Council of Family Relations and the Health Advisory Board for Head Start of Jefferson Davis Parish.