Important Legislation for Social Health
Why Curandi supported the 2023 Oregon Legislature SB 1074
Curandi has no political purpose but supports its members, especially when they promote necessary social health reform. In this case, it was a small step in the right direction. The effort failed.
Despite bipartisan support, a last-minute event at Oregon's 2023 legislative session prevented the passage of SB 1074. This legislation would have "authorized a two-year demonstration project in two counties to test whether expanding the compensable services provided by Community Health Workers (CHW) can improve outcomes for low-income families and children at risk of entering the foster care system."
Under the current rules, CHWs working for local social service providers must provide the client's medical diagnosis for reimbursement. This is despite the Oregon Health Authority (OHA) expansion of funding through Health-Related Services (HRS), Flexible Services (FS), and Community Benefit Initiatives (CBI). These worthwhile funding initiatives are hindered by older rules that limit their effectiveness.
Why it matters: Social instability disrupts Oregon's healthcare, education, government, business, and more. The costs are enormous and far more than healthcare. More importantly, an unseen tsunami of upstream misery is coming.
These core social issues require improvement within the local human and social services community. They are too different and far outside the scope of medicine.
SB 1074 would enable local innovation and testing, a systemic approach to a systemic problem.
This social system reform uses CHWs as critical members at the point-of-care within a multi-disciplinary support network.
At the social system level, authorization should be based on evident social risk. Return on investment comes from an increase in competent and resilient people and more people moving up the ladder of success. All of this is measurable.
California's Whole Person Care (WPC) shows the value of this approach.
SB 1074, if it had passed, would have provided an opportunity to demonstrate the value of local social system integration.
An example case from the archives: A single mother working full time has a teenage daughter who develops severe anxiety and anorexia. The mother first consulted a physician who engaged a psychologist in her care. She went back and forth between medical and psychological care.
These disciplines work to improve the individual. Social health improves the context around the individual.
Her condition worsened as she became older, and new treatments were recommended. Confused and wanting to be normal, she withdrew, refused help, and bounced between emergency rooms, psychological crisis centers, and her bedroom.
No doubt, her providers considered social factors and services. Care providers are empathetic and want to help those they care for --- it is a core value.
Eating disorders in adolescent girls are enormously complex. It is easy to simplify things outside your scope of practice, especially when the focus is on the individual, and the surrounding social context is outside your scope of practice.
All of us who have practiced medicine have wanted a social system to support us and our patients as we struggled with multi-disciplinary problems like this.
A more powerful and effective human and social service system is possible. It can be there when we need it, for when social circumstances complicate the recovery of our patients or clients.
Curandi's purpose is to improve the ability of human and social services to achieve better outcomes for those they serve.