Covid-19 Response/ Blueprint

Baltimore: Fighting Covid-19, Joblessness and Inequity with One Innovative Project

The city of Baltimore is launching an urgent and innovative effort to tackle the multipronged crises of public health, unemployment and persistent inequity, partnering with The Rockefeller Foundation to create and test-drive a contact tracing model that could be adopted in cities throughout the country.

The program dramatically expands Baltimore’s contact tracing capacity to meet Covid-19 needs—a rapid scaling up occurring all over the country. It differs from many of these programs by creating solid career pathways into public health through training and employment support while incorporating equity-oriented recruiting and hiring to combat historical discrimination, and simultaneously offering broad care coordination for the community.

Pulling together the Baltimore Health Corps project in record time has required massive collaboration. “Normally, setting up a program with a couple partners and a couple philanthropic supporters and hiring just a few dozen people would take probably a year,” said Brendan Hellweg, Special Projects Manager and Innovative Team Data Lead with the Mayor’s Office of Performance and Innovation. “What we are doing right now has taken under two months.”

“It’s been incredibly difficult because we’re in the midst of the response to Covid-19, so our team has been putting in 18-hour days, developing this late at night after the normal work of the day is done,” added Jennifer Martin, Deputy Commissioner at Baltimore City Health Department.

  • Having the values and priorities outlined from the beginning of the project has helped ground us in what we’re trying to accomplish.
    Sarah Flammang
    Vice President of Operations and Administration, Baltimore Corps

Intense Coordination, Late Night Calls

Utilizing inclusive practices to ensure that recruitment is equitable and representative, the Baltimore Health Corps program will hire 276 contact tracers or care coordinators and 33 administrative, management and employment development staff over a three-month period. This will expand outreach capacity by over 31,200 individuals over one year. No healthcare experience is required for most jobs, and extensive training will be provided.

 
 

The annual salaries range from $35,000 to $80,000, and all employees receive free training, including 12-15 hours for the jobs of contact tracing and care coordination and an optional 100 hours for core community healthcare worker competencies. Those who take the optional training will be well-positioned to receive state certification as community health workers, expanding their career opportunities in a growing field.

“The economic impacts of Covid-19 are now part of our public health response here in Baltimore,” says Martin. “One of the really exciting things about this program is the way it’s been designed to both immediately improve our department’s capacity to respond to Covid-19, while also bringing new transferrable skills and steady income to individuals who may have lost their jobs due to the pandemic.”

Employees receive a healthcare stipend, and from the time of employment, the Mayor’s Office of Employment Development will provide support to help those hired identify career interests and goals, and find permanent work. Additional workforce assistance will include financial coaching, professional behavioral health support, and legal services.

“This initiative is aligned with our agency’s mission to pursue economic justice,” said Rachel Brash, a strategist with the Mayor’s Office of Employment Development. “We worked with our partners to craft job descriptions and a hiring process to ensure these jobs were as inclusive as possible.” Experience as a community health worker can lead to jobs in hospitals, community health centers, substance abuse service providers, state and local health departments, and community-based organizations.

The project, which will run until June 2021, will cost $12.4 million, with 90 percent of that spent on personnel. The Foundation committed an initial $2 million and the city has made a $4.5 million commitment, tapping into its CARES Act Funds. The Foundation is working with the city to raise additional funds, and so far another 11 partners have committed to contributing.

The Blueprint

Steps to Setting Up Program in Seven Weeks

 
  1. The Foundation established a partnership with the Baltimore City Health Department, the Mayor’s Office of Employment Development, the Mayor’s Office of Performance and Innovation, Baltimore Corps, HealthCare Access Maryland and other local and national organizations.
  2. The initiative’s City-led planning team equally prioritized health and economic challenges in designing a program to increase capacity to carry out contact tracing and care coordination while hiring and training a workforce with a secondary goal of launching sustainable new careers.
  3. The planning team grounded the program in equity in terms of both those served and those hired, with the goal of making sure the newly employed mirror the community they will serve.
  4. The City connected with partner organizations to provide operational support for recruitment and training, as well as workforce supports such as legal and mental health services. This effort focused on leveraging and scaling up existing infrastructure to quickly build the program.
  5. The planning team established care coordination so that Baltimoreans impacted by Covid-19 can have the support they need to effectively isolate. Given the depth of the crisis, the team decided to extend support to other vulnerable residents: elderly, uninsured, those on medical assistance, and those who are pregnant or have infant children.
  6. Once the team had developed the project strategically, they secured public funding and sought other potential funding partners to increase impact.
Meeting This Moment

“We know that America is being hit with both an old and a new pandemic: the old pandemic of racism and the new pandemic of Covid-19,” Otis Rolley, the Foundation’s Senior Vice President, U.S. Equity and Economic Opportunity Initiative, said at a news conference announcing the initiative. “Without equal access to tests, treatments, and vaccines, we will not be able to end the Covid-19 pandemic and therefore prevent further unnecessary deaths, particularly among the African-American community which, due to structural racism, is often less resourced, more exposed, and less protected in this fight.”

Rolley himself moved to Baltimore in 1998 and served as the city’s planning director from 2003 to 2007. Addressing the equity recruitment aspect of the program, he noted: “The Covid-19 economic crisis is disproportionally hurting African-American households. Higher than the national average, one out of every three African-American households have had one or more members file for unemployment. You cannot eat, you cannot have shelter, you cannot clothe yourself and your family without income. In many ways, you can’t live.”

Plan Tackles Challenges Both Recent and Longstanding

Baltimore was identified for the pilot in part because the challenges it faces are both particular and representative in terms of health, economy and social inequity.

From March 1st to May 16th, 53,378 Baltimore residents filed for unemployment insurance during a period when the city would normally anticipate about 4,000 applications. Over 50,000 more residents in this city of about 600,000 were newly out of work, with the number growing daily.

 
 

Even before Covid-19, Baltimore faced high levels of unemployment, poverty, and violence. The median income in Baltimore was $48,840, compared to $81,868 in Maryland in 2018. Nearly a quarter of Baltimore’s residents were living in poverty, compared to about 9 percent in Maryland and 12 percent in the United States.

Source: https://planning.baltimorecity.gov

Baltimore’s 2019 homicide rate per capita, at 57 deaths per 100,000 residents, was fifth highest in the nation. Additionally, wide disparities exist in health care, and life expectancy varies by as much as 20 years depending on zip code. In Baltimore, 12 percent of coronavirus patients whose ethnicity is known are Hispanic, while they make up 5.49 percent of the population. City officials acknowledge this is an undercount because 41 percent of cases are missing ethnicity data. Baltimore is 61.3 percent African-American alone, and 27.7 percent white alone.

Challenges in setting up the program included the need to work across departments and interests more deeply than ever before. “There’s a natural tension between creating the best public health program that supports economic development, and the best economic development program that supports public health,” the city’s Hellweg said. “We’ve had a lot of group phone calls.”

An anticipated challenge will be to build community confidence while doing virtual work. Because of this, empathy and the ability to create trust are the primary skills the newly employed workers need to bring to the job.

The expected outcomes: a new sustainable career path for hundreds of Baltimoreans who come directly from the hardest hit communities, better control of the transmission of Covid-19 through a team of community health care workers and greater focus on addressing the social needs of the city’s most vulnerable.

Baltimore Corps

Baltimore Corps enlists talent to accelerate social innovation in Baltimore and advance a citywide agenda for equity and racial justice.

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